The Surgical Technologist (ST), often called a scrub tech, is an allied healthcare professional who plays an active role in the operating room. This professional works directly under the supervision of a surgeon to facilitate the safe execution of invasive surgical procedures. The ST’s primary contribution is preventing infection by maintaining a highly sterile environment and ensuring all equipment is prepared and organized.
The Role of the Surgical Technologist
The Surgical Technologist is a member of the surgical team responsible for managing the instruments, equipment, and supplies within the sterile surgical field. This role demands a deep understanding of human anatomy, surgical procedures, and aseptic principles to anticipate the needs of the surgeon. The ST primarily functions in the “scrub role,” meaning they wear sterile attire and work directly at the operating table.
The scrub role is distinct from the duties of the circulating nurse, who is a licensed registered nurse working outside the sterile field. The circulating nurse manages the overall operating room environment, documents the procedure, and procures non-sterile supplies. The surgical technologist is sterile and positioned next to the surgeon, providing hands-on support that keeps the procedure moving forward.
Core Duties During the Surgical Procedure
Maintaining the Sterile Field
Protecting the patient from surgical site infection is a primary responsibility of the surgical technologist during the operation. The technologist establishes and continuously monitors the sterile field, which includes the draped patient, instrument tables, and the attire of the scrubbed personnel. This involves applying rigorous aseptic technique to prevent contamination from non-sterile items or breaches in sterile barriers. The technologist must also alert the team to any potential break in sterility, such as a tear in a glove or a non-sterile person crossing the boundary.
Handling Instruments and Supplies
The surgical technologist’s knowledge of the procedure allows them to anticipate the surgeon’s needs. They organize the surgical instruments on the back table and Mayo stand in a methodical manner that follows the flow of the operation. Instruments are passed to the surgeon in a firm, deliberate manner, placing the handle directly into the surgeon’s hand in the correct functional position. The technologist also manages surgical specimens, ensuring they are correctly labeled with the patient’s information and site of origin before passing them off the sterile field for laboratory analysis.
Assisting the Surgeon
During the operation, the surgical technologist performs specific tasks under the surgeon’s supervision. This includes holding tissue retractors to maintain exposure of the operative site. The technologist may also use suction to keep the surgical field clear of blood and fluid, allowing for better visualization. They may apply an electrosurgical pencil to a hemostat on a small bleeding vessel, a process known as “running the Bovie.” The technologist also cuts suture material after the surgeon ties a knot, ensuring the remaining tail is the appropriate length.
Pre-Operative and Post-Operative Responsibilities
The technologist’s work begins well before the patient enters the operating room. Pre-operatively, the ST gathers all necessary supplies, instruments, and equipment specified for the scheduled procedure. They open sterile packs, organize the instrument tray, and prepare sterile solutions like saline for irrigation. The initial instrument, sponge, and needle counts are conducted jointly with the circulating nurse to establish a baseline before the incision is made.
Post-operatively, the surgical technologist helps secure the dressing over the incision site. The final count of all instruments, sponges, and sharps is performed with the circulating nurse to ensure no foreign objects are retained in the patient. After the patient is transferred, the technologist participates in the decontamination and preparation of instruments for sterilization processing. They also assist in turning over the operating room by disposing of contaminated materials and preparing the suite for the next surgical case.
Scope of Practice and Legal Limitations
The scope of practice for a surgical technologist is defined by their education, certification, and by state-level practice acts and institutional policies. Technologists are restricted to performing tasks that fall under the category of technical assistance and are prohibited from engaging in activities reserved for licensed practitioners. For example, they cannot administer any medications, including local anesthetic agents, or perform patient assessments. They are also not authorized to document in the patient’s official medical record, a duty reserved for licensed nurses or physicians.
These professional boundaries emphasize that the technologist functions under the direct supervision of a licensed healthcare professional, usually the surgeon or the circulating nurse. Professional organizations, such as the Association of Surgical Technologists (AST), publish standards of practice that define the ethical and professional expectations for the role. Following these standards and state regulations is necessary for the technologist to maintain professional standing and ensure legal compliance.
Required Education, Certification, and Career Advancement
A career as a surgical technologist begins with completing an educational program that can lead to a certificate, a diploma, or an Associate of Applied Science (A.A.S.) degree. These programs are found at community colleges, vocational schools, or hospitals and range from 9 to 24 months in length. The curriculum includes classroom instruction in anatomy, physiology, and microbiology, along with extensive clinical practice in a working operating room setting.
The Certified Surgical Technologist (CST) credential is the nationally recognized standard and is preferred by employers, though not mandated in all states. This certification is obtained by passing an examination administered by the National Board of Surgical Technology and Surgical Assisting (NBSTSA). Technologists work in various settings, including university hospitals, community hospitals, and specialized outpatient surgery centers. Experienced technologists may advance their careers by pursuing further education to become a Certified Surgical First Assistant (CSFA), allowing them to perform advanced tasks like suturing and wound closing. Other paths include becoming an educator or moving into a management role within a surgical department.