What does a Surgical Tech do? This is what I’m asked whenever I bring up my operating room experience. The best job description I can give is to walk you through a typical day.
Keep in mind, though, no two days are alike in the OR. Almost no two surgeries are alike for that matter. There are so many different factors during the day and across different facilities.
You must be constantly adaptable to changing conditions. If you like regular working days that are more or less all the same, Surgical Technology is not for you! This is my broad overview video about being a surgical tech:
A Day in the Life of a Surgical Technologist
Hopefully, your work day started the afternoon and night before in preparation for today. Hopefully, as much gear and positioning equipment as possible was pulled for your first surgery of the day. We call each surgery a “case”.
Preparation and anticipation are two ideals that a Surgical Tech lives and dies by. You must constantly anticipate the next instrument, suture, gear, etc. through the day.
On your work day you walk into your clinic or hospital and change into scrubs. You might have a morning meeting, then find out who your circulating OR nurse is. This is the nurse that is in your room. They document everything that happens, positions the patient, preps that site, assists Anesthesia, and gets us anything we don’t have up on the sterile field.
Operating room nurses are full RNs that went to an extra OR school. They bust their asses all day every day, but I’ll write a full article about them some other time.
You find out which surgeon you are first working with and which surgery you are starting the day with. I speak only about the first surgeries because things constantly shift and change throughout a surgery day. Surgeons change rooms for efficiency. Sometimes there are delays and cancellations. Nothing is set in stone in a busy operating room.
The main focus in the morning for a Surgical Tech are the surgical instruments that are required to start the day. For anticipation, we also have an eye on the rest of the cases for the day.
Your Instruments and Gear Better Be Here!
The morning mad scramble is on to make sure you have everything in (or around) your surgical room (surgical suite). You and your nurses hunt down the sets of instruments and gear.
Focus and anticipation are needed. You must be up on the surgeon’s needs. Surgeons change the way they do procedures in minor ways all the time. Of course, different surgeons operate in different ways. You must pay attention to detail. Don’t be afraid to ask questions, even though some surgeons are total dicks.
More issues might pop up through the day. Your surgeon may be trying a new company’s plates and screws to repair broken bones. A surgical rep might be on the way with a unique piece of gear. You or your nurse may have to call and make sure the rep is on the way.
This gear must be sterilized before surgery, so that will take a couple hours. All of these issues must be known ASAP. Usually this is happening at 6:30 to 7:00 in the morning and only half way through our first coffee. Wakey, wakey!!
The goal in my mind is to never have to pause surgery for any instruments or gear, though this happens all the time. I usually pull more than I thought I needed, though this makes for extra stuff to be put away later.
So, you have all the sterile gear and the right instrument sets in the room. You should have a printout or card of what the surgeon wants for that surgery. It is best to mark off everything to be as sure as you can that you have all your shit together. Hopefully, this was done the day before.
The Surgical Tech and the nurses open all the gear in a specific sterile way. Our hands cannot touch anything that will be on the sterile field. All contamination must be avoided 100%. The scrub tech (OR Tech) makes sure they have their eye protection on and nothing is in their pockets that they don’t want. It’s a good time to drop the phone.
Time to Scrub in and Set Up
We go out of the room to the sinks and scrub our hands in a very specific, sterile way. We come in and are the first ones to interact with the sterile field that we have just opened. The Surgical Technologist grabs their sterile towel, dries off their arms without dripping dirty water on the field, and puts the sterile gown and gloves on themselves. These techniques are the focuses of tech school.
Once we are gowned and gloved, we turn to setting up the sterile field in a logical flow for surgery. You must avoid dropping, tearing, tripping, and anything else that will contaminate sterility. Speed is necessary, but care of sterility should be the prime concern.
After we are “gowned and gloved”, it’s time to set up the sterile table. We organize the gowns for anyone else scrubbing in, drapes to isolate the surgical site, put our instrument sets on the table, and any other sets or power tools that are needed. We have a stand that rolls over the patient called a “Mayo stand”. This is our main working spot. The most used instruments go there for efficiency.
We count everything that is disposable and the nurse documents it. At the end of surgery, we recount everything to make sure nothing is left behind (in the patient). In open abdomen cases, we count every instrument, too. This can be a long process, so I always scrubbed in as early as I could to do this.
The patient is usually rolled into our operating room while we are setting up. Sometimes a surgery is cancelled at the last minute for a medical reason or something else.
Anesthesia puts the patient to sleep and secures the airway. The OR Nurse positions the patient and cleans (preps) the surgical area. If the positioning is complicated, the surgeon will mostly do it. The surgeon(s) scrub in. The Surgical Tech puts the gowns and gloves on them.
Kicking Off the Surgical Case
We take the sterile drapes and “drape off” the area we will be working on with the surgeon. Next, we bring our mayo stand and table(s) to the patient’s side. As surgery progresses, we hand instruments, load sutures onto needle drivers, help hold retractors, cut sutures, and obsess over our countable instruments and consumables. We are communicating with the room nurse about gear and anything else important.
When surgery is done, the surgeon leaves the room to go dictate everything they did. We make sure our instrument and gear counts are all correct and safely dispose of the sharps. The OR team helps clean up the patient as anesthesia wakes them up.
The patient gets transferred to the gurney and rolls off to recover from anesthesia. At this time, the Surgical Tech either starts cleaning the room for the next surgery or hopefully gets a break! Sometimes there is a huge amount of blood to clean. If you are squeamish, Surgical Technology is definitely not for you!
This cycle continues throughout the shift. Finding lost gear is a fun time consumer for us through the day. A big factor in the day is the mood that your surgeon is in and how smoothly the procedures are going.
That’s a good, broad overview, I think. To summarize the day for a Surgical Technologist, we make sure we have everything ready, assist with surgery, clean, clean, clean, and repeat.
A good Surgical Tech is a team player, adaptable, can stand long periods of time, lift heavy shit, hold awkward positions for hours, troubleshoot well, follow instructions perfectly, be around suffering people, and handle the smells and fluids that come from a human body.
I hope this helps answer the question of “What a Surgical Tech does?” If you think it’s for you, best of luck at Surgical Tech school! It can be tough, but rewarding.