The Association of Surgical Technol...

The Association of Surgical Technologists (AST) lately outlined a national legislative and regulatory strategy to expand the character of the surgical technologist (ST) from scrubbing to circulating, first assisting, and supervising in ORs across the country? Initiatives to achieve the association's objective include supporting the propos changes to the "Conditions of Participation for Hospitals Receiving Medicare/Medicaid Reimbursement" from the Health Care Financing Administration (HCFA), which do away withs prescriptive language for RNs in the OR, and promoting legislative activities in California, Illinois, Missouri, of recent origin York, Tennessee, Texas, and Washington. In the latter part of 1998 ST attempted to ask regulation in Arizona and Wisconsin. Although AORN has been able to stop legislation in these states in the past, AST is working harder to attain statutory recognition and is funding efforts in these and other elucidation states to ensure the succes of its legislative campaign.

of the present day YORK: REGULATION OF SURGICAL TECHNOLOGISTS

upon Aug 24, 1998, the recent York State Education Department (SED)--the department responsible for regulating and overseeing professions practicing in the state--released its decision onward hospital use of personnel as first assistants to surgeon The decision came after several years of state agency meetings, at which AORN past-President Jane Rothrock RN DNSc CNOR, and President-elect Trish Seifert, RN MSN CNOR, CRNFA, testified. Essentially, the S establish that state law prohibits ST from first assisting at surgery The S also held that it is against the law for physicians or RN to delegate first assisting functions to unlicensed assistive personnel

Mixed answer The New York State encourages Association (NYSNA) supports AORN in efforts similar as this that stop ST from practicing as first assistants and has helped AORN notify OR supervisors, directors, coordinators, and promote managers in New York of the S ruling. The recent York State Society of Physicians Assistants (NYSSPA) also set againsts the new proposal.

reciprocally the Medical Society of the State of just discovered York (MSSNY)--one of the greatest in quantity powerful lobbying groups in the state--supports physicians' rights to have the first assistant of their choice and was angered by way of the ruling. Several members of MSSNY have trained and consistently use ST illegally as first assistants. Another powerful lobby the Hospital Association of recent York State (HANYS), also supports the use of ST as first assistants.

inferior attempt. With the help of MSSNY AST wasted no time after the S ruling and cause to growed a second strategy, which calls for a regulatory domination change to the New York Department of Health's (DOH) medical statutes governing physician assistants (PAs) and special assistants. The change would allow ST to be registered as surgical assistants. the pair AORN and NYSNA, through the coordination of of the present day York National Legislative Committee (NLC) state coordinator Judy Fox RN CNOR, and AORN member Marlene Craden, RN BSN CNOR, CRNFA, have vigorously oppos the propos ruling.

AORN actions. upon Oct 14, 1998, Seifert, Craden, AORN legislative program coordinator Candace Romig, and representatives of NYSNA met with DOH staff members. AORN firmly oppos the regulation of ST and held that now passing law dissuades creation of a strange health care professional. Representatives of NYSNA discussed the ne to restrict the character of STs and to require ST to have

* direct "visual" physician supervision,

* restrictions to practice of intraoperative care,

* no power to give orders to RN and

* no prescriptive authority.

Unfortunately, DOH staff members believe that ST commonly first assist anyway and that registration will enable the state to have minimal have the direction of over them.

Further efforts. In reply to the controversy created at this proposed rule change, the fresh York Governor's Office of Regulatory Reform (GORR)--which approves all regulatory proposals before they are released for public review--held a meeting of stakeholders forward Dec 15, 1998, to clarify positions. Craden and Althea Dunscombe, RN CNOR, CRNFA, delineateed AORN. The meeting went well, and AORN has been asked to draft a detailed description of first-assisting tasks, which will be used to support the ne for more education for the first-assisting position. In addition, the of recent origin York State Council will observe members to determine the number of RNFAs practicing and the number of ST that would be practicing--if the S had not issued its ruling in August. This will help determine if hospitals are indeed in chaos because of a lack of first assistants, as HANYS suggests

The propos behavior change will be made public after March 1 1999 AORN chapter presidents and AORN-member RNFAs have been asked to

* contact the S to thing to the existing educational requirements in the surgical assistant proposal, which AORN believes should require ST to have an education equivalent to that of PAs;

* write the DOH objecting to placing ST in the category of surgical assistants and describing circumstances in which PAs or RNFAs have been replaced through STs;