To lay upon an operating table is to put a lot of trust into other people’s hands — willingly or not.
Trust that medication has been dosed correctly.
Trust that the surgeon will get the job done right.
And trust that everyone in the room is educated and accredited appropriately.
A bill that’s pending in the Illinois Senate and backed by dozens of Central Illinois surgeons is aimed specifically at that latter part: Ensuring that surgical technicians, the right hand of surgeons in the operating room, come from accredited education programs and are nationally certified.
“What is happening is that there are hospitals… who are offering ‘on-the-job’ training and online programs and there is no formal education behind it,” said Melissa Jensen, a surgical technician and Illinois State Assembly board member. “Then, these individuals are getting placed in the OR [operating room], which is a very dangerous, important job.”
The Illinois State Assembly is a professional organization representing surgical technicians across the state, one of 50 similar organizations in the country. It’s also one of several organizations championing Senate Bill 2653, introduced in January, which would require hospitals to hire surgical technicians that have graduated from accredited education programs and have passed a national certifying exam.
Jensen, who’s been working in the profession for three years, said the measure is a response to online program offerings that have increased since the COVID-19 pandemic.
“I feel like it has picked up a lot because there’s a shortage of certified surgical technologists. As a board, we are seeing a lot of on-the-job programs and a lot of online programs popping up and being created,” she said. “That is where I would say that probably in the last year we really, really picked up trying to pass this legislation.”
What's changed
Typically, an aspiring surgical technician would attend community college for a corresponding degree where they would take classes in a similar line up to those of nursing students. They’d also go through clinical hours to complete their program before going to work at a hospital.
The online educational programs offer an accelerated version of what a student might go through at community college; on-the-job training, depending on the hospital, would allow an aspiring surgical tech the chance to work in an operating room. And as Jensen said, it’s likely partly a response to a shortage of surgical techs, as the healthcare system at-large grapples with a deficit of workers.
According to the Bureau of Labor Statistics, an average of about 8,600 surgical technologists and assistants will open each year over the next decade. Filling them will be the challenge, which is why the Illinois Health and Hospital Association [IHA], an advocacy and membership group for hospitals, said in a statement it opposes the legislation.
“IHA and the hospital community are concerned that SB 2653 increases the regulatory burden on Illinois hospitals and unnecessarily restricts pathways to certification for surgical technologists, which will exacerbate the healthcare worker shortage that plagues Illinois hospitals and presents significant challenges to maintaining health services in communities across Illinois,” the organization said.
Carle Health, a regional nonprofit healthcare system, also said in a statement it supports on-the-job training because “like all healthcare employers, we face shortages in many positions, and recruitment remains a top priority.” Peoria-based OSF HealthCare deferred to the IHA’s position when asked about its practices.
The bill requires potential surgical technicians to have graduated from an accredited associate’s degree program in surgical technology and to have passed an exam offered by the National Board of Surgical Technology and Surgical Assistants. The IHA, opposing the bill, has maintained that requiring an associate’s degree and requiring a specific national certification is restrictive to the profession.
The bill’s proponents have emphasized that it would not go into effect until 2026 and that it would not result in layoffs for anyone working as a surgical technician who lacked the certification come 2026. It also allows hospitals to, if they’ve done an exhaustive search, hire surgical technicians that don’t meet the legislation’s exact standards — a nod to the difficulty of staffing hospitals in some communities.
“There are a number of hospitals throughout the state that already require this. It’s just a handful that are trying this ‘shortcut’ method with on-the-job training,” said Margaret Vaughn, a longtime lobbyist now working to pass SB 2653. “What happens is that a student goes in there, they don’t have a medical background, they get overwhelmed. And then they quit. It’s not a long-term solution.”
Both Vaughn and Jensen noted that on-the-job training can come with its own stipulations, such as having to work for the providing hospital for a couple of years in return or, more frequently, being paid lower wages.
“That's a huge, huge reason why they feel that, instead of hiring educated credentials surgical technologists and paying them what they're worth, it would be easier to on-the-job train,” Jensen said.
Jensen, who graduated from Parkland College in Champaign before moving to northern Illinois, said that she believes even just a few instances of on-the-job training can pose risks in the operating room. She described working with a “non-credentialed” medical staffer during an abdominal surgery.
“We do closing counts to make sure that no sponges or items get retained in a patient. I went to do my closing count and I was missing a sponge,” she said. “The first assistant and the surgeon were closing the patient and I had to spend time searching around… looking for this sponge.”
The fear was that the sponge was still inside the patient’s body, already sutured up from the procedure. Jensen said she eventually spotted the sponge in the garbage, wrapped up in a glove, its tail sticking out.
“We don't throw these sponges away until they are counted, and we know we have every single sponge that we started with,” Jensen said. “It just makes me think — and I hope patients and everybody else start thinking — when are we going to start looking at if there was a certified surgical technologist in the room or not?”
While the pending bill marks 22 opponents, many of them healthcare systems, it’s also backed by dozens of surgeons — some of whom are employed by the same healthcare systems opposing the bill.
