Off again, on again.

Everybody that knows me knows that I like to work. You can usually count the number of days that I'm not on call in any given month on one hand. Every now and then (today for instance) one of my ortho docs uses a PA when he's on call. The local trauma center employs a PA from 0700- 2000 every day but Sunday for Ortho trauma. On those occasions when the orthopods tell me they are going to use the PA, I'm fine with it. In fact, I kinda like the break when I regain one more precious day for myself. What's a little bit annoying is when I think I'm off and then get called in anyway because the PA can't stay. Like last night, and like this morning.

Another Surgery Addict

This email comes from Jackie. Jackie craves surgery as much as I do.

I'm a 21 year-old pre-Med student from Phoenix, AZ. I'll be graduating in May, and due to economic and personal concerns, I will not be able to pursue my medical education at a 4-year Medical School.

I ran across your blog while looking for alternative, and I found that we are very much alike - I am also addicted to surgery, using my internship with a Kidney Transplant surgeon as an opportunity to get into the OR at every turn. I believe that a career as a 1st Assist is something that I would greatly enjoy!

However, I have had difficulty pinpointing the best way to go about this. I have found that the best way to go would be to become a CST. However, what is the quickest route to 1st Assist from there? Do I need to take more courses, or simply amass enough cases to qualify? Is it necessary to become certified as an assist, or can I be a CST and, with experience, become recognized as an assist without additional certification?

I am by no means interested in the "easiest" way, I would just like to get back into the OR as soon as possible after school, as well as possibly begin working, so that I can, in the future, accomplish my goal of medical school.

Any tips? I find your writing and blog inspiring, and I am looking forward to your insight!

- Jackie

Jackie,
First let me say that while I respect your concerns, it's unfortunate that you will be unable to pursue med school at this time. If I knew then what I know now, as the saying goes, I most certainly would have pursued med school and a surgical (trauma?) residency while I was in my youth. It seems as time goes by and our lives becomes increasingly full of responsibilities, it becomes harder to devote such an enormous amount of time and money to such an endeavor. If it is truly what you want though, you will find a way.
In the meantime..... the quickest way back into surgery would certainly be as a surgical technologist. You can complete a certificate program in about 9 months, sit for your certification upon graduation, and off you go scrubbing as a certified tech. In fact, the clinical portion of your school will be spent scrubbed in. From there it is simply a matter of taking a first assist course. Most programs consist of didactic, usually offered by distance, a 6 day (min) hands on skills workshop, completion of a suture and tying course, and completion of 350 supervised clinical cases in a variety of specialties. There are several schools out there but I would say the average time of completion is 18-24 months. While there is nothing that says you must become certified as an assist, I would highly recommend it. Legislation is always changing and soon it may be required. Best to sit for the test while it is fresh rather than waiting and having it forced upon you several years later.
I'm not sure what your long term goals are but if you enjoy the whole gamut of patient contact, from clinic to surgery to post op, why not look into P. A. school? If you are graduating pre-med, I believe you would have the pre-reqs out of the way. The tuition is much less than med school and there are (were anyway) certificate, Bachelor's and Masters PA programs. A little more time to dedicate (2 years?) but if you land the right job, you will be more valuable to your surgeon, eligible for Medicare reimbursement ( as minute as it may be) , and hopefully still get to go to the Operating Room two or three days a week.
RNFA is another option. You are probably looking at four years, if I remember correctly- two year BSN, 2000 hrs of circulating (for CNOR eligibility) , and an RNFA program. If I don't have those facts straight, I apologize. I do remember being faced with the same dilemmas when I decided that assisting was the way for me and, next to med school, I remember RNFA was the longest route. If you decide on RN, I would also recommend continuing on to APN for reimbursement and advanced knowledge though I don't have a clue what attaining those titles entail.
I will say this about what I do. For me, it is the best job in the world. I do all of the fun stuff and don't have to deal with any of the not-so-fun stuff. That is, clinic, pre and post-op, phone calls from the floor, etc. All I do is OR all the time.
What I find missing from what I do? Knowledge. I crave more medical knowledge. The pathophysiology of trauma, diagnosis, in depth pharmacology, anaesthesia, what it feels like to put in a chest tube. OK, I'll never know the last one. I am self educating myself as best I can from books but it's certainly no substitute for an organized formal education. Heck, I can't even get lab values memorized!
Well Jackie, I hope that gives you some answers or at least a general idea of what to expect. If you do choose surg tech, be sure to go to a CAAHEP accredited program or you will run into roadblocks for certification. Generally, you must be a certified ST in order to be approved for hospital privileges which you will need in order to be able to assist.
Thank you for enjoying IntraopOrate and feel free to ask any other questions.
Best of luck to you,

MMT

Q and A

Went and dusted the cobwebs out of my in-box and found this letter from Ryan, a prospective student of surgical technology. While I have already replied to him via email, he was kind enough to allow me to post his questions on the blog. So, an entry for me, and perhaps answers for others with the same questions.
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I have been reading thru your blog and I love it. Thank you for much for writing it.
Thank you so much for reading it!

I have some questions about becoming/being a surgical tech. I have been researching several health care related careers including surgical tech, RN and respiratory therapist.

Since you are a surgical tech I will focus and this field and my questions for you:

First, let me clarify that while I will always be a surgical tech, I'm currently a self employed first assist. I did scrub for seven years.

Have you found being a surgical tech rewarding?
I loved to scrub. If you have a touch of OCD (obsessive compulsive disorder!) I think it's helpful. I found it both rewarding, especially the first time I was involved in a surgery that actually saved someones life, and challenging. I constantly challenged myself to set up faster, anticipate better,know the anatomy involved, count an entire set of instruments with the circulator and still keep up with the closing suture, etc. I liked to identify the patterns of certain services, mark-inject-cut, drill-measure-tap-screw, clamp-clamp-cut-tie-tie, heparin in for two minutes-eleven blade-potts scissors, clip-clip-clip-scissors, right angle-vessel loop-hemostat, the list goes on and on and almost never varies....did I mention OCD?

How is the job market for surgical techs right now? ( I have read contradicting things about this some say good some say bad)
Since I have been out of the market for a few years, I'm not sure I know the answer. I would say that some regions, and even different hospitals within certain regions, prefer to use RN scrubs. I would definitely research your region before jumping in. Perhaps look at the on line job openings with your local hospitals, that should give you an idea. I will say that in my experience, there always seems to be a shortage of Certified techs.

Did you find the schooling/program difficult?
I did not find any of my school or training difficult. I did a combination of OTJ and an Associates program (2 yr). My interest was so great in the subject matter that it was fairly easy to grasp. I will say that clinicals can be very stressful depending on your demeanor. The OR is most certainly NOT for everybody. Unfortunately, some students don't discover that they are not able to handle the environment until they are doing clinical cases in the OR. There are various programs available, the shortest route would be a certificate program. Word of warning....be sure the school you choose in CAAHEP accredited or you will find it very difficult to get your certification.

How is the pay?
The pay can vary greatly between regions and hospitals. I started at $9 something an hour (way too low!) and when I quit, $24 an hour with an additional $2 shift differential. Trauma centers typically pay more and some hospitals will pay an extra percentage if you become a specialty tech for one of the services, say General or Ortho. If you need extra money, someone is always willing to give you their call. Call pay can be anywhere from 3-6 dollars an hour, and if you get called in, you receive time and one half.

I see on your blog that you work a lot of call hours, is this the norm for this position or do you choose this? The call hours I work as a first assist are excessive because I take call with so many different surgeons. The most call I've had to take as a tech was 176 hours every month. More typically, in a large hospital with more than one shift, call should average about 48-72 hours a month. Plus, as I've said, you can almost always find someone to who is willing to take it from you.

I am 34 and changing careers is this to old to start training for surgical tech?
I began scrubbing when I was 40! You can complete the course in 18 months or less depending on which one you choose (certificate programs are typically 9 months), sit for your certification at the end of the course and off you go. Once you start working, you can take that career anywhere in the country and find a job. You may decide to become a traveler, go into nursing, or assisting, or, you may even decide to go to med school. I find it very exhilarating to work at a major trauma center. Others are more suited to out patient surgery centers where there is typically no call required and you don't work holidays or weekends.

I am sure I have a million more questions, but these are the basics.
If you have any more questions, feel free to ask.

Thanks in advance for your insight.
Ryan
You're welcome. Thanks for enjoying the blog and look for more frequent entries as the weather gets colder and I get back on track!

MMT