OR Nurses: An Interview with Cindy McPhee, RN

OR Nurses
Cindy McPhee, RN

OR Nurses

Our podcast today is with Cindy McPhee, RN. Cindy McPhee has been a registered nurse for over 33 years. She attended Youngstown State University and graduated with an associate degree in registered nursing. After passing the NCLEX-RN, she began working as an OR nurse. In her career, Cindy trained as a Circulating Nurse, Scrub Nurse, and First Assistant.

In her interview today Cindy answers questions about her OR experience and also explains the role of registered nurses (RNs) and licensed practical nurses (LPNs) in the operating room.

Cindy’s responses to our questions provide insight on the following topics:

  • The courses involved in training for the operating room.
  • How experience could be gained.
  • The responsibilities of an RN or LPN in the operating room.
  • The difference between a scrub nurse and a circulating nurse.
  • The types of surgeries an OR nurse might participate in.
  • What they don’t show on television.
  • What school may not prepare an OR nurse for.
  • The best nursing degree to obtain if you want to work in the OR.

If you prefer to read the transcript, click here.

Cindy mentions LPNs, RNs, and surgical technologists as part of various surgical teams. If you’d like to learn more about any of those careers, check out the following articles:

Start learning medical skills today!

Interested in becoming a healthcare professional – nurse, surgical technologist or perhaps a surgeon? Learn, enhance or perfect your skills with one of these kits.

The Apprentice Doctor® Suturing Course and Kit is a resource that will teach you How to Suture Wounds in a couple of hours! If you want to become a Surgeon or a nurse – why not learn how to suture wounds now?

The Apprentice Doctor® Phlebotomy Course and Kit is a resource that will teach you how to confidently perform phlebotomy procedures in a couple of hours! If you want to become a great medical professional – why not learn how to perform venipuncture procedures now?

The Apprentice Doctor® Academy has also developed and perfected an Online Course for Future Doctors to assist then towards fulfilling their dreams of becoming great medical professionals. The For Future Doctors Foundation Medical Online Course with accompanying Medical Kit has helped launch the career of thousands of want-to-be doctors!

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Check out the Sterility and Aseptic Techniques on Apprentice Doctor Academy.

Also, explore the Scrub for Surgery Kit on Apprentice Doctor Kits.

 

Beginning Moments For Everyone

The day was going relatively well. I had just closed a heartfelt texting conversation with my friend, who was wonderfully in a good mood, and I had moved on to studying my venipuncture course. Short Notes On Other Bodily Fluids. Complications.

I was reading about catheter related infections when the phone rang, and it invited me to go over to my grandmother’s apartment.

“You can check my glucose level and I’ll tell you how much insulin to give me.”

“Great. Coming.”

Five minutes later I was at her door, jacket been put on, block been walked, elevator been ridden, and door been knocked on.

“Hello doctor!”

(Not quite)

I set up her lancet device, swabbed her preferred finger, and,

“1-2-3”

Prick

Blood(!)

I let the blood drop onto the disposable blood glucose test strip, and mission accomplished!

Okay, let me not hide the honesty. There was an “ERROR,” but an easy one to correct. I squeezed some more blood, victory in town. She told me how much insulin to draw up, and I did just that, while she–with her many years of efficient experience–revealed her abdomen and wiped it with an alcohol prep swab. After another round of-

“1-2-3”

Prick

(No blood)

The needle went in and I was as happy as my shoes were when I took them off after a five-mile jog (that never happened). I even remembered to aspirate! (That is only an accomplishing excitement in my brain.)

She thanked me and I thanked her. She was relieved that I’d be of assistance if she ever needed my help. I was happy to get to prick actual flesh.

On the way home, less in a rush than before, I realized how privileged and superior it was to actually get to administer a subcutaneous injection before receiving a diploma or degree. (Unless you count elementary school graduation.) (Don’t count elementary school graduation.)  And that even if I won’t get to be a real doctor, but hopefully something in healthcare one day, this put a warm smile on my face and bubbled up my insides. And I am thankful that I was able to do at least that (…for now).

I can imagine how pathetic this must sound to anyone who has ever done anything more amazing than this, but this is my start and I like it. Because it’s one such prick that wraps up an average day in a big glitter bow and sunny smiles. And it’s an incident like this that puts you to sleep with a smirk and an imaginary victory dance.


Written by B Green

I really want to become a Doctor – Is there anything I can do straight away?

Check out the Foundation Medical Course on Apprentice Doctor Academy.

Also, explore the Future Doctors Kit on Apprentice Doctor Kits.

 

Does Technology Put Your Health at Risk?

Story at a Glance

  • Does technology put your health at risk? There are seven ways it could be.
  • Light from your devices could impact your sleep and make you more hungry when you normally wouldn’t be.
  • Eye strain, neck, and shoulder pain are common complaints of people who use computers for long hours.
  • Use of social media and spending time surfing the net can create depression and anxiety in some people.
  • Headsets, as great as they are, can contribute to hearing loss.
  • The good news is that there are simple, inexpensive hacks to combat each of these problems so you can continue to use and benefit from all your technology.

Can technology really put your health at risk?

In the early 60s, The Jetsons, a space-aged cartoon pulled kids to television sets on Saturday mornings. The futurist gadgets the family used inspired wonder and possibilities. Today many technologies shown in the animation exist. Most of us own them and use them. They are a natural part of our lives. But does technology put your health at risk? Research seems to indicate it does.

Listed are 7 ways digital technology may destroy your health. All 7 lead to rising costs of healthcare. But we’re giving you 7 easy prevention hacks, too. Implementing all of them can safeguard your physical well-being.

1. Sleep Deprivation

Being fully present during your waking hours means nabbing at least eight hours of sleep. However, many of us only grab six hours or less. The presence of digital technology in almost every room of the house discourages sleep. Bright light interrupts sleep patterns because it reduces the amount of melatonin the body produces. Without melatonin, you remain alert. In turn, this shifts your body’s natural sleep rhythms, keeping you tossing and turning.

Night-lights, television light, or the glow emitted from your digital clock all contribute to sleep deprivation.[1] Using a night mask is an excellent way to block sleep-impairing light. If you don’t like anything covering your eyes, try leaving your phone or laptop in another room at bedtime. Make your bedroom a device-free zone. Turn off the television before burrowing under the covers. Both actions are quick, no-cost steps you can take to catch an extra hour or two of sleep.

2. Weight Gain

The same light that disrupts sleep also makes you hungry. So when working on digital devices, there’s a tendency to snack. Eating while sitting at a computer may cause you to snack more, especially if you’re looking at pictures of food.[2] In 2014 Stanford University conducted a National and Nutritional Examination Survey. Researchers found that the percentage of inactive women in American rose from 19.1 to 51.7 between the years of 1994 and 2010. During that same time, the rate of inactive American men rose from 11.4 to 43.5 percent.[3] With the increase in device use, that number could get higher.

Not even today’s technology has found a way to burn excess calories without exercise. Sitting more and moving less almost always results in weight gain.

Flip your technology into a healthcare benefit. Hundreds of exercise routine apps are available on smartphones. Finding one that fits your personality and activity preferences, even if you travel a lot, is easy. The routine doesn’t have to be difficult or take hours of time. Thirty minutes a day can make improve your cardiovascular health more than you think. Through trial and error, you can find a favorite exercise app at zero to no cost. By offsetting some of your screen time with movement, you’ll be able to lose, or at least stabilize your weight.

3. Eye Strain

Most people spend five or more hours a day viewing digital screens. Did you know you forget to blink when working at a computer for extended periods? Research studies reveal blinking occurs ten technology put your health at risk with eye straintimes less than usual when sitting at a computer display. Lack of blinking deprives your eyes of necessary moisture.

Almost 7 out of 10 Americans who routinely use computers complain of eye irritations. Signs of strain include dry eye, burning, itching, and even blurred vision. Although most symptoms are temporary, they are uncomfortable and can lead to headaches.

Try these quick fixes. Adopt a 20/20/20 system. Set your smartphone for a 20-minute time block. When it buzzes, look away from your computer. Focus on something 20 feet across the room for 20 seconds. Then return to work and repeat the cycle. Another helpful activity is intentional blinking. Train yourself to blink, using your breathing pattern as a reminder. Blinking goes a long way toward keeping your eyes moist and pain-free.

4. Neck and Shoulder Pain

Most of us know leaning over laptops, smartphones or tablets for extended periods tightens the muscles between the shoulders. Even something as simple as tilting your head pulls tendons and ligaments in your back and neck.

An average adult head weighs anywhere from 10 to 12 pounds. When tilted toward a computer even 15 degrees, that weight increases to 27 pounds. If you bend it at a 30-degree angle, your back and neck support 40 pounds. Multiply that by five or more hours a day, and it’s not surprising many people go to the doctor for neck, back, and shoulder pain.

You can combat any pain, and even any poor posture working at a computer creates. When walking, pull back your shoulders and stand as straight as possible. Or, when you’re taking a vision break, shrug your shoulders. Moving your muscles in a different direction keeps you flexible and loose. Lastly, stretch your muscles by tiptoeing the fingers of each arm as far as you can slowly up a door jam. Do the same on the other side. The stretch feels amazing.

5. Depression

Does digital technology cause depression? Some research indicates it does. Other research suggests people who are lonely and possibly depressed, use digital technology more. In this case, digital technology primarily refers to social media outlets.

If you suspect your online time lowers your mood, ask yourself some simple questions. Do you feel sad, annoyed or even angry after reading postings? Does your body feel sluggish or tired when you’re interacting with sites? Do the lives of other people seem better than yours? If your answers are positive, they may suggest the amount of time you spend engaging in social media negatively impacts your mood.

The fix is little digital detox. Reduce the amount of time you spend reading posts. Another way is to “unfollow” people who are consistently negative. Avoid videos seeped in anger and other negative emotions. Verbal aggression, even on screen, can pull down your mood. The good news is that you have 100% control over your screen time and what you read or watch. By absorbing less, your outlook could improve. And you may find you have more energy and time to do other things that interest you.

6. Anxiety

Although the Internet provides a lot of useful information, can it put your health at risk? It can, especially if you are self-diagnosing suspected medical problems.

If you suspect something is amiss within yourself, a family member, friend, or pet, avoid rushing to the computer to look up symptoms. Researching medical difficulties is rarely a good idea for two reasons. The first is, if you don’t find the symptom(s), you may assume you’re fine. That could be true, but what if you’re not? On the other hand, what you learn could lead you to believe something is very wrong – even if you’re fine. Your stress and anxiety will increase because the human tendency is to conclude the worst.

If you think you are ill, take two simple actions to prevent excessive anxiety and possible panic. The first is: don’t research your symptoms. The second is: call your primary care provider and make an appointment for a proper diagnosis.

 

technology put your health at risk with hearing7. Loss of Hearing

The number one cause of hearing loss in America is excessive noise. According to the Hearing Health Foundation, the number of Americans experiencing hearing loss doubled between the years of 2000-2015. Sixteen percent of our teens complain about hearing loss.

Too much noise directly into your ears can cause damage to tiny hair cells inside the inner ear. These hair cells do not repair themselves, creating an irreversible hearing loss. Headphones are the primary culprits. Headsets for your computers, phones, and tablets direct all noise (no matter how much we enjoy the content) straight into your ears. They amplify sounds up to and above 85 decibels, which deteriorates your hearing.[4]

The prevention hack here is “noise-canceling” headsets. Simple earbuds can’t drown out sounds around you. So there’s an inclination to crank it up. From a healthcare standpoint, that means it’s probably too loud. Older, earmuff style models block out background noises and lower the volume. They may be big and a bit cumbersome, but they protect your hearing better.

Regardless of the headset you use, ensure your volume is set to a reasonable level. And take regular breaks from your headphones.

Don’t let technology put your health at risk. Protect your health from these 7 digital challenges with a few simple healthcare hacks. Then enjoy your technology without sacrificing your well-being.

Interested in becoming a healthcare professional who treats some of these digital technology side effects? Perhaps an orthopedic doctor, ENT (otolaryngologist) or audiologist. What about an ophthalmologist? Read How to Become a Medical Doctor (General Practitioner). If surgical technology sparks your interest, read Becoming a Certified Surgical Technologist.

 

Why not start your medical career right away?

Future doctors kit


The Apprentice Doctor® Academy
has developed and perfected an Online Course for Future Doctors to assist them towards fulfilling their dreams of becoming great medical professionals. The For Future Doctors Foundation Medical Online Course with accompanying Medical Kit has helped launch the career of thousands of want-to-be doctors!

Launch your medical career today!

For those of you who’ve decided the healthcare field is right for you, enhance your skills with one of these kits.

The Apprentice Doctor® Suturing Course and Kit is a resource that will teach you How to Suture Wounds in a couple of hours! If you want to become a Surgeon or other medical professional – why not learn how to suture wounds now?

Suturing kit

 

____________

References:
[1] Grandner MA; Gallagher RAL; Gooneratne NS. The use of technology at night: impact on sleep and health. J Clin Sleep Med 2013;9(12):1301-1302. www.aasmnet.org/jcsm/ViewAbstract.aspx?pid=29250
[2] Spence C; Okajima K; Check AD; Petit O; Michael C; 2016, Brain and Cognition, Volume 110, pos. 53-63, Eating with our eyes: From visual hunger to digital satiation. www.sciencedirect.com/science/article/pii/S0278262615300178
[3] Bach, Becky, Stanford Medicine, 2017, lack of exercise, not diet, linked to rise in obseity, Stanford research shows, https://med.stanford.edu/news/all-news/2014/07/lack-of-exercise–not-diet–linked-to-rise-in-obesity–stanford-.html
[4] Noise-Induce Hearing Loss, National Institute on Deafness and Other Communication Disorders (NIDCD) NIH Publication NO. 14-4233, 2/7/2017 https://www.nidcd.nih.gov/health/noise-induced-hearing-loss

I really want to become a Doctor – Is there anything I can do straight away?

Check out the Medical Terminology: Decoding the Language of Healthcare on Apprentice Doctor Academy.

 

7 Reasons Medical Students Drop Out of Medical School

 

Medical students drop out of medical school for any number of reasons. Behind each medical student who makes this difficult decision is a name, a face, and a personal story. Starting and completing medical school is a commitment that can last anywhere from eight to ten years in the United States. During that time life circumstances can change in unexpected ways. The quantity of possible changes is why it can be challenging to pinpoint primary reasons for medical school attrition. However, homesickness, financial concerns, and lack of adequate academic preparedness can contribute to someone dropping out of medical school. Other reasons include absenteeism, feelings of displacement, and overall depression.

Nevertheless, there remains a core of 7 serious reasons medical students drop out of medical school.

Less than 15% of students applying to medical school will be accepted (the figure varies from one medical school to the next – here are the figures as in October 2020 as per individual medical schools). Before choosing medical studies and a medical career, assess your vulnerability to all seven reasons. You may not be able to prevent some of them from happening, but by being aware, you may be able to plan what to do should you encounter any of them.

1 – Changes in life circumstances

Medical students spend anywhere from eight to ten years in medical school.[3]. Your life circumstances at enrollment may change as you progress through different levels of medical studies. Once you finish high school, you’ll have four years of pre-med curriculum at a college or university. This is followed by medical school and then a residency and/or fellowship period.

Think about the last ten years of your life. Is anything the same today as it was ten years ago? Or even five years ago? Entering medical school doesn’t stop life from happening, so you have to make adjustments along the way. Sometimes events in your life can negatively impact your ability to stay in medical school. Finances, the death or severe illness of a family member, or even falling in love are all things that can pull you away from staying in school. Before starting medical school, be sure you have sufficient support, whether that is financial, emotional or both, to get you through moments that may be more challenging than others.

2 – Academic capacity

Academic capacity does not necessarily refer to someone’s academic or intellectual ability. It can mean anything from insufficient academic preparedness in high school and college to an inability to retain sufficient amounts of difficult and complicated material.

The Medical College Admission Test® (MCAT) does a credible job of measuring someone’s “academic ability to be successful in medical school. It assesses problem-solving, critical thinking and knowledge of natural, behavioral, and social science concepts and principles prerequisite to the study of medicine.” (https://students-residents.aamc.org/applying-medical-school/taking-mcat-exam/about-mcat-exam/) By passing it, medical schools know you have the capability needed to become a successful medical student. But this admissions test is not foolproof, nor does it measure your stamina to deal with stress, long periods of study and the other pressures of medical school.

Assessing your academic preparedness

When considering your academic preparedness, take a look at your high school and college curriculum. Did you take a lot of science, biology and chemistry courses? If not, it’s possible your science foundation is not strong enough to enter medical school.

How are you at sitting for long periods of time and absorbing vast amounts of information? While aspects of learning can be enjoyable, the main reason for going to medical school is to learn to practice medicine. Some students enroll only to find, after struggling for a while, that they can’t assimilate all the material. If you are to absorb all the academic material, you must have consistent high levels of focus. You must also be willing to sacrifice personal time in favor of study time.

This kind of requirement leads to intensive studying regimes over prolonged periods of time. In many cases the result is burnout, loss of focus, and even depression. This was also confirmed by a recent study, “Burnout and serious thoughts of dropping out of medical school: Multi-institutional study” [4]. A serious loss of focus and feelings of depression lead to poor academic performance and, in many cases, dropout.

Even if you’re good at a variety of subjects, studying content such as anatomy, physiology, pathology, microbiology, biochemistry, and pharmacology, may prove to be extraordinarily difficult to even the most dedicated medical students.

Talking to a medical school dean or director and reviewing your curriculum first can help you assess your foundation. Further discussion with this same person can help you determine what changes in study habits and life style you may need to prepare for to be a successful and ongoing medical student.

Why medical students dropout of med school

3 – Working part-time to pay tuition fees

When entering medical school, you may have no financial concerns. But over time a previously worry-free financial condition may change into one fraught with anxiety. Worries about money and paying for tuition can impact your focus on classes and clinical work. Money concerns can create sleepless nights, poor nutrition, and even depression.

The Public Agenda Report[1] identifies tuition fees as one of the leading causes of medical students dropping out of school in the United States. Studying medicine is expensive and increases in tuition fees each year can be overwhelming, up to the point where you’re forced to drop out.

Medical students try to finding part-time jobs that can support the cost of medical studies. However, the rigor of medical school both in and out of the classroom makes it almost impossible to juggle both a job and the curriculum. Stress and worry mount until the day comes when there may be no choice but to exit.

4 – Absenteeism and leave of absence

There is little doubt that failure to attend classes, lectures and scheduled labs will result in more time studying and less comprehension about the content. The further behind a student gets, the more overwhelmed a student becomes until catching up feels hopeless. That’s when dropping out may occur.

As a medical student, although you are old enough to make your own decisions and determine your schedule, you are also old enough to make your own rules. Successful medical students make allowances for a social life but always put the classroom and homework first. You are paying for a medical school education. So skipping classes and not taking advantage of every opportunity to learn is throwing away that money. Medical students who remain in school and achieve academically sometimes view the link between tuition and education with a sense of consumer savvy. They are going to get what they are paying for. So they spend their time learning.

What is a leave of absence?

You may also hear of something called a leave of absence. A leave of absence is a period colleges, and universities allow students where they take a break from medical school. But they must return by a predetermined date. During a leave of absence, the stress and pressures of medical school are absent. Life is simpler and students frequently succumb to a more relaxed lifestyle and just don’t go back. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3565981).

When committing to medical school, controlling what you can control is often the difference between failure and success. Attendance rests with you. So, make a promise to attend all your classes. And, avoid taking any leave of absence.

5 – False perception of their medical specialty before enrolling

Favorite medical television shows, pressure from friends or family to enter what is perceived as a lucrative profession, or even inspiration from books and articles can spur you to go into medicine. You may also imagine yourself being a surgeon or oncologist because you like a specific character on television who performs that kind of work. While all these subtleties can lead you to making good choices about a medical career, they can also lead you into making those decisions without knowing how such a long-term goal is achieved. When we see doctors, even those on television, they are accomplished physicians. We forget they didn’t start out that way. They all began as students without any knowledge or experience.

Is becoming a medical student right for you?

So, how do you know if you’ll like medicine or not? One thing you can do is shadow someone in the field for a week or so. Get an idea of what it’s really like. Talk to the dean or the director of a medical school. See if you can audit a class. Interview some medical students. Most people are willing to help you by providing accurate information.

If none of those tasks are possible, consider your characteristics. Do you like studying for long periods of time? Is school something you enjoy? Does learning something new energize you? A “yes” to these questions are signs that you possess the right perspective to be successful in medical school.

Next, consider the physical demands. There are long hours of sitting and standing. There is a certain amount of stress to learn, compete and achieve. Social life is minimal. Are these sacrifices you can manage for multiple years? If so, you may be someone who can make it through medical school.

Lastly, consider your sensitivity to human anatomy. What is your response, or reaction, to needles? What about the sight of blood? If you’ve ever dissected anything, what was your reaction? You’re required to go to anatomy dissection halls, which are specific rooms filled with cadavers (human corpses) specially prepared for medical students’ practical classes. Some students are repulsed by the smell of certain chemicals like formaldehyde and human body parts, etc. Although continued exposure can desensitize some students, others can’t get past feeling ill. You have to figure out which kind of person you might be.

Occasionally students in medical school struggle with the dawning realization that they just don’t like it. Maybe they don’t have the right passion, or the motivation to become a doctor. Some students in this situation continue their studies, and incur additional expenses, even if they don’t like it. Pressure from family or fear of disappointing them contributes to this kind of a decision. But in most cases, without enjoyment or passion for the field, most students choose to dropout early in their studies.

6 – Lack of discipline and self-organization

When graduating from high school, you may have a general idea that college is a place to have fun and make lifelong memories. While this is true, you need to be aware that in medical school you are often pushed to your limit. To do well as a medical school student, you need to dedicate plenty of time, focus, and energy to study. If you are aiming at a competitive residency, such as neurosurgery, you will have to ensure that you are in the top 5% of academic excellence in your class.

As a medical school student, you must be very disciplined and well-organized to succeed. This is critically important for those medical students trying to balance work, family, and studies.

When enrolling in medical school, do so accepting the fact that you will have very little free time, especially during surgical rotations. If a carefree, fulfilled life is your preference, then pursuing a less demanding career path may be a better decision for you. Talking with friends and family who can be honest with you, and not project on you what they would do, can often help you make this significant decision.

7 – Behavioral related reasons: drug addiction, alcoholism, illegal activities, conviction

As unlikely as it seems, there is one final group of reasons that contribute to dropping out of medical school – chemical dependency, engaging in illegal activities to gain financing for studies, and potential legal issues, which may include one or more bouts with the criminal justice system.

Students may view these activities as ways to cope with the financial hardship, long hours, stress, and pressure inherent in medical school. Even if none of them cause a student to drop out, they can result in permanent expulsion from medical school, without forgiveness of any debt incurred.

Conclusion

Although these seven reasons can cause someone to drop out of medical school, awareness of them before starting can help you prevent some of them. Without awareness, they can sneak up on you and overtake you before you realize it. If that happens, one or more of them can be difficult to manage and overcome.

The Public Agenda Report found that 65% of medical school dropouts think about returning to college or medical school. They feel that they failed to accomplish something important in their lives by dropping out of school and want to return. However, life obligations sometimes prevent that from happening, and they experience a certain sense of loss and regret. They may like their second best career choice, but it may never measure up.

Although there are many challenges on the path to becoming a doctor, most physicians will tell you the ultimate achievement is well worth the sacrifices.  There are very few professions that can give you both the personal and professional rewards that being doctor provides.

I want to become a doctor – Is there anything I can do right now to get started?

Absolutely!

The Apprentice Doctor® Academy has developed and perfected an Online Course for Future Doctors to assist them towards fulfilling their dreams of becoming great medical professionals. The For Future Doctors Foundation Medical Online Course with accompanying Medical Kit has helped launch the career of thousands of want-to-be doctors!

Launch your medical career today!

I really want to become a Doctor – Is there anything I can do straight away?

Check out the Foundation Medical Course on Apprentice Doctor Academy.

Also, explore the Future Doctors Kit on Apprentice Doctor Kits.

 

Associate Degree Versus a Bachelor Degree in Registered Nursing

Associate Degree versus Bachelor Degree – the initial question for student nurses

If you want to become a registered nurse, is it better to enter a two-year associate degree program (ADN) or a four-year bachelor degree program (BSN)? Graduates of either one are eligible to become registered nurses. So most students who want to become registered nurses ask the same question – why would I go to school four years when I can get the same registered nursing license in two? It’s a fair question, and the answer depends upon your career goals and financial resources.

First let’s look a basic nursing education ladder.

Nursing Education Ladder

Name of Nursing Degree Details about Credential
Diploma in Nursing •    12-18 months to complete.

•    May trained in a hospital.

•    Less common today.

•    Gradually being phased out.

Associate Degree in Nursing (ADN) •    18-24 months to complete.

•    Offered in community colleges and career/trade schools.

•    Sometimes there is a waiting list to get in.

Bachelor of Science in Nursing (BSN) •    4 years to complete.

•    18-24 months to complete if applicant has an associate degree in nursing.

•    Offered in colleges, universities and some career schools.

•    Some lecture classes may be offered online.

Doctorate in Nursing •    Depending upon type of doctorate, can take 3-6 years to complete.

•    Can be completed on ground or online.

•    Offered at universities.

•    Three possible credentials:

•    Doctor of Nursing (ND)

•    Doctor of Nursing Science (DNSc)

•    Doctor of Nursing Philosophy (PhD)

As you can see, if you embark upon a nursing career, you can start at a diploma level and gradually advance to the next nursing credential. But there are limitations on what you can do with each one. Each successive degree takes longer to complete and requires a greater financial investment. However, the more education you have, the better your income and career opportunities.

Beyond the BSN there is the MSN (master’s of science in nursing) and doctorate degrees as well as specialized nursing certifications. The minimum of a BSN is required to pursue many of them.

In November 2017, a survey was facilitated by Nurse.Org. Results revealed the current top ten nursing specialties. The pie chart below shows you those, many of which require at least a BSN plus an additional certification to get started. The information on the chart may assist you in determining whether to start your education at an associate degree level or if it’s better to enroll in a BSN program right away.

What advantages are there to being a BSN-prepared nurse?

It’s important to understand that regardless of your initial degree (AND or BSN), once you pass the National Council Licensure Exam for Registered Nurses (NCLEX-RN) you will be a registered nurse. You can learn more about the license through the National Council of State Boards of Nursing.

With an ADN you’ll provide basic patient care and may work under the supervision of an RN who possesses a BSN. While there may be some advancement, options are limited. But a BSN opens more doors, and opens them more quickly.

A typical registered nurse position includes some or all of the following tasks:

  • Conducts more complex procedures than an ADN-trained RN.
  • Consults closely with doctors.
  • Educates patients.
  • Provides basic nursing care.
  • Records patient symptoms and medical history.
  • Supervises staff.
  • Supports the family of the patient.
  • Uses simple medical equipment.

With a BSN you’ll often be seen as a leader and may be promoted faster. If you choose, you can go into nursing fields outside hospitals. You could become a nurse educator or public health nurse. You can more easily step into one of the nursing specialties, which enables you to earn higher salaries. With a BSN you’re also only a step away from a master’s in nursing (MSN), which makes you eligible for additional nursing certifications.

The following charts provide a quick view of the primary advantages of both degrees. If you strictly compare the number of advantages between the two, the BSN is the optimal choice. But numbers cannot make all decisions. How an additional two years of education versus four years of education impacts your life and your financial resources is an intangible you have to consider in your decision.

The main advantages for obtaining a BSN

BSN Advantage Explanation of BSN Advantage
Some nursing careers are open only to BSNs. •    A BSN is necessary if you want to go to graduate school (MSN).

•    Advancing into one of four of the highest paying nursing jobs requires a BSN. (These are: nurse anesthetist, clinical nurse specialist, nurse midwife, and nurse practitioner.)

•    A BSN is required to move beyond providing basic clinical care.

•    Only BSNs can move into administration and supervision.

BSN curriculum goes beyond teaching of clinical skills. •    BSN curriculum includes communication, critical thinking and leadership skills – all required for higher paying nurse employment.

•    The American Association of Colleges of Nursing (AACN) considers a BSN as the minimum requirement for a professional nurse.

BSN holders provide better patient care. •    Research by the AACN as well as the Health and Medicine Division (HDM), appears to validate a BSN nursing education translates into better patient care, including lower mortality rates.

•    AACN research indicates BSNs have better proficiency in making good diagnoses.

BSN may be a future requirement. •    The HDM recommends that the number of nurses holding BSN degrees be increased from 50% to 80% by 2020.

•    The HDM strongly encourages nurses to get their BSN within five years of earning an ADN.

•    The AACN is following the HDM’s recommendations.

•    Many healthcare providers will only hire BSNs.

BSNs are eligible for a wider range of professional advancement. •    With a BSN, you can enter specific nursing specialties such as surgery, gynecology or oncology.

 

The main advantages for obtaining an ADN

ADN Advantage Explanation of ADN Advantage
Obtaining an ADN gets you into nursing practice quicker. •    An ADN only takes 18-24 months to obtain.

•    An ADN enters the field of nursing practice quicker.

•    Less time is spent in theory and more time is spent in practical application while in school.

•    Less time in school means you enter the job market sooner.

Because an ADN program is shorter, tuition costs are lower. •    Less time in school means less tuition to repay.
ADNs who pass the NCLEX-RN are still registered nurses licensed to practice nursing. •    Although an ADN takes less time, you still acquire the skills you need to be a registered nurse and to pass the NCLEX-RN.

Why do hospitals prefer BSN-trained nurses?

Because healthcare is such pervasive topic in the United States, all providers strive to meet the highest clinical practice guidelines possible. The less arbitrary the practice, the more consistent medical care becomes. As a result, the Institute of Medicine (IOM), now known as the Health and Medicine Division (HDM), a part of the National Academies of Sciences, Engineering Medicine adopted, and published eight care standards. Now hospitals and other allied health providers conduct self-evaluations to ensure they meet those criteria. One of the guidelines is to hire only BSN-trained nurses. You may wonder about this distinction if the registered nursing licenses are the same.

Ongoing research appears to validate that BSN-prepared nurses administer a higher quality of care to patients. As a result they achieve better patient outcomes. The two additional years of education students in BSN programs experience provides greater rigor, depth, and scope of training and clinical experiences. This creates positive differences when starting to work with patients on a nursing floor.

The following video gives you more information on the HDM (formerly IOM) standards and their development.

Is a BSN mandatory?

You may have heard discussions that registered nurses who don’t have a BSN will have to get one. The HDM is applying much pressure on the healthcare industry to make a BSN the minimum requirement for nurses. Their recommendation is for 80 percent of all nurses to hold a BSN by the year 2020. Although no formal requirement is yet in place, it seems likely that this qualification will become standard. As a result, many employers, especially hospitals, are voluntarily making the BSN a minimum requirement for their nursing staff.

The following video from The Robert Wood Foundation provides additional information, and insight, on this discussion.

What are the educational differences between an ADN and a BSN?

The education in an ADN program and the one offered in a BSN program is vastly different. There are two immediate distinctions.

  • Length of time – An ADN can be completed in 12-18 months. Most BSN programs take 48 months. So, entering the nursing field is quicker for ADN-credentialed nurses.
  • Financial investment – The longer a program takes, the more expensive it is for a student. Additionally, the longer a person is in school, the longer it takes to enter the field and start earning a salary.

According to American Association of  Colleges of Nursing (AACN), traditional ADN and BSN programs both teach the competencies of nursing. Both also require nursing clinical experiences, which provide direct patient-care learning and application in healthcare settings.

But BSN programs also give students more gives students a more comprehensive vision of patients and patient care. Clinical experiences are more extensive, and include the practical application of leadership and supervisory skills

BSN programs provide:

  • Advanced classes – Advanced classes provide higher and more in-depth detail about the complex issues affecting patients and the overall healthcare environment.
  • Leadership training – Specific training on leadership, management, public health, social sciences, and critical thinking helps nurses gain employment as administrators, researchers or educators.
  • Nursing informatics – Advanced courses teach new technologies present in the workplace.
  • Nursing theory – Nursing theory teaches nurses how to see a broader picture of healthcare and how they fit into that picture.

Because healthcare must be viewed in light of cultural, economic and social issues, a BSN curriculum also incorporates how those factors impact medicine and healthcare delivery systems. These additional courses contribute to why better patient outcomes and higher standards of care are attributed to BSN-prepared nurses.

However, not everyone is in a position to start out in a four-year program. So earning an associate degree in nursing and then passing the NCLEX-RN is an excellent place to start. Then, with time and experience, practicing nurses can go back to school and obtain their BSN.

What are bridge programs?

Current ADN registered nurses who want to earn the BSN credential in less time can complete something called an RN to BSN bridge program. A bridge program is exactly that – an educational “bridge” that moves RNs from an associate degree to a bachelor’s in 12 to 18 months. The number of courses an applicant has satisfactorily completed in their associate degree program that can also transfer into the bridge program determines its length.

Individuals seeking a second career as a nurse may also find a BSN bridge program helpful. It can assist in adapting someone’s acquired skills to the skills needed for entry into a formal nursing program.

Still undecided?

Committing to two or four years of school is a big decision. So sitting down with trusted friends and family and reviewing your options may be helpful. Creating a support system to help you with transportation, homework, and other life obligations can create the time and environment you need to take on the demands of professional nurse training. Whether you start out with an ADN or a BSN, you will find this kind of preparation makes a positive impact toward achieving your goal.

Take time with your decision, and then make the one that best suits your needs.

What’s next?

Would you like to get started on a path to nursing right away? No problem. The Apprentice Doctor offers two different kits that can help you take your very first step.

The Apprentice Doctor® Suturing Course and Kit is a resource that teaches you how to suture wounds in a short period of time. As a nurse, you’ll use this skill, so why not get started now? The kit contains everything you need to get started. Take a look at the following video for a closer view of kit items.

The Apprentice Doctor® Phlebotomy Course and Kit is another handy resource at your fingertips. This kit teaches you how to confidently perform phlebotomy procedures. Drawing blood is another skill nurses need – and they have to be very good at it to minimize discomfort to the patient. If you want to start your education in nursing, why not begin phlebotomy training right away? Take a quick look at the following video to see all the items contained in the kit.

The Apprentice Doctor offers more articles on nursing. You may be interested in the following:

8 Surgical Specialties for Registered Nurses
5 Reasons Your Application Gets Rejected by Nursing Schools

For an podcast interview with a surgical nurse, click here.


I really want to become a Doctor – Is there anything I can do straight away?

Check out the Foundation Medical Course on Apprentice Doctor Academy.

 

Vital Signs – What Do They Reveal?

When we go to the doctor, several things happen when reach an exam room. A nurse, or medical assistant takes our temperature and blood pressure and listens to our heart – all tests measuring our vital signs.

We ask about the numbers, and more often than not have an idea if they fall within acceptable ranges. But do we know why measuring vital signs are always part of any examination? Are they performed just to keep us busy, or are there valid medical reasons behind them?

As you may suspect, there are significant reasons a doctor needs to know our vital signs before performing additional aspects of a physical examination.

4 primary vital signs

Vital signs measure functions of the body that are essential for good health. There are four vital signs nearly all physicians measure before beginning any physical examination. They are:

  • Body temperature
  • Pulse rate
  • Respiration rate
  • Blood pressure

When vital signs fall within normal ranges, it indicates that your body is operating as it should. But ranges falling outside of what is typical for your age, can be a sign of a medical problem.

Body Temperature

The amount of heat contained in the body is its temperature. Most people maintain a body temperature anywhere between 97.7°F to 99.5°F (36.5°C to 37.5°C). Gender, age, time of day and even physical activity can impact your body’s temperature. Additionally, some people always seem to be hot while others always seem to be cold. So what’s normal for you may be different than what’s typical for someone else. You can determine your baseline temperature by taking it at the same time every day over a week or two.

The body is very good at maintaining whatever your normal temperature is. It makes adjustments regardless of the weather. But if your temperature is too high or too low, it can signal an underlying medical condition.

Your body temperature can detect:

  • Fever and if a medication is effectively reducing it.
  • Hyperthermia – very high body temperatures in people who have been exposed to heat.
  • Hypothermia – very low body temperatures in people who have been exposed to cold.

Excessively high or low body temperatures signal that it may be in distress. With the use of a medical history, a physician can determine whether there is cause for concern, or if the condition can be eliminated through a standard treatment option.

Pulse Rate

When you measure the number of times your heart beats per minute, you measure your pulse rate. Your pulse rate also measures:

  • Heart rhythm – between 60 and 100 beats per minute in most adults.
  • Strength of the pulse – how efficiently your heart works.

Your pulse rate may fluctuate with exercise, illness, injury, and emotions. Age, gender, and athleticism can also impact a pulse rate. Changes in pulse rate are expected as a person ages, but too much change, or an unexpected change at any age may signal that a heart condition, or other medical concern is developing.

Your pulse/heart rate can reveal:

  • Dehydration or overhydration.
  • Diabetes or internal body conditions that, if untreated, could lead to diabetes.
  • Excessive caffeine.
  • High levels of stress.
  • Lack of exercise – An indicator of heart-health and level of fitness is the ability of your heart to quickly lower back to a regular beat after intense activity. Healthier hearts recover faster than unhealthy ones or ones unaccustomed to physical activity.
  • Medication – The addition of medication, or changes in medication can impact the heart rate.
  • Under- or overactive thyroid.

Respiration Rate

Similar to counting the number of times your heart beats per minute, your respiration rate is the number of breaths you take in a minute. And, like other vital signs, respiration rates may be impacted by fever, illness, and other medical conditions. One thing medical personnel check when taking a respiration rate is if a person has any difficulty breathing. An average respiration rate for an adult person at rest ranges from 12 to 16 breaths per minute.

An abnormal respiration rate, increased or decreased, may be symptomatic of an underlying condition which must be treated. Some of these conditions are included below.

Increased respiration rate

Some of the more common causes of an increased respiratory rates include:

  • Asthma – Asthma attacks may increase respiratory rates. Even the smallest increase in respiratory rate could signal a worsening condition.
  • Dehydration – Dehydration can result in more rapid breathing.
  • Fever- When a fever is present a person will breath faster trying to lose body heat.
  • Infections – Flu, pneumonia, and other infections can result in rapid breathing.

Decreased respiration rate

A decreased respiratory rate can also be a sign of concern. Some causes include:

  • Sleep apnea – With sleep apnea, people often have episodes where they stop breathing mixed with bouts of decreased and elevated breathing rates.
  • Medications
  • Use of alcohol
  • Use of narcotics – prescribed and illegal

It’s important to note that rate of breathing is not the same as feeling short of breath. Sometimes a person can feel short of breath and have an unusual respiratory rate, but the two may be unrelated. Only your healthcare provider can determine if they are linked.

Blood Pressure

According to the American Heart Association,High blood pressure (HBP or hypertension) is when your blood pressure, the force of the blood flowing through your blood vessels, is consistently too high.” [1]

High blood pressure, diagnosed as hypertension, is often referred to as the silent killer because a person generally doesn’t experience any symptoms. Uncontrolled it may lead to some of these more common medical conditions:

  • Aneurysm
  • Heart attack or heart failure
  • Stroke
  • Trouble with memory or understanding

Blood pressure consists of two numbers. The top number, systolic blood pressure tells a physician or other qualified healthcare provider how much pressure your blood is exerting against your artery walls when the heart beats. The bottom number, diastolic blood pressure reveals how much pressure your blood is exerting against your artery walls while the heart is resting between beats.

Although both numbers are significant, doctors tend to pay more attention to systolic blood pressure, or the top number because it could mean a person is at risk for cardiovascular disease. The risk is particularly true if the person is 50 years or older.

National Heart, Lung, and Blood Institute (NHLBI) of the National Institutes of Health (NIH), is one organization that defines what is considered high blood pressure for adults. Until very recently the ranges were:

  • 140 mm Hg or greater systolic pressure (top number).
  • 90 mm Hg or greater diastolic pressure (bottom number).

In 2003, the NHLBI added a new blood pressure category which they called prehypertension, which means a person is at risk of developing hypertension. But in late 2017, the NHLBI published a new comprehensive set of guidelines which eliminates the prehypertension category.

Understanding the newest blood pressure guidelines

In the new blood pressure guidelines, the NHLBI lowered the range of what is considered high blood pressure. The new range means approximately 46 percent of the U.S. adult population can be diagnosed as hypertensive. Younger people are the ones most impacted by the new definition, with the prevalence of hypertension doubling for women under 45 and tripling for men under 45. [2].

The following chart shows the new guidelines and associated stages of hypertension[2].

Stage Ranges
Normal Less than 120/80 mm Hg.
Elevated Systolic between 120-129 and diastolic less than 80.
Stage 1 Systolic between 130-139 or diastolic between 80-89.
Stage 2 Systolic at least 140 or diastolic at least 90 mm Hg.
Hypertensive crisis Systolic over 180 and/or diastolic over 120, with patients needing prompt changes in medication if there are no other indications of problems, or immediate hospitalization if there are signs of organ damage.

In a corresponding analysis of the guidelines’ impact, Paul Muntner, PhD, et al. [3], suggests, “the 2017 ACC/AHA hypertension guideline has the potential to increase hypertension awareness, encourage lifestyle modification and focus antihypertensive medication initiation and intensification on US adults with high CVD risk.”

Bear in mind these are only guidelines. Age, family history, insufficient exercise, excessive sodium in your diet, high stress and a variety of other factors can affect your blood pressure. Some of these factors are situational. When the situation resolves, blood pressure may return to normal ranges. So, an isolated high blood pressure reading may not be indicative of a problem. If readings remain elevated after a series of measurements taken over days or weeks, then see your healthcare professional for possible treatment.

Can your blood pressure ever be too low?

Having high blood pressure is a more common condition than having low blood pressure. More often than not, the lower your blood pressure, the better off you are. There are no guidelines suggesting someone’s blood pressure is too low. Consistently low blood pressure is a high-risk situation only if accompanied by one or more of the following symptoms:

  • Blurred vision
  • Cold, clammy, pale skin
  • Dehydration and unusual thirst
  • Depression
  • Dizziness or lightheadedness
  • Fainting
  • Fatigue
  • Nausea
  • Lack of concentration
  • Rapid, shallow breathing

As with high blood pressure, some situational factors can create a single reading of lower than average blood pressure. Certain medications, pregnancy, allergic reactions, or inadequate nutrients such as Vitamin B-12 can result in low blood pressure numbers. If you are experiencing physical symptoms along with low blood pressure, it’s best to see your physician to determine your risk of a health condition.

Want to learn more about vital signs?

Tests measuring your vital signs are quick, and the methods relatively easy when compared to other tests. If you are interested in learning how you can take your vital sign measurements at home, The American Heart Association can tell you how on their website.

 


[1] American Heart Association (2017) The Facts About High Blood Pressure (Retrieved from https://www.heart.org/HEARTORG/Conditions/HighBloodPressure/GettheFactsAboutHighBloodPressure/The-Facts-About-High-Blood-Pressure_UCM_002050_Article.jsp#.Wiwol6OZO8U)

[2] American College of Cardiology (2017) New ACC/AHA High Blood Pressure Guidelines Lower Definition of Hypertension (Retrieved from https://www.acc.org/latest-in-cardiology/articles/2017/11/08/11/47/mon-5pm-bp-guideline-aha-2017)

[3] Munter P, Carey R, Gidding, S, Jones D, Taler S, Wright Jr., J, Whelton P, (2017) Potential U.S. Population Impact of the 2017 American College of Cardiology/American Heart Association High Blood Pressure Guideline. (Retrieved from https://www.onlinejacc.org/content/early/2017/11/01/j.jacc.2017.10.073)

I really want to become a Doctor – Is there anything I can do straight away?

Check out the Pulse Oximetry Mini Course on Apprentice Doctor Academy.

 

6 Nursing Career Options for Registered Nurses

Six General Nursing Career Options

Whether you graduate with an associate degree (ADN) or a bachelor’s degree (BSN) in nursing, you’re still a registered nurse. Six nursing career options are available to all nurses holding a valid RN license – even if you’re brand new in the field. All six can provide you with a respectable salary

Hospital nurse

Many individuals with an RN apply for floor nurse positions in hospitals. Registered nurses in this setting may work standard eight-hour shifts. In other cases they may only work three, twelve-hour days per week, leaving the balance of the week for their own pursuits. Some nurses work weekends only. Most nurses can’t pick their own schedules since hospitals themselves determine how shifts are arranged.

Registered nurses can be assigned to almost any floor, or department in a hospital. As a hospital nurse, you may find yourself in the emergency room, on a pediatric floor, or even a geriatric unit. In striving for the best health and comfort of patients, most of the tasks you perform in a hospital are general in nature, and may include:

  • Adjusting patients’ medications as needed.
  • Creating and evaluating customized care plans as well as maintaining charts and medical histories.
  • Maintaining inventory levels of supplies.
  • Observing and recording patients’ behaviors, including changes in condition, physical activities and personal care routines.
  • Providing triage care in medical emergencies.
  • Preparing rooms, decontaminating equipment and instruments and prepping patients for doctor examinations.
  • Serving as informed advocates for patients’ families, sometimes providing information on illnesses or diseases.

Outpatient care nurse

Registered nurses can also work in outpatient care facilities. Due to advances in healthcare, illnesses and injuries that used to require hospital stays can be taken care of in outpatient settings. As a result, an RN employed in an outpatient care clinic will assist in treating a multitude of conditions. Job duties often include some of the following:

  • Assisting patients with the navigation of the healthcare system and/or insurance requirements.
  • Evaluating patient outcomes.
  • Health education to patients and families.
  • Identifying and clarifying patient needs.
  • Patient and family advocacy.
  • Reporting on the progression of surgery or other procedure to family members.

If you want to work as an outpatient care nurse, but prefer to become skilled in working with one disease, illness or condition, you can seek out a specialization clinic. Podiatry or ophthalmology are two examples that fall into that category.

RegisteredNurseRn created a video about working as an outpatient care nurse, which they refer to as an ambulatory care nurse.

Private Duty Nurse

Private duty nurses are also known as home health nurses, home care nurses or even personal care nurses. This is one of the top fields registered nurses can enter. Private duty nurses care for patients who are at home as opposed to in hospitals. If a person requires 24/7 care, there may be three nurses who regularly assist that individual in a 24-hour period. Other patients may only need daytime care while their family is working.

Tasks performed by private duty nurses sometimes just focus on assisting individuals with activities of daily living, also known as ADLs. Other times total care is required. Assignments can be relatively short-term, such as working with someone recovering from a knee or hip replacement. On the other hand, if a person is only partially recovered from a stroke, the job  may be longer, or even permanent. There is also respite care, which is very short term. In respite care, family members tend to the person most of the time but may decide to take a weekend off, or even go a week’s vacation. A private duty nurse manages the patient in the family’s absence, but the job concludes when the family returns.

Job duties for a private duty nurse are dependent upon the type of care being provided, but in most cases, they will include:

  • Administering or adjusting medication as needed.
  • Observation of the patients’ condition and subsequent reporting of it to the family and possibly the attending physician.
  • Providing companionship to the patient.

Hospice care is a highly specialized area for a home care nurse. Hospice duty is a growing field for registered nurses. As difficult as this specialty can be, if patients can be home during their final days they will generally choose to do so.

RegisteredNurseRn created a video that gives some insight on this career.

Physician’s office nurse

In this employment setting, registered nurses work for medical doctors or even a team of medical doctors. Their primary role is treating individual patients who are well enough to make appointments.

In some offices you may be the only person there with the doctor. Other practices are large enough that other people will be on staff, such as a receptionist and medical assistant. Regardless, your duties change from day-to-day. Stress levels also vary depending upon how many appointments are scheduled. There are also times when appointments are urgent and must be squeezed in between those already on the books. Those kinds of days run long and frequently involve a nurse interacting with worried and frustrated people as well as crying children.

A sample of duties for a physician office nurse include:

  • Ascertaining patient priority about when or how quickly someone needs to be seen.
  • Assigning clinical staff specific responsibilities.
  • Interacting with walk-in patients and assessing their condition.
  • Maintaining medication sample closet.
  • Managing clinical staff schedules.
  • Ordering office medications and medical supplies.
  • Problem-solving anything from patient issues to insurance concerns.
  • Taking incoming calls from patients and providing them with medical information according to office policy.

If you are the only staff member in a private office, you may also have some administrative duties like answering the phone, pulling and replacing files and maintaining an atmosphere of calm hospitality in the waiting area.

Nursing care facility nurse

If you are someone who enjoys providing high levels of care, being a registered nurse in a skilled nursing facility is a career option. Although these care units are frequently associated with caring for the senior population, in some cases accidents occur to younger people that make it necessary for them to have managed care away from home. Because people are living longer, but not necessarily healthier, the demand for nurses in skilled care is growing.

As a registered nurse in this environment, duties are similar to those of hospital nurses. Responsibilities may involve:

  • Administering medication.
  • Creating treatment plans and providing case management.
  • Interacting with family members, or reporting on a patient’s condition or status.
  • Supervising staff, including licensed practical nurses and certified nurse assistants.

In some states, responsibilities like preparing IVs and administering respiratory care may require some additional education and certification. If you believe you would like to include these types of tasks as part your job, check with your state on certification requirements.

Telenurse

With advancements in technology and the growing preference of people gathering information online, one of the newest registered nursing positions is telenursing.

A telenurse is someone who interacts with patients, or clients, in a type of virtual environment. Communication is conducted over the phone, or through video applications such as Skype. Telenursing is especially convenient in rural settings where getting out to a clinic or hospital is difficult for people and the service needed is not urgent or the condition is not life-threatening.

Engaging a telenurse does not replace the need for in-person appointments. And a telenurse may well recommend for someone to see a doctor face-to-face. However, talking to a nurse in this setting may eliminate the need for someone to make a physical visit, thereby reducing co-payment and insurance costs. It may also prevent worry.

Telenurses may be required to perform some or all of the following:

  • Checking in with patients electronically.
  • Listening and asking appropriate questions about someone’s symptoms.
  • Recognizing signs of more serious medical conditions and recommending a course of action.
  • Responding to hotlines or advice lines.
  • Using video technology to evaluate conditions like rashes or other skin ailments.

A telenurse must excel at listening and providing careful communication. Since a great deal of this position involves phone and video work, a registered nurse in this position must possess a clear voice, a great amount of confidence and the ability to work independently.

As helpful and knowledgeable as telenurses are, they are not permitted to diagnose conditions. The primary focus of their role is to gather information so that they can guide a patient to the next steps.

Still interested?

If any of these careers has sparked an interest in a nursing career, stop back for even more information on different careers in the nursing field.

In the meantime, you can get started right now with one of two kits from The Apprentice Doctor. There’s no need to wait until you are in an official nursing program, or even in college. Either kit enables you to practice skills you’ll need in any nursing career.

The Apprentice Doctor® Suturing Course and Kit is a resource that will teach you How to Suture Wounds in a short period of time. As a nurse, you’ll use this skill frequently, so why not get started now? The kit contains everything you need to get started. Take a look at the following video for a closer view of the contents of the kit.

The Apprentice Doctor® Phlebotomy Course and Kit is another handy resource at your fingertips. This program teaches you how to confidently perform phlebotomy procedures. Drawing blood is a skill you may need as a nurse. And you have to be very good at it to minimize discomfort to the patient. If you want to start your education being a great nurse, why not begin phlebotomy training right away? Take a look at the following video to see all the items contained in the kit.

You can also read about 8 Surgical Specialties for Registered Nurses.

Continue stopping by to remain up-to-date about medical education.


I really want to become a Doctor – Is there anything I can do straight away?

Check out the Foundation Medical Course on Apprentice Doctor Academy.

 

Becoming a Certified Surgical First Assistant / Surgical Assistant

If, after becoming a certified surgical technologist and working in the field for a period of time, you may want to advance in this allied health career. If this sounds like you, investigate becoming a Certified Surgical Assistant (CSA), or Certified Surgical First Assistant (CSFA).

Surgical assistants are medical professionals who assist both surgeons and nurses during surgical and other medical procedures. Like surgical technologists, they have specific responsibilities in the operating room, plus pre- and post-surgery duties.

A first assistant position is not an entry-level position. Because it is the next level up in skills and leadership, you must already work in the healthcare field as a surgical technologist, nurse or other health professional, preferably in a surgical capacity.

surgical assistantWhat does a surgical assistant do?

The primary duty of surgical assistant is assisting surgeons. You’re under their supervision when performing all tasks.

Typical duties include:

  • Administering needles.
  • Closing surgery sites.
  • Collaborating with doctors, consultants and other surgical team members to ensure the proper post-operative care of patients.
  • Controlling bleeding.
  • Dressing wounds.
  • Monitoring electronic medical equipment.
  • Performing minor surgical procedures.
  • Positioning and prepping patients prior to surgery.
  • Resuscitating patients.

Responsibilities of a surgical assistant can be broken down into four different areas which align with most surgical assistant education programs.

Preoperative

  • Facilitate positioning of the patient, taking into consideration:
    • Patient’s anatomical and physiological limits.
    • Surgeon’s preference.
    • Surgical procedure to be performed.
    • Surgical site.
  • Assist circulator and anesthesia provider in some of the following ways:
    • Catheter placement.
    • Tourniquet application.
  • Other procedures as needed.

Intraoperative

  • Perform specific tasks utilizing appropriate techniques.
    • Achieve hemostasis by means of injection.
    • Aide in implanting, securing, and/or removal of devices and drains.
    • Apply appropriate dressing material(s).
    • Incision and layered closure of surgical sites.
    • Manipulation and dissection/removal of tissues.

Postoperative

  • Aid in transfer of the patient.
  • Apply specific dressing material such as splints or casts.
  • Assess skin integrity.
  • Follow patient to recovery as needed.

Specialty Procedures

  • With appropriate training and supervision:
    • Graft and implant preparation.
    • Vein and graft harvesting,

The responsibilities of a surgical assistant help surgeons perform safe operations resulting in optimal results for the patient. Tasks are more expanded and elevated than those of a surgical technologist. The pressure is also higher, so when considering this professional career, you will have to decide if you want to deal with this type of stress on a daily basis.

Work environment

The work of a surgical assistant is every bit as physically demanding as that of a surgical technologist. You’re on your feet most of the day, and are expected to stand throughout all procedures regardless of length. You must always be attentive, anticipating what tools the surgeon may need and respond quickly when she or he asks for them.

Like surgical technologists, surgical assistants wear scrubs to minimize the possibility of infection to the patient. And similar to all members of a surgical care team, jewelry and long nails (even artificial nails) are almost always prohibited.

As a surgical assistant, if you have an entrepreneurial nature, you may decide to be self-employed. You can also work in hospital surgical units, surgery centers or private surgical medical practices. If you enjoy teaching others about the profession, you can also become an academic instructor.

Hours

Almost all surgical assistants are hired as full-time employees. Hours and weeks are long depending upon the number of surgeries scheduled in any given day or week. If you go into this career field, expect early morning hours, being called in to assist with emergency surgeries, and working on holidays and weekends.

Required education

In all cases, to become a surgical assistant you’ll need to graduate from an accredited surgical first assistant program.

In most cases, in order to enter a surgical first assistant program, you must first have an associate degree in surgical technology from an approved, accredited surgical technology program. You must also have successfully passed your Certified Surgical Technologist (CST) exam conducted by the National Board of Surgical Technology and Surgical Assisting (NBSTSA).

Some surgical assistant programs may also require one or more of the following:

  • Several years of experience in operating room assisting (often must be completed within the last 3-5 years).
  • Proof of a current CPR certification for healthcare providers.
  • Updated immunization records.
  • Certain course work such as physiology, microbiology and/or medical terminology (taken within the last 7 years).

Check the admissions guidelines of the surgical assistant program you are interested in. Once you find the right educational program for you, it can be completed in as little as 12 months.

The overall objective of most surgical assistant programs is ensuring students can perform surgical assistant skills with proficiency. The curriculum provides students with the experiences necessary to document 135 or more procedures, all designed to verify competencies required of the position.

Specific program objectives will meet standards established by the various approval and accrediting organizations.

Most will be similar to the following:

  • To provide a competency-based environment where students can apply their advanced knowledge of normal and pathological surgical anatomy and physiology.
  • To deliver a training program in various settings where students can demonstrate preoperative, intraoperative and postoperative skills.
  • To offer students opportunities to acquire and practice professional behavior in working relationships with patients and members of a surgical care team.
  • To ensure students are able to communicate patient needs and surgeon preferences to all members of a surgical care team.
  • To facilitate the professional leadership growth of students through knowledge of the role and how it pertains to ethical, moral and legal responsibilities.

Surgical assistant programs are carefully sequenced between clinical experiences, and classroom theory. Although you will have assisted in many procedures as part of your surgical technology degree and experiences, the clinical cases in a surgical assistant program involve utilizing more skills. The variety and intensity will be different than what you’re used to.

The concentration curriculum of most surgical assistant programs is comprised of advanced courses in surgical technology. Although you may have taken similar courses in your associate degree program, surgical assistant courses go into much more detail.

Programs may be separated into specific areas and look something like this:

Healthcare Sciences

  • Microbiology
  • Pathology
  • Pharmacology

Technical Sciences

  • Information technology
  • Robotics

Surgical Technology

  • Case management
  • Intraoperative duties
  • Preoperative duties
  • Postoperative duties

Surgical Speciality Procedures

  • Gynecology
  • Obstetrics
  • Orthopedic
  • Neurosurgery
  • Plastic and Reconstructive
  • Clinical rotations (135 or more procedures plus observation of many more)

Professional Practices

  • Ethics
  • Healthcare facilities
  • Legal

If you are interested in earning an a degree or certificate in surgical assisting and then taking the CSFA exam, a list of approved education programs can be found at the Commission on Accreditation of Allied Health Education Programs (CAAHEP).

If you want to take the CSA exam, you can be a graduate of a surgical assistant program approved and accredited by either CAAHEP, or ABHES, the Accrediting Bureau of Health Education Schools as long as the program has completed the National Commission for the Certification of Surgical Assistants (NCCSA) approval process.

First-time certification

Graduates of a surgical assistant program can then become Certified Surgical First Assistants (CSFAs) or Certified Surgical Assistants (CSAs). Each credential is offered by a different organization and has different eligibility requirements.

Both of these exams are standardized tests that prove you possess the appropriate level of education, experience and skills to be a trusted surgical assistant. Passing one is required in order to work as a surgical assistant.

Certified Surgical First Assistant (CSFA) credential

The CSFA exam is administered by the National Board of Surgical Technology and Surgical Assisting (NBSTSA).

Currently the test is composed of nine graded, multiple-choice questions and you must correctly answer a specific number of them to pass. All applicants for the exam must be graduates from a CAAHEP-accredited training program. In the alternative, with documentation of appropriate work experience, continuing education and certification, this requirement may be waived.

Eligibility Table

Status Documentation Needed Other Items to Include
Graduate of surgical first assisting program – CAAHEP approved Evidence of graduation through one of the following:

•    Notarized letter on institutional letterhead from program director or registrar (name, date of graduation, type of degree awarded); OR

•    Copy of graduation certificate/diploma or transcript.

•    CSFA exam application

•    Appropriate fee

Currently certified Surgical Technologist (CST) who can demonstrate appropriate experience •    CST credential

•    Verification forms from sponsoring agencies for:

•    200 cases (75 general surgery; 75 in one speciality area; 50 in any other speciality area(s)) within 2 years prior to application date & during a pre-approved timeframe.

•    CSFA exam application

•    Pre-authorization form

•    Evidence of malpractice coverage

•    Appropriate fees

Graduate of military surgical technology training program Verification forms or case log(s) for:

•    200 cases (75 general surgery; 75 in one speciality area; 50 in any other speciality area(s)) within 4 years prior to application date.

•    CSFA exam application

•    Evidence of graduation (ex. DD214) and/or completion certificate)

•    Appropriate fees

Current Certified Surgical Assistant (CSA) •    CSA credential

•    Verification forms or case log(s) from sponsoring agencies for:

•    200 cases (75 general surgery; 75 in one specialty area; 50 in any other specialty area(s)) conducted within 2 years prior to application date.

•    50 continuing education credits within 2 years prior to application date.

•    CSFA exam application

•    Continuing education reporting form

•    Appropriate fees

Once your application is approved, NBSTSA sends you an Authorization to Test number (ATT) and a phone number/web address for an approved testing agency. You will schedule your exam with that agency. The entire process takes 4-6 weeks to complete.

Remember, if the surgical assistant program you are considering is not CAAHEP-accredited, obtaining the CFSA credential may prove difficult. The CFSA is the credential most employers look for.

Certified Surgical Assistant (CSA) credential

The CSA credential is administered by the National Commission for the Certification of Surgical Assistants (NCCSA). Currently this exam consists of nine sections. You must correctly answer a percentage of them in order to pass.

All applicants for the exam must be graduates from a NCCSA-approved training program which is accredited by either CAAHEP or the Accrediting Bureau of Health Education Schools (ABHES). With appropriate documentation, there are some alternatives to this, such as military training, that may be used in lieu of this requirement. Check the NCCSA website for the specific documents you may need you’ll need for your status.

Eligibility Table

Status Documentation Needed Other Items to Include
Graduate of surgical first assisting program NCCSA approved AND either CAAHEP approved or ABHES approved •    Evidence of graduation

•    Proof of formal training

•    CST credential

•    Experience affidavit

•    Skills affidavit

•    3 letters of recommendation from surgeons you assisted

•    Verification of one year of case logs proving you were the primary assistant in at least 2250 procedures within the last 3 years.

•    CSA exam application

•    Appropriate fees

New graduate (within last 12 months) of surgical first assisting program NCCSA approved AND either CAAHEP approved or ABHES approved •    Evidence of graduation

•    Proof of formal training

•    CST credential

•    Experience affidavit

•    Skills affidavit

•    3 letters of recommendation from surgeons you assisted

•    Verification of one year of case logs proving you were the primary assistant in at least 2250 procedures within the last 3 years.

•    CSA exam application

•    Appropriate fees

Active military surgical training •    Evidence of graduation

•    Proof of formal training

•    CST credential

•    Experience affidavit

•    Skills affidavit

•    3 letters of recommendation from surgeons you assisted

•    Verification of one year of case logs proving you were the primary assistant in at least 2250 procedures within the last 3 years.

•    CSA exam application

•    Appropriate fees

Once your application is approved, within 48 hours you will receive a phone call to schedule your testing date.

Required continuing education and renewal certification

Like with most professions in allied health, surgical assistants are required to take additional courses once they are certified. Depending upon the type of certification you have, the renewal criteria is different.

CSFA Renewal

Every four years, the NBSTSA requires 75 credits of continuing education for CFSA renewal. Proof of these 75 credits is submitted with your renewal application. If you happen to hold both a CST and a CSFA, when you complete 75 credits, both credentials can be renewed. Details, steps for renewal, and updates are always located on the NBSTSA site.

Eligibility Chart

Option 1 Option 2 Other Items to Include
Documentation of 75 continuing education credits earned within the 4-year cycle Retake the CSFA exam, meeting all the initial requirements •    CSFA renewal application

•    Appropriate fees

CSA Renewal

If you possess a CSA, you are required to complete 50 CSA credits within your two-year certification period. Details, steps for renewal, and updates are located on their website.

Eligibility Chart

Option 1 Option 2 Other Items to Include
Documentation of 50 continuing education credits earned within the 2-year cycle Retake the CSA exam, meeting all initial requirements •    CSA renewal application

•    Appropriate fees

Fees and deadlines for certification and renewal

Regardless which certification you opt for, following the eligibility requirements exactly is important or there will be delays in obtaining your certification or renewal. Without it, you may be unable to practice in the field. In the case of renewal, if you allow your certification to lapse, you may be suspended from practice until your renewal is taken care of.

Take your first-time certification exam as soon as possible after graduation. Bear in mind that while your education is extensive, it will not be enough to pass the test. Purchasing a study guide or registering to take a qualified review course immediately prior to the exam will improve your chances of passing the test.

Apply for renewal two to three months prior to the expiration of your current certification. Be sure you have participated in continuing education credits throughout the period of your certification. You will be unable to secure all the necessary hours in a short period of time. When sending in your documentation, always keep copies.

Fees for certification and renewal range from $100 to $700. If you are a member of a surgical technology support association (ASA or NSAA), fees for these tests are normally reduced. The CSFA test recognizes membership in the Association of Surgical Assistants (ASA). The CSA test recognizes membership in the National Surgical Assistant Association (NSAA). Proof of your membership is required. More information on these two organizations is located at the end of this article.

Job outlook

The Bureau of Labor Statistics (BLS) indicates the demand for surgical assistants will rise 12% through 2026. People are healthier than ever before, and they are living longer. However, 60% of the senior American population suffer, on average, from at least two chronic illnesses. So the demand for all healthcare professionals is high. For more statistics and estimates of annual salaries, you can visit the BLS.

General skills needed for a surgical assistant

To be a successful surgical assistant, there are essential technical skills you’ll need beyond those required of a surgical technologist. In hiring situations, employers look for the following primary competencies:

  • Ability to correctly respond to orders – You have to cheerfully follow orders precisely and immediately.
  • Effective communication skills – You must be able to communicate all types of information to patients and members of a surgical care team.
  • Handling high-pressure situations – Due to the intensity levels in an operating room, you must be able to react intuitively in short time frames.
  • High attention to detail with a long attention-span – Attentiveness to anything abnormal in a patient’s vital signs is essential.
  • Personal fitness – You have to lift and reposition patients, so a certain level of fitness is beneficial.
  • Self-confidence – Pre- and post-surgery procedures are frequently performed alone, so you have to possess enough confidence to do them and know you’re doing them correctly.
  • Strong hand-eye coordination and dexterity – Surgical work involves both large and small surgical procedures. A surgical assistant must be able to assist with both.
  • Wide range of personal and professional skills – This encompasses technical skills inside the operating room and leadership skills outside of it.
  • Working both independently and in a team environment – You must be comfortable working with peers as well as people in positions of authority. Outside of the OR, you will be expected to work on your own when following up with patients.

3 reasons to become a surgical assistant

Work with the latest technologies

Many surgical assistant programs provide some robotic surgical procedure training. The workplace may expose you to others. Opportunities to remain current with the most recent advances that minimize risk to patients and speed up recovery time can be exciting.

Learn something new daily

Although you acquire a lot of education when becoming a first assistant, you’ll learn even more from members of your surgical team. The more you know, the more valuable you are.

Work with a team

Working in an operating room is demanding. Team members of a surgical care unit are no less so. Collaborative team membership adds to your leadership and technical skills.

Surgical assistant organizational support

As a surgical assistant, or even a surgical assistant student, you can join the Association of Surgical Assistants (ASA). This organization supports people in the profession, and those aspiring to the career. It works toward ensuring optimal surgical patient care. It also promotes the recognition of surgical assistants and offers continuing education opportunities.

You may elect to become a member of the National Surgical Assistant Association (NSAA) on their site. They promote excellence in the field, offer educational opportunities and professional certification, and encourage the recognition of surgical assistants.

Want to start now?

Even if you are still in high school, if you are interested in the field of surgical assisting, you can begin today by acquiring a suturing kit.

The Apprentice Doctor offers these kits, complete with instructional videos. You can practice suturing, tying knots and other skills common in the field. As you’ve learned, you need a lot of self-confidence as a surgical assistant. With a suturing kit, you can begin growing that confidence as you gain agility in performing critical suturing tasks. After completing this internationally accredited program, you’ll possess advanced skills and knowledge in the field.

Learn more about the suturing mastery course.

For more information on the first step in becoming a surgical assistant, read our previous article on – Becoming a Certified Surgical Technologist.

And read an interview with a practicing surgical technologist.

I really want to become a Doctor – Is there anything I can do straight away?

Check out the Sterility and Aseptic Techniques on Apprentice Doctor Academy.

Also, explore the Scrub for Surgery Kit on Apprentice Doctor Kits.

Becoming a Certified Surgical Technologist

If becoming a doctor isn’t the right career for you, but you would like to work in allied health, surgical technology may be a good option. Surgical technologists work alongside doctors and surgeons. They are frequently present during operations and provide critical assistance to operating room physicians.

What does a surgical technologist do?

The primary duty of surgical technologists is assisting surgeons during surgical procedures. They prepare operating rooms, arrange equipment, and even help in post-operative recovery rooms.

Typical duties include:

  • Preparing patients for surgery.
  • Transporting patients to and from operating and recovery rooms.
  • Sterilizing equipment and ensuring adequate supplies for surgery are available.
  • Passing surgeons instruments and other sterile supplies.
  • Maintaining a sterile environment.
  • Providing tools and suturing wounds for surgical team members.
  • Observing and reporting patients’ vital signs.
  • Organizing paperwork documenting any surgical procedure.
  • Utilizing medical tools.

Certified Surgical TechnologistSurgical technologists are important members of surgical teams, especially since technologists are responsible for many preparatory tasks relating to surgeries. For example, you may be asked to prepare an operating room. This can range from setting up trays of instruments in a sterile field to preparing patients for surgery. Because you’ll know how medical equipment works you may be required to ensure all surgical machines are working properly. You will be familiar with these tasks since they are all part of a surgical technology education.

Your job duties don’t end at pre-operative care. When watching medical shows on television, you have probably seen individuals pass instruments and supplies to surgeons during an operation. Surgical technologists are frequently the individuals who do this. You may also be asked to hold internal organs in place while the surgeon operates. In some cases you may handle specimens taken for laboratory analysis.

At the conclusion of an operation, surgical technologists dress incision sites. You may be asked to take patients into a recovery room and observe them until they come out of anesthesia. Restocking operating room supplies after a procedure may be one of your responsibilities.

Duties vary from day-to-day, and sometimes hour-to-hour. It’s an exciting field with many possibilities for personal and professional growth.

Work environment

The work of a surgical technologist is physically demanding. You’re required to remain standing throughout the entire surgical procedure. Some operations are short. Others can be as long as eight or ten hours. You must be alert and constantly aware of what is happening around you for the duration of the procedure.

Being comfortable with the sight of blood, bones and internal organs is essential. You must be equally comfortable holding living organs inside a body cavity of a patient. In addition to these sights, you are exposed to unpleasant odors and possibly communicable diseases. While all precautions are taken, there is always some risk when performing this kind of a job.

Surgical technologists wear prescribed clothing called scrubs. Scrubs are special sterile clothing operating teams must wear to minimize the possibility of infection to the patient. Depending upon where you work, specific colors and types may be required. As part of this dress code, jewelry, long nails (and even artificial nails) are almost always prohibited. The risk of an earring, or acrylic nail falling into an open body cavity is too great, so this requirement is a typical standard of care.

Places you can work include hospital surgical units, ambulatory surgical centers, free-standing out-patient surgery centers or private surgical medical practices.

Hours

Although surgical technologists can work part-time, most are hired as full-time employees in hospitals and clinics. Where you work determines hours and shifts. However, since many surgeries are performed in the mornings, your day may start as early as 5:00 a.m. Hours fluctuate depending upon the daily and weekly operating room schedule. You can be called in at the last minute to assist with an emergency operation.

You may also specialize in a type of surgery, such as cardiovascular, and become a regular member of a surgical team. In those cases your hours may be a little more predictable, but they will still be long (over eight hours a day) and rigorous. Surgical technologists will have rotations where they are on call during nights, weekends and holidays.

Required education and certification

In most cases, to become a surgical technologist you’ll need some kind of a degree from an accredited surgical technology program. Graduates of these programs can then become Certified Surgical Technologists (CSTs). The CST exam is a standardized test that helps employers know you have the skills and knowledge necessary to be a capable and trusted surgical technologist.

The CST test is conducted by The National Board of Surgical Technology and Surgical Assisting (NBSTSA). Their website provides comprehensive information about the exam, practice tests, and eligibility requirements.  Although some employers don’t require certification, most do. In all cases having a CST after your name enhances your employment opportunities.

You can earn a degree in surgical technology in 12-24 months. Most programs are on-ground, although some may be a combination of on-ground and on-line courses. All surgical technology programs require an externship, or internship, of surgical rotations. Practical experience is part of any surgical technology curriculum. The experiential components of the program applies what you’ve learned in the classroom to actual operating room experience. Like doctors, you’ll rotate through different types of surgeries. In these rotations you’ll determine if there is one type of operation you prefer over another.

The objectives of most surgical technology programs are:

  • To provide a competency-based environment in a classroom using current models and trends in the industry.
  • To deliver a training program in a setting where surgical technology students can apply the theoretical knowledge gained during the lecture portion of the training to the performance of skills used in an operating suite.
  • To offer students opportunities to acquire and practice professional behavior in working with relationships with patients and members of a surgical care team.
  • To facilitate the occupational growth of students by providing access to the knowledge base and applied skills necessary to become an integral member of a surgical care team.

Surgical technology programs are linear. Linear means that with some exceptions, you’re required to take the courses in a certain sequence. Surgical technology courses build upon each other. In other words, you need to know the information in one class to understand the information in the next course and so on.

Most surgical technology programs provide the study of general and specialty surgical procedures. An academic associate degree in surgical technology will include some general education courses like psychology and English composition. An associate degree takes longer to complete. However, the general education courses assist graduates in growing professionally and in developing the ability to assume roles of leadership in the work environment.

The concentration curriculum of most surgical technology programs will consist of the following types of courses:

  • Medical math and calculations
  • Medical terminology
  • Anatomy & physiology
  • Medical ethic
  • Clinical procedures (general medical procedures)
  • Pharmacology for the surgical technician
  • Surgical technology techniques
  • Surgical procedures (multiple courses)
  • Specialty surgical procedures (multiple courses)
  • Surgical externships (could be 500+ hours of practical application threaded through some specific courses)

Like with most professions in allied health, surgical technologists are required to take additional courses once they are certified. Every four years, the NBSTSA requires 60 credits of continuing education for CST renewal. You will have to provide proof of these 60 credits when you submit your renewal application. Details and updates are always located on the NBSTSA site.

If you are interested in earning an associate degree in surgical technology, a list of approved programs can be found at the Commission on Accreditation of Allied Health Education Programs (CAAHEP), or at the Accrediting Bureau of Health Education Schools (ABHES). Both of these organizations approve and accredit surgical technology programs.

With a surgical technology degree you can obtain employment as a Surgical Technician or Surgical Technologist.

Job outlook

The Bureau of Labor Statistics (BLS) indicates the demand for surgical technologists is rising. This career is expected to grow at the rate of 12% between 2016 and 2026, which a faster pace than other careers.

General skills needed for a surgical technologist

To be a successful surgical technologist there are important technical skills you’ll need.

In hiring situations, employers of surgical technologists look for the following primary skills:

  • Aseptic – You must understand how to maintain an environment that is free from bacteria and contamination.
  • Cardiopulmonary resuscitation (CPR) – In an emergency, you may be required to keep brain function intact until an appropriate medical professional arrives on the scene. A certification in CPR is always required and something you’ll obtain as part of your education.
  • Communication – You must be able to communicate verbally and also on paper (medical records and patient charting). Part of your communication skills include superior listening since care of patients includes knowing how they are feeling.
  • Computer skills – Many hospitals now have their records on computer. They also record notes and observations in real time on tablets. Knowledge of computers and other technical devices will help you in securing a job.
  • Organization – In this position you have to keep medical supplies, operating room instruments, and even schedules organized and free from chaos.
  • Patient care – You must truly enjoy working with people and listening to what they have to say.
  • Physical demand – The ability to stand for long periods of time is essential. You’ll also be required to transfer patients, so lifting a certain amount of weight is expected.
  • Sterile techniques – Knowing how to set up, maintain, and remove sterile fields is required.
  • Surgical procedures – You may be asked about your familiarity with various types of surgical procedures.
  • Teamwork/collaboration – Surgeries are performed by surgical teams that perform well together. Since surgical technologists are vital members of these teams, you must be able to interact and get along well with team members.

5 reasons to become a surgical technologist

You can enter the field quickly – Surgical technology programs take anywhere from 12-24 months to complete. By researching approved programs, you’re apt to find one that meets your budget and your time frames.

Demand is high – Because an increase in surgical technologists is expected through 2024 (BLS), once you’re a CST, employers will be interested in hiring someone with your skills and credentials. Growth is high due to ongoing advances in surgical technology. These advances mean more surgical procedures can be performed, many with lower risks to patients. A larger, and aging population also contributes to the demand.

You can work anywhere – A CST (Certified Surgical Technologist) is a national certification, so your qualifications move with you. Additionally, since most surgical technologists are hired by hospitals, and hospitals are located throughout the United States, job opportunities exist in most places.

There is a lot of variety – Even if you specialize in a specific surgical technology area, no patient or procedure is ever the same. So your days and weeks will not be spent in repetitive task assignments. Although the pressure is high, some of the uniqueness of your days may be a good offset for you.

You can make a difference in someone’s life – Patients undergoing surgery are usually scared. Since part of your job as a surgical technologist is interacting with patients before and after surgery, you can provide assurance to them. It is also very satisfying to see patients thrive and return to their life interests after a surgery is conducted. As a surgical technologist, you will have contributed to their return to health and lifestyle.

Surgical technology organizational support

As a surgical technologist, or even a surgical technology student, you can join the Association of Surgical Technologists (AST). This organization supports people in the profession, and those aspiring to the career. It provides information on technical advances, public policy, and changes in educational standards.

Want to start now?

If this article has sparked your interest, you can begin practicing some of the skills required for a surgical technologist, regardless of your age.

Through The Apprentice Doctor you can acquire a suturing kit, complete with instructional videos. With this kit you can practice suturing, tying knots and other skills common to the field of surgical technology. You’ll grow in confidence as you gain agility in performing these critical tasks. More importantly, after completing this internationally accredited program, you’ll know without a doubt you want to become a surgical technologist.

Learn more about the suturing mastery course.

If surgical technology interests you, you may want to read:

Becoming a Certified Surgical First Assistant.

An interview with a practicing surgical technologist.

I really want to become a Doctor – Is there anything I can do straight away?

Check out the Sterility and Aseptic Techniques on Apprentice Doctor Academy.

Also, explore the Scrub for Surgery Kit on Apprentice Doctor Kits.

 

Becoming a Certified Phlebotomist

Did you know that you can become a phlebotomist in a year or less? You can even get certified, which a lot of employers prefer.

If you have visited The Apprentice Doctor previously, you know we are a group of professionals dedicated to supporting individuals interested in pursuing careers in allied health professions. If you’d like to enter the healthcare field quickly consider become a certified phlebotomist. If needles make you uncomfortable with needles, don’t worry. You may be able to overcome any initial discomfort, or fear, through practicing with a venipuncture kit at school or even at home.
certified phlebotomist

What does a certified phlebotomist do?

Work environment

Where a phlebotomist works dictates the pace of the schedule. For example, phlebotomists who work in hospitals go from room to room to draw blood from patients. The day may feel hectic and create stresses not present in an outpatient diagnostic lab. There are also traveling phlebotomists who work in more rural areas where labs are less plentiful than in urban spaces. Regardless of where a phlebotomist works, they are always caring for individuals who may be ill, and many times afraid. So a person entering this profession must maintain high levels of compassion and patience all the time. Being able to draw blood with confidence goes a long way to keeping a patient calm, and sometimes even preventing them from fainting. The more you practice the skill, the more proficient you’ll be.

Hours

The work environment of a phlebotomist determines your hours, and even within the same organization they may vary from location to location. If there are only certain times you can work, inform a potential employer of this up front. But as with all allied health careers, schedules are hectic and demanding.

If you choose to work in an outpatient facility, chances are good you will work days and your shift may approximate a 9-5 schedule. However, if you work in an inpatient facility or hospital, your shifts and hours will vary and could include holidays, nights and weekends.

In some places you may be assigned to work three days consisting of 12-hour shifts, which is considered full time. In some cases, this may be 7:00 a.m. to 7:00 p.m. Or, if you are new, you may be assigned to the 7:00 p.m. to 7:00 a.m. shift. Transitioning to a 12-hour schedule, morning or night can be stressful. But the advantage is that you’ll have more free days during the week for family time or personal hobbies.

Required education

Phlebotomists can enter the field with a high school degree, or equivalent, and some postsecondary training. Almost all phlebotomy programs are non-degree programs. They are offered in many places, including vocational or technical schools and take a year or less to complete.

Training incorporates classroom and practical application. A certain number of needle sticks, or venipunctures (drawing blood from veins) and arterial punctures (drawing blood from arteries) are almost always required. Programs leading to certification require a minimum number of documented “sticks” to meet testing eligibility criteria. Phlebotomy kits are helpful for practicing in off hours.

Phlebotomy curriculum includes the following types of courses:

  • Anatomy and physiology – Students learn about the circulatory, lymphatic and urinary systems as well as about other bodily functions.
  • Blood and cell composition – These courses teach how blood and cells are affected by infection and disease, which is the heart of the phlebotomy field.
  • CPR and first aid – Since many people are afraid of needles and may also react negatively to blood draws, phlebotomists learn how to manage these situations. Adverse reactions include fainting, dizziness or more severe reactions.
  • Lab safety – Almost all lab courses teach students how to safely handle all the lab equipment and how to clean up spills without endangering yourself or others.
  • Phlebotomy – A phlebotomy course prepares students to perform venipuncture and arterial punctures on different types of people – newborns, children, adults, and seniors. Every kind of person requires a different technique.
  • Medical terminology – Learning medical vocabulary and how to spell medical terms may be woven throughout the curriculum, or presented as a separate course early in a training program.

In addition to the theory courses, programs include hands-on lab classes and a short externship under the supervision of a phlebotomist or other seasoned professional such as a doctor or a nurse.

If you decide phlebotomy is the right field for you, your next step is selecting an appropriate program that fits your needs, timeframes and financial resources.

When considering your options, keep in mind several items:

  • Type of certification – Not all schools prepare you for all the available certifications. And not all certifying agencies accept all the institutional or programmatic accreditations. Review the upcoming section on certifications before selecting a school. You may find once you determine a specific certification, your program choices narrow. Then you can consider other factors.
  • Location – If you need something close to home, search for a program nearby. If you can commute, your options are broader.
  • Time to complete – How quickly do you want to enter the field? Some programs may take as long as a year to complete while others may only take six months. Consider your schedule and narrow your search that way.
  • Accreditation – If you plan is to obtain certification at the conclusion of your program, you must ensure the program you select is accredited. Accreditation may also allow you to apply for some federal financial assistance.

You may wonder if you can obtain phlebotomy education online. There are no fully online programs. However, you may be able to locate a blended program that offers the theory portion online. But in every case, you must physically perform the minimum number of finger and needle sticks. If you enroll in a blended program, the challenge will be finding places that can provide you with the required supervised, practical experience. It would be up to you to find a site and set it up for yourself. If this makes you uncomfortable, you’re better off going through a 100% on-ground program. In all cases you can purchase an inexpensive venipuncture kit and get needle stick practice at home.

Certifications

Is certification necessary to practice phlebotomy? The answer is: Not always. While some employers will hire phlebotomy technicians who are not certified, others may require it as part of their hiring practices. In certain states certification is required by law.

Certification gives employers the confidence that the education you received, and the practice you obtained has been verified by a third, non-school affiliated organization. Since you’ll be dealing with needles and people, which do represent specific risks, employers are very particular about the people they hire. The primary advantage of being certified is that you have a broader set of employment options and may have fewer employment barriers. Obtaining certification may earn you slightly higher wages because it verifies you possess a competent, enhanced skill set.

Each of the five available certifications has its own set of requirements. All of them are similar, but none of them are the same.

When considering a training program, if you want to seek certification, first identify the type of certification you want. Knowing that will help you select the appropriate training program. Sometimes certification preferences are determined by geographic region. It’s best to check with employers in your area to see which one they prefer when hiring.

Agency Title
National Healthcareer Association (NHA) Certified Phlebotomy Technician (CPT)
American Society for Clinical Pathology (ASCP) Phlebotomy Technician (PBT)
American Medical Technologists (AMT) Registered Phlebotomy Technician (RPT)
National Center for Competency Testing (NCCT) National Certified Phlebotomy Technician (NCPT)
American Certification Agency (ACA) Certified Phlebotomy Technician (CPT)

Candidates for certification must meet the eligibility requirements laid out by each organization. Most require some classroom education and clinical experience. All exams are written, but a few may also ask you to apply some of your skills, such as drawing blood, a skill you can perfect with an in-home venipuncture kit.

The charts below show the various eligibility routes of each organization. It is always advisable to refer to the organization’s website for the most current information. Unless otherwise indicated, all routes require you to pass the written and practical exams.

National Healthcareer Association (NHA)

Although the NHA offers some provisional and limited certifications, we will only cover the Certified Phlebotomy Technician (CPT) since it is the most popular one. With a high school diploma or GED, there are three eligibility routes.

Titles Eligibility Requirements Additional Information
Certified Phlebotomy Technician (CPT) •   High school graduate or GED.

PLUS

•   Certificate of completion from an accredited phlebotomy training program.

OR

•   Formal medical services military training in phlebotomy.

OR

•   One year of supervised work experience in phlebotomy within the past three years.

PLUS

•   30 venipuncture.

•   10 capillary sticks.

•   They do not guarantee their certification complies with state requirements. It is up to the applicant to determine individual state differences.

You can refer to the NHA video on how to apply for certification through them:

American Society for Clinical Pathology (ASCP)

Although the ASCP offers a Phlebotomy Technician (PBT) certification. They’ve established four eligibility routes. If you select this certification, you’ll have to ensure the program you enroll in is approved by the National Accrediting Agency for Clinical Laboratory Sciences (NAACLS). A list of their accredited programs is on their site.

Titles Eligibility Requirements Additional Information
Phlebotomy Technician (PBT) •   High school graduate or GED.

•   Complete NAACLS-approved phlebotomy program within the past five years.

OR

•   High school graduate or GED.

•   Complete two-part formal structured program of:

•   40 hours classroom training and 100 hours of clinical training.

•   100 successful unaided blood collections.

OR

•   High school graduate or GED

•   One or more years working full time as a phlebotomy technician.

•   NOTE: Lab must be accredited and work must have been in the last five years.

OR

•   High school graduate or GED.

•   Possession of an RN, LPN or other allied health degree that included phlebotomy training. Must have included 100 skin and venipunctures.

•   They do not guarantee their certification complies with state requirements. It is up to the applicant to determine individual state differences.

•   It may take up to three months to receive a testing date.

Their video explains their credentialing process:

American Medical Technologies (AMT)

The AMT Registered Phlebotomy Technician (RPT) may be the most widely recognized certification. AMT provides three eligibility routes.

Titles Eligibility Requirements Additional Information
Registered Phlebotomy Technician (RPT) •   High school graduate or GED.

•   Graduation from an accredited phlebotomy training course in the last four years. Must include 120 didactic clock hours. More hours may be required by state law.

OR

•   High school graduate or GED.

•   1040 or more hours of experience as a phlebotomy technician in last three years.

OR

•   Possess another organization’s certification PLUS

•   Meet one of the other two AMT eligibility requirements.

•   This route does not require an exam; you only have to pay a fee.

 

NOTE: All applicants must have completed:

•   50 successful venipunctures.

•   10 successful capillary punctures.

•   They do not guarantee their certification complies with state requirements. It is up to the applicant to determine individual state differences.

 

Although AMT does not provide a video on how to become certified with their organization, the following video reviews value of AMT certification.

 

National Center for Competency Testing (NCCT)

If you decide you’d like the certification for the National Certified Phlebotomy Technician (NCPT), you will have to ensure the school you select is NCCT-approved. There may or may not be a school in your area. Their website provides a list of their approved schools. The NCCT allows for two eligibility options.

Titles Eligibility Requirements Additional Information
National Certified Phlebotomy Technician (NCPT) •   High school graduate or GED.

•   Graduation from NCCT-approved training program within the past five years.

OR

•   One year documented full time experience as a phlebotomy technician within the past five years.

OR

•   Completion of phlebotomy technician training or equivalent during US military service within the past five years.

•   2080 hours or one year of phlebotomy work experience.

•   They do not guarantee their certification complies with state requirements. It is up to the applicant to determine individual state differences.

•   Site does provide detailed information if an applicant is testing and wishes to practice in California.

American Certification Agency (ACA)

Like many of the other organizations, ACA provides you with more than one eligibility route. Their certification is a Certified Phlebotomy Technician (CPT).

Titles Eligibility Requirements Additional Information
Certified Phlebotomy Technician (CPT) from ACA •   High school graduate or GED.

•   Completion of phlebotomy training program.

•   Proof of:

•   100 clinical hours.

•   100 venipunctures.

•   10 dermal punctures.

OR

•   High school graduate or GED.

•   One year experience as phlebotomy technician.

•   Proof of:

•   100 venipunctures.

•   10 dermal punctures.

OR

•   Have current, valid certification from another certification agency approved by ACA.

•   Meet recertification requirements.

•   They do not guarantee their certification complies with state requirements. It is up to the applicant to determine individual state differences.

Almost all these agencies provide practice tests, review courses and other materials to help you pass their exam. Regardless of the certification you select, it is always a good idea to take advantage of these materials. Doing so goes a long way toward helping you pass the exam.

Re-certification and continuing education

As with all healthcare professions, continuing education (CEU) and periodic re-certification are required.

Phlebotomy re-certification cycles differ from organization to organization, although most have adopted a program where they convert CEU credits to points. All require a re-certification fee. Each agency provides detailed manuals on how to become certified and re-certified. Once you are certified as a phlebotomist, it is strongly advised you carefully review the appropriate manual immediately so that you understand the re-certification process and the documentation required.

Agency Type of Certification Re-Certification Cycle Additional Information
National Healthcareer Association (NHA) Certified Phlebotomy Technician (CPT by NHA) Every two years from date of initial certification. •   10 CEUs.

•   Two hours of attendance equals one CEU credit.

•   See their manual for details.

American Society for Clinical Pathology (ASCP) Phlebotomy Technician (PBT) Every three years from date of initial certification. •   Utilizes a CEU credit to point conversion system.

•   See their manual under Credential Maintenance Program (CMP) for details.

American Medical Technologists (AMT) Registered Phlebotomy Technician (RPT) Every three years from date of initial certification. •   Utilizes a CEU credit to point conversion system.

•   See their manual for details.

National Center for Competency Testing (NCCT) National Certified Phlebotomy Technician (NCPT) Every five years from date of initial certification. •   System includes process of annual re-certification status which is incorporated into the five-year cycle.

•   Utilizes a clock-hour to point conversion system.

•   See their manual for details.

American Certification Agency (ACA) Certified Phlebotomy Technician (CPT by ACA) Every month/year. •   CPTs must obtain .05 CEUs monthly (Example: For one year, you will need 0.5 hours x 12 months, or 6 CEUs).

•   See their manual for details.

Job outlook

As you may have determined, blood work is of vital importance in diagnosing illnesses. It can also determine minimal and optimal levels of nutrients in the body so that doctors and dietitians can assist people in improving their diets. The U.S. Department of Labor expects the employment of phlebotomists is projected to grow 25 percent from 2016 to 2026.

Job prospects improve for phlebotomists who receive certification from one of the several reputable organizations mentioned in this article. Employers also value phlebotomists who can draw blood smoothly with minimal discomfort to the patient; a skill you can perfect by practicing at home.

General skills needed for a phlebotomist

When interviewing a person for a phlebotomy position, employers always look beyond education and certification. They also want phlebotomists with softer skills that assure them you have the personality, and aptitude to work with people who need blood work. They may be ill, and/or afraid of needles. So the phlebotomist must be self-assured, and very smooth when inserting shunts and needles. It also helps if you are:

  • Compassionate – Since some individuals are afraid of having their blood drawn, phlebotomists must be caring in performing their duties.
  • Detail oriented – Blood work is vital to doctors so they can diagnose health issues accurately. So phlebotomists must draw the correct vials of blood for the tests ordered, track them and then accurately enter data into a database. Attention to detail is critical. Lack of precise information could result in a misdiagnosis or patient injury.
  • Dexterous – The best phlebotomists perform needle sticks successfully on the first attempt, regardless of the type of patient. Excellent hand-eye coordination is a characteristic that contributes to this level of competence, as does ongoing practice.

One of the most difficult challenges you may face in your job search is how to secure employment without experience.

A video from the Center for Phlebotomy Education discusses this. Watching it and following the advice given may provide you with a slight edge over your competition:

Phlebotomist organizational support

Six organizations support phlebotomists and students of phlebotomy. Some of them have membership options. Membership may reduce your certification and recertification fees.

Some of the organizations only certify and re-certify phlebotomists and other healthcare professionals. Others include additional resources, continuing education, conferences, legal information, and updates on policy, safety standards, and healthcare reform.

  • American Certification Agency for Healthcare Professionals – They provide and promote competency certification and recertification for some healthcare professionals, including phlebotomists.
  • American Medical Technologists – AMT is nationally and internationally recognized as a certification and membership society for many allied health professions. This group ensures programs meet the highest standards of education. Their mission is promoting and supporting their members.
  • American Society for Clinical Pathology – They provide support, advocacy, and education for a variety of allied health careers. Their goal is improving patient care and advancing laboratory medicine.
  • Center for Phlebotomy Education – Their mission is to support and provide additional education for phlebotomists.
  • National Center for Competency Testing – The NCCT is a certifying agency for healthcare professionals. However, they also provide types of ongoing education for various healthcare providers.
  • National Healthcareer Association – The NHCA certifies and educates various healthcare professionals. Their mission is improving health care by advocating for greater competency in healthcare workers.

Phlebotomy course from The Apprentice Doctor!

There is no need to wait on getting practice with needle sticks. Before you step into any situation on a campus, or in a medical office, you can perfect your phlebotomy skills. The Apprentice Doctor® Phlebotomy Course and Kit teaches you how to confidently perform phlebotomy procedures. If you want to start your education toward becoming a great phlebotomist. Begin training today!

I really want to become a Doctor – Is there anything I can do straight away?

Check out the Venipuncture & Phlebotomy on Apprentice Doctor Academy.

Also, explore the Venipuncture – IV & Phlebotomy Practice Kit on Apprentice Doctor Kits.

 

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