RN Circulator within the OR suite assigned will perform patient care functions related to preparation of supplies and equipment in an operating room, and promotion of education and training related to the surgical scrub role. Fulfillment of job duties requires the employee to have access to medication storage areas and to transport medications to/ from medication storage and delivery areas.
Attending Surgeon will assist with surgical procedures within the scope of the surgical technologist First Assist role and consistent with Maryland Code 10.32.12.01-05.
Principal Responsibilities and Tasks
Definition of Care or Service:
The Certified Surgical Technologist First Assistant [STFA] is a specifically trained individual who provides assisting services for the surgeon in both the preparation for and performance of surgery. These services include both First Assist and General OR duties, but are not limited to; patient preparation (i.e. skin prep; clipping; SCD placement, etc.), tissue handling, wound retraction/exposure, positioning, providing hemostasis and suturing of tissue, as directed.
Services provided by the Surgical Technologist First Assist will be limited to the Perioperative/OR Suite Service areas thereby not allowing participation as a Surgical Technologist First Assist in off-floor procedures.
Scope of Service Supervised by Attending Surgeon may include:
Determine specific equipment needed
Review consent to confirm procedure and any special needs and participate in "time out" session prior to surgery
Select and place x-rays for reference
Assist in moving and positioning of patient
Insertion and removal of Foley urinary bladder catheter
Place a pneumatic tourniquet
Drape patient within surgeon's guidelines
Provide retraction of tissue and organs for optimal visualization with regard to tissue type and appropriate retraction instrument/technique
Assist in maintaining hemostasis by direct pressure, use of appropriate surgical instrument for task, placement of ties, placement of suture ligatures, application of chemical hemostatic agents, or other measure as directed by the surgeon
Use electrocautery mono and bi-polar
Clamp, ligation and cutting of tissue per the surgeon's directive
Maintain integrity of sterile field
Close subcutaneous tissue and skin per the surgeon's directive
Insert drainage tubes per surgeon's direction
Select and apply wound dressings
Assist with resuscitation of patient during cardiac arrest or other life-threatening events in the operating room.
May not perform dissection down to the area to be repaired, replaced, etc., [Domain of the surgeon].
As a general rule when assisting the surgeon, the STFA may share a single surgical site with that surgeon. The STFA may not independently perform a procedure on an opposite site except subcutaneous tissue and skin closure. For example, the surgeon and STFA may not work bilaterally, i.e., surgeon working on one side of the patient while the STFA is working on the opposite site.
The Surgical Technologist First Assist may not place a screw or manipulate a tool when manipulation and positioning of the hardware must be held in such a specific position that that particular maneuver can only be accomplished by the surgeon. All prosthetic placements, use of tools (drills, saws, etc.) and measurement to determine prosthetic size is performed by the orthopedic surgeon.
May not prepare a tendon for grafting; homograft tissues, heart valves, conduits and/or vessel preparation. (Surgeon or designated licensed personnel harvest &/or prepare all grafts).
First Assist the surgeon who will utilize a DaVinci Robot:
The Surgical Technologist First Assist must have completed the DiVinci training program followed by observation by a proctor for 10 training cases.
Once training is complete the Surgical Technologist First Assist may under the direct supervision of the attending surgeon;
Set up and connect system components,
Drape and position arms,
Balance and calibrate endoscope and camera,
Inspect set up for functionality and defects,
Place and exchange instruments in the robotic arms,
Insert instruments into the trocars,
Removal, exchange, cleaning and re-introduction of endoscope,
Steps to safely and quickly move the system components in an emergency,
Proper cleaning, disinfection and sterilization of reusable instruments, accessories and endoscopes, and
Troubleshooting
The following statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not to be construed as the definitive list of all job duties performed by personnel within the classification.
Demonstrates Clinical and Service excellence behaviors in daily interactions with patients, families, co-workers and physicians.
Scope of Service Supervised by OR Suite assigned Circulating RN;
Assists in the preparation of the operating room and in the selection of surgical instruments and equipment by reviewing the surgeon preference list and conferring with the circulating nurse to gather appropriate equipment.
Assists with counting needles, sponges and instruments to assure compliance with regulatory standards.
Ensures that all medications on the sterile field have been properly labeled.
Ensures that all fluids are maintained at a safe temperature for patient care.
Assists with preoperative preparation of patients, such as positioning, skin preparation, and draping patients for procedures in accordance with department procedures and protocols, as needed.
Matches preference cards [PLs] to correct scheduled cases and work with assigned provider to update PLs working with individual surgeons and surgical services.
Performs related duties associated with basic patient care, such as, picking-up blood, delivering specimens to clinical laboratories, performing room turnover between cases, escorting patients when assigned and checking emergency carts for needed supplies by nursing staff. Transports patients and runs errands as directed by the circulating RN or assigned provider.
Assist in the preparation of supplies for sterilization by washing (i.e. removal of bioburden &/or foreign material) and wrapping instruments. Ensures appropriate sterilization method used with various implants, instruments and supplies.
Assists the provider of assigned service as requested in assuring that instrumentation, supplies, equipment, and specialty items are obtained, stored, and ready for use when required. Works with assigned provider in limiting supply and instrument costs through good inventory control.
Ensures all policies and procedures are followed to promote optimal care to patients both directly and indirectly. Reviews and revises policies and procedures as assigned by provider related to the patient care in the Operating Room to promote a safe environment for patients and staff.
Assists the provider of the assigned service in providing guidance to others regarding procedures and the service by functioning as a resource person. Promotes a continual learning environment by providing training to others formally and informally as needed or requested.
Assesses the environmental needs of the area and recommends and/or initiates appropriate action in coordination with professional staff.
May perform as a primary preceptor for new surgical tech staff and for nursing staff orienting to the scrub role. Assists with the orientation of Surgical Technologists by explaining department policies and procedures.
Assists in the development of individualized orientation programs and collaborates with other team members in evaluating students. Prepares and presents one formal and one informal staff inservice each year.
May assist in the development of policies, procedures and protocols at the department levels.
Company Description At Shore Regional Health, you can learn, grow and make a lasting impact on patients and families. You'll experience the support of a collaborative work environment and a sense of collegiality unlike any other. Our comprehensive system has many locations and practice options to choose from throughout the beautiful Eastern Shore of Maryland.
Qualifications
Certification:
Current certification by one of the following national examinations:
National Board of Surgical Technology and Surgical Assisting (NBSTSA)
National Surgical Assistant Association (NSAA) as a CSA
American Board of Surgical Assistants (ABSA) as a SA-C
National Assistant at Surgery Council (NASC)
Education and Training
Graduation from an accredited high school or possession of a GED certificates
A minimum of 3 years of experience as an STFA is desired.
A minimum of 5 years of experience as a Surgical Technologist is required.
Evidence of successful graduation from an accredited First Assist training program
Additional Information All your information will be kept confidential according to EEO guidelines.
