Key Responsibilities and Required Skills for Operating Room Technician

🎯 Role Definition

An Operating Room Technician (also commonly called a Surgical Technologist or Scrub Tech) is a perioperative team member responsible for preparing the operating room, maintaining a sterile field, passing instruments and supplies during surgical procedures, and supporting patient safety throughout perioperative care. This role requires detailed knowledge of surgical instruments and procedures, strict adherence to aseptic technique, clear communication with surgeons and nurses, and the ability to anticipate needs in a fast-paced surgical suite.

📈 Career Progression

Typical Career Path

Entry Point From:

Certified Nursing Assistant (CNA) or Patient Care Technician with exposure to surgical units
Sterile Processing Technician / Central Sterile Services (CSSD)
Graduate of an accredited Surgical Technology diploma or associate program

Advancement To:

Senior Surgical Technologist / Lead Scrub Tech
Perioperative Charge Technologist / Charge Surgical Technologist
Operating Room Supervisor / Perioperative Manager
Clinical Educator, Surgical Technology Program Instructor
Transition pathway to Registered Nurse (perioperative or scrub-to-RN programs)

Lateral Moves:

Sterile Processing Supervisor
Endoscopy Technician
Surgical Equipment/Device Sales Clinical Specialist

Core Responsibilities

Primary Functions

Prepare the operating room environment prior to procedures by verifying equipment function, assembling and arranging sterile instrument sets, drapes, sutures, disposables, and specialty devices according to surgeon preference cards and case requirements to ensure efficient case flow and patient safety.
Perform a formal surgical count of sponges, sharps, and instruments with circulating nurse and scrub team, reconcile discrepancies, document counts per hospital policy, and take immediate corrective action when counts are incorrect to prevent retained surgical items.
Maintain and monitor the sterile field: scrub in, don sterile attire, establish and preserve aseptic technique, and ensure all team members adhere to sterile-field protocols throughout the case to minimize infection risk.
Anticipate the surgeon’s needs by selecting, preparing, and passing instruments, sutures, and supplies in a timely and ergonomic manner to support procedural efficiency and reduce operative time.
Assist with patient positioning, padding bony prominences, and applying safety straps and positioning devices while protecting sterile drapes and maintaining access to the surgical site.
Prepare and handle surgical specimens with correct labeling, preservation media, and chain-of-custody procedures; coordinate timely transport to pathology and document specimen tracking.
Operate and troubleshoot commonly used operating room equipment (surgical lights, electrosurgical units, suction devices, laser safety equipment, endoscopic towers) and coordinate biomedical/equipment service as needed to avoid procedural delays.
Set up specialty instrumentation and implants for orthopedic, neurosurgery, cardiovascular, obstetrics/gynecology, ENT, and laparoscopic procedures, ensuring readiness of trays and sterile disposable components.
Participate in surgical timeout and verification processes (patient identity, procedure, site, implants) and report any discrepancies or safety concerns to the surgical team immediately.
Decontaminate, disassemble, and prepare instrumentation and reusable devices for transport to Central Sterile Processing, following hospital SPD and manufacturer cleaning instructions to preserve instrument longevity and sterility.
Implement infection control measures including appropriate personal protective equipment (PPE) use, sharps vigilance, spill management, and adherence to hospital and regulatory standards (AORN, CDC).
Document intraoperative events, instrument counts, and procedural notes in the electronic health record (EHR) and perioperative documentation systems accurately and contemporaneously.
Assist with intraoperative wound closure by supplying sutures, staples, hemostatic agents, and dressings and managing irrigation/aspiration devices as directed by the surgeon.
Manage implantable device handling and inventory control: verify lot numbers, expiration dates, sterile packaging, and implant documentation to ensure traceability and regulatory compliance.
Support emergency procedures and dressing changes in the OR, including rapid setup for bedside or emergent surgery, airway assistance support, and preparation of resuscitation supplies when needed.
Participate in preoperative and postoperative patient care tasks as delegated by the perioperative team, including transporting specimens, applying postoperative dressings, and assisting with transfer from OR to PACU while maintaining sterile technique until patient handoff.
Follow and enforce safety policies for radiation protection, laser safety, and biohazard containment when applicable to the procedure and equipment used.
Collaborate with supply chain and materials management to maintain adequate inventory of surgical supplies, reorder frequently used items, and assist with cost-effective utilization and waste reduction initiatives.
Support quality improvement and infection surveillance activities by collecting data, participating in root cause analyses, and implementing corrective actions to improve perioperative outcomes.
Train and mentor new scrub techs, students, and cross-training staff, demonstrating proper scrub technique, instrument identification, and case setup according to department standards and surgeon preferences.
Participate in multidisciplinary perioperative team briefings and debriefings to review case flow, safety events, instrument issues, and opportunities for process improvement.

Secondary Functions

Assist in orientation and competency assessments for new perioperative hires and temporary staff; document training and competency outcomes.
Maintain sterile processing logs and equipment maintenance records and coordinate preventative maintenance schedules for OR devices.
Support departmental audits and regulatory inspections (Joint Commission, state health departments) by providing documentation and demonstrating compliance with perioperative standards.
Contribute to the development and updating of surgeon preference cards, instrument sets, and procedural protocols to optimize tray configuration and reduce turnover time.
Engage in continuing education and professional development; attend in-service training, simulation exercises, and certification renewal activities to maintain current clinical competencies.
Participate in cross-functional projects such as OR scheduling optimization, supply chain standardization, and cost-savings initiatives.
Provide vendor support during in-service introductions of new devices or implants and ensure vendor representatives comply with hospital policy while in the sterile environment.
Support translational activities between perioperative nursing, anesthesia, and surgical services to improve communication and case coordination.

Required Skills & Competencies

Hard Skills (Technical)

Mastery of sterile technique, aseptic principles, and perioperative infection control practices in accordance with AORN and CDC guidelines.
Expert instrument recognition and handling for multiple surgical specialties (e.g., general, orthopedics, neurosurgery, cardiovascular, ENT, OB/GYN, endoscopy).
Proficient in instrument and implant tray setup, decontamination procedures, and SPD/sterile processing workflows.
Accurate surgical counts protocol execution (sponges, sharps, instruments) and documentation in both paper and electronic systems.
Familiarity with operating room equipment operation and troubleshooting: electrosurgical units, suction regulators, insufflators, imaging equipment, endoscopic towers, and patient positioning devices.
Competence with electronic health records (EHR) and perioperative documentation systems (e.g., Epic, Cerner, Meditech) for case documentation, instrument tracking, and specimen logging.
Knowledge of device/implant handling, traceability, lot tracking, and regulatory documentation requirements.
Basic life support (BLS) certification required; ACLS and PALS preferred for certain specialty ORs or advanced roles.
Ability to read and interpret surgeon preference cards, operative plans, and sterile package labeling.
Understanding of OSHA regulations, bloodborne pathogen standards, sharps safety, and hazardous material handling in the surgical environment.

Soft Skills

Strong situational awareness and the ability to anticipate procedural needs, prioritize tasks, and remain calm during high-stress situations.
Clear, concise communication with surgeons, perioperative nurses, anesthesia providers, and central sterile staff to coordinate care and prevent errors.
Excellent teamwork and collaboration skills—works effectively within multidisciplinary perioperative teams.
Meticulous attention to detail and documentation accuracy to ensure patient safety and regulatory compliance.
Time management and organizational skills to enable efficient room turnover and case flow.
Adaptability and learning agility to adopt new technologies, procedures, and surgeon preferences.
Professionalism, dependability, and integrity in patient care and handling confidential health information.
Problem-solving and basic troubleshooting ability for equipment and instrumentation issues that arise intraoperatively.
Teaching and mentoring aptitude for orienting new staff, students, and cross-trained colleagues.
Commitment to continuous improvement and quality-focused thinking to enhance perioperative outcomes.

Education & Experience

Educational Background

Minimum Education:

High school diploma or GED and completion of an accredited Surgical Technology certificate program or equivalent on-the-job training in a hospital perioperative setting.

Preferred Education:

Associate degree in Surgical Technology or related allied health field from an accredited institution.

Relevant Fields of Study:

Surgical Technology
Nursing (pre-RN pathways)
Allied Health Sciences
Biology or Health Sciences

Experience Requirements

Typical Experience Range:

Entry-level: 0–2 years with completion of accredited surgical tech program
Experienced: 2–5+ years of perioperative experience depending on specialty complexity

Preferred:

1–3 years of hands-on experience in a hospital operating room, with demonstrated experience in high-acuity specialties (orthopedics, cardiovascular, neuro, robotics, or trauma) for roles supporting complex cases.

Certifications (commonly required/preferred)

Certified Surgical Technologist (CST) by NBSTSA (preferred or required by many employers)
Basic Life Support (BLS) — required
Advanced Cardiac Life Support (ACLS) / Pediatric Advanced Life Support (PALS) — preferred for some specialties
State surgical technologist licensure or registration where applicable