Surgical Procedures Clinical II

Course Description

Surgical Procedures Clinical II is intermediate participation as a surgical technologist by practicing learned skills and acquiring additional skills in clinical affiliate facility's operating rooms in various surgical specialties and procedures.

Within the SCNS taxonomy, STS is the Surgical Technology prefix, the L suffix marks this as a clinical course, and the 0000-level number marks it as PSAV clock-hour instruction. Daytona State publishes it at 375 clock hours, offered spring. ⚠ It carries no college credit.

At 375 hours this is by a wide margin the largest course in the programme — roughly 30 percent of all STS-prefix hours in a single term, and it runs concurrently with STS0121 (88.2 hours) and STS0008. Spring is the demanding term, and students who have not arranged their employment, transport, and childcare around it in advance are the ones who struggle. The word in the catalog description is intermediate: the expectation now is that you scrub routine cases competently with decreasing supervision, and the case log grows fastest here.

Learning Outcomes

Required Outcomes

• Function as the scrub in routine procedures with decreasing supervision.
• Apply sterile technique reliably without prompting.
• Set up efficiently for a range of procedures across specialties.
• Anticipate the surgeon's needs consistently through routine cases.
• Pass instruments accurately and without delay.
• Manage the back table and Mayo stand efficiently in longer cases.
• Participate accurately and assertively in surgical counts.
• Resolve a count discrepancy following correct procedure.
• Handle sharps safely and consistently throughout every case.
• Prepare and manage medications and solutions on the sterile field.
• Handle implants with correct verification and documentation.
• Set up and troubleshoot endoscopic and powered equipment.
• Handle and label specimens correctly across specialties.
• Scrub cases across a range of surgical specialties.
• Apply specialty-specific setup and instrumentation knowledge.
• Participate fully in the surgical safety checklist and time-out.
• Respond appropriately to intraoperative complications within your role.
• Manage room turnover efficiently as part of the team.
• Communicate assertively about safety concerns, including to senior staff.
• Apply radiation and laser safety practice.
• Maintain professional conduct under sustained pressure.
• Maintain an accurate and current case log across required specialties.
• Seek, receive, and act on feedback systematically.
• Evaluate your own performance accurately against programme standards.

Optional Outcomes

• Scrub complex or specialty cases under supervision.
• Participate in robotic procedures.
• Participate in trauma or emergency cases.
• Rotate through additional services or facilities.
• Assist with orientation of newer students.
• Develop employment references and begin job seeking.

Major Topics

Required Topics

• The scrub role with decreasing supervision
• Reliable sterile technique
• Efficient setup across specialties
• Consistent anticipation
• Instrument passing under pressure
• Back table management in long cases
• Assertive count participation
• Resolving count discrepancies
• Consistent sharps safety
• Medications on the field
• Implant verification and documentation
• Endoscopic and powered equipment
• Specimen handling across specialties
• Scrubbing across specialties
• Specialty setup knowledge
• Safety checklist participation
• Responding to complications
• Room turnover
• Assertive safety communication
• Radiation and laser safety
• Professional conduct under pressure
• Case log across specialties
• Acting on feedback
• Accurate self-evaluation

Optional Topics

• Complex and specialty cases
• Robotic procedures
• Trauma and emergency cases
• Additional service rotations
• Orienting newer students
• Employment references and job seeking

Resources & Tools

• Surgical Technology for the Surgical Technologist: A Positive Care Approach (AST) — the core text, and the one the CST examination is built around.
• Alexander's Care of the Patient in Surgery — the comprehensive perioperative reference.
• Berry & Kohn's Operating Room Technique — the standard on technique and sterile practice.
• Surgical Instrumentation (Rutherford) — instrument identification, which is largely a memorisation task and needs a good picture reference.
• AST — Association of Surgical Technologists (ast.org) — the professional body; student membership is inexpensive and includes practice materials.
• NBSTSA (nbstsa.org) — free CST examination content outline and eligibility rules; read the eligibility page before you enrol anywhere.
• ARC/STSA (arcstsa.org) and CAAHEP (caahep.org) — free accreditation lookup; verify your programme.
• AORN (aorn.org) — perioperative nursing body whose Guidelines for Perioperative Practice are the standard the whole room works to.
• Flashcards for instruments, and a study partner — unglamorous and the single most effective study method in this programme.
• Anatomy atlas or app — surgical anatomy is approached by region and approach, not by system, and a visual reference helps.
• Your programme's mock operating room and open lab time — gowning, gloving, and draping are motor skills built only by repetition.

Career Pathways

• Surgical technologist — SOC 29-2055.
• Hospital operating rooms — the largest employer, and where most graduates begin.
• Ambulatory surgery centres — a large and growing Florida sector, frequently with better hours than hospital work.
• Specialty services — cardiovascular, neurosurgery, orthopaedics, and transplant; specialisation raises pay significantly.
• Labour and delivery — caesarean section teams.
• Physician offices and specialty clinics performing procedures.
• Central sterile processing — a related pathway with its own certification.
• Travel surgical technologist — substantially higher pay for mobility, once experienced.
• Surgical first assistant — an advanced role requiring further education and separate credentialing (CSFA); the usual route to higher earnings in this field.
• Medical device and instrument sales or clinical support — companies recruit experienced surgical technologists specifically for operating room credibility.
• Programme instruction — teaching in a surgical technology programme after several years in practice.
• ⚠ Progression to nursing, physician assistant, or other licensed roles requires separate degree programmes, and PSAV clock hours generally do not transfer into them — plan the pathway deliberately if that is the goal.

Special Information

⚠⚠ Speaking up: the hardest and most important thing you will learn

• You will at some point see something unsafe done by someone far senior to you — a break in technique, a skipped count, a sharp passed carelessly. Saying so is your job.
• State the observation, not a judgement. "I think that glove touched the drape" is heard; "you contaminated yourself" is argued with.
• Say it immediately. Contamination becomes harder to raise with every second that passes, and a delayed report protects nobody.
• Most professionals respond well, because the alternative is a patient harmed and an incident report with their name on it.
• If you are dismissed and the risk is real, escalate — to the circulator, the charge nurse, or your clinical instructor. The escalation route exists precisely for this.
• Never let seniority silence you on patient safety. This is the core of surgical conscience and it is why the value is taught from the first week.
• Document and report through the proper channel afterwards rather than discussing it in the corridor or online.
• Genuine abuse is separate from sharp instruction and should be reported to the programme — you are entitled to a safe learning environment.

⚠ Sustaining yourself through the heaviest term

• 375 clinical hours in one term alongside two classroom courses is a full-time commitment and then some. Treat it as a job, because that is what it is.
• Arrange work, transport, and childcare before the term begins. Retrofitting these mid-term is the most common cause of students falling behind or withdrawing.
• Sleep is not optional in a role where a lapse of attention is a retained item or a sharps injury.
• Eat before long lists and hydrate sensibly — you cannot leave the field once scrubbed.
• Look after your feet and back deliberately. Good footwear, compression stockings, and stretching are how people last in this career.
• Keep the case log current daily. With this volume of cases, a week's backlog is genuinely hard to reconstruct.
• Ask for the cases you still need — specialty coverage requirements do not fill themselves, and clinical coordinators can only help if they know.
• Tell someone if you are struggling, early. Programmes have far more options in week four than in week fourteen.

⚠⚠ This is a PSAV clock-hour course — it carries no college credit

• The leading zero in the course number is the signal. Under the Florida Statewide Course Numbering System, a 0000-level number denotes postsecondary adult vocational (PSAV) instruction, which is measured in clock hours rather than semester credit hours. These courses carry zero college credit.
• ⚠ A catalog may display the clock-hour figure under a heading that reads "credit hours." It is not credits. When you see a number like 192 or 375 attached to a 0000-level course, that is hours of instruction — no course is worth 375 semester credits.
• PSAV hours do not transfer as college credit to an associate or bachelor's degree, and they do not satisfy general education requirements.
• What they do produce is a workforce credential — a career certificate that qualifies you to sit a national certification examination and to be hired. For many students that is exactly the right outcome, and it is reached faster and more cheaply than a degree.
• Some institutions offer articulation from a PSAV certificate into a related associate degree, sometimes through an articulated credit agreement or a "gold standard" statewide articulation. ⚠ These are institution-specific and change. If your intention is to continue to a degree later, get the articulation in writing from the receiving institution before you enrol, not after you finish.
• Financial aid rules differ for clock-hour programmes. Eligibility, disbursement, and satisfactory-progress rules are not the same as for credit programmes — ask the financial aid office specifically about clock-hour programmes.
• Attendance is the currency. Clock-hour programmes track attendance directly, and hours missed generally must be made up; this is stricter than a typical credit course.

⚠ Clinical placement requirements — sort these out early

• Health clearance and immunisations are required before you may enter a clinical facility — typically hepatitis B, MMR, varicella, tetanus, an annual influenza vaccination, and tuberculosis screening.
• Level 2 background screening and drug testing are standard for Florida health care placements, and a facility may refuse a student it declines to screen.
• Current BLS certification is normally required, from a provider the programme accepts.
• You travel to the affiliate, and placements are assigned rather than chosen. Transport is your responsibility, and a Florida clinical affiliate can be a substantial drive.
• Clinical hours are unpaid and follow the operating room's schedule, not a class timetable — expect early starts, full days, and occasional late finishes when a case runs long.
• Plan employment and childcare around the rotation, not the other way round. This is the single most common reason students struggle in the clinical terms.
• Professional behaviour is assessed continuously, and a facility may remove a student for conduct without a right of appeal to the college.
• You are a guest and a learner, not staff. Work within your role, ask when unsure, and never exceed what you have been checked off to do.
• HIPAA applies fully. No phones in the operating room, no photographs, and no discussion of cases outside the clinical team — a social media post about a case ends placements and careers.

⚠⚠ Surgical conscience: if you break sterility and nobody saw, you say so

• This is the defining professional value of surgical technology, and it is taught from the first day because everything else rests on it.
• Sterility is absolute, not probabilistic. An item is sterile or it is not; there is no "probably fine." When in doubt, it is contaminated.
• You will contaminate something, and the only question is what you do next. Announcing your own break in technique — when no one else noticed and no one would ever know — is the whole of surgical conscience, and it is the single trait that defines a trustworthy surgical technologist.
• The consequence of staying silent is a surgical site infection in a real person. That is not an abstraction; it is prolonged illness, reoperation, and sometimes death.
• Know the boundaries of the sterile field — table height, gown front from chest to sterile-field level and sleeves from cuff up, and never turn your back on the field.
• Monitor everyone. Watching for other people's breaks in technique is part of the role, and saying so out loud is expected of you, not presumptuous.
• Movement discipline matters — sterile to sterile, non-sterile to non-sterile, face the field, and keep hands above waist and below shoulders.
• Verify every package. Integrity, indicators, expiry, and moisture — a wet package is a contaminated package.
• Speaking up is a clinical skill, and programmes assess it. A student who will not say "that's contaminated" to a surgeon is not yet safe to practise.

⚠⚠ Counts — a retained surgical item is a never event

• A sponge, needle, or instrument left inside a patient is classed as a "never event" — an error considered wholly preventable. The count is how it is prevented, and the scrub role owns it jointly with the circulator.
• Counts happen at defined points: before the procedure, before closure of a cavity, at the start of wound closure, and at skin closure, plus whenever staff change.
• Count audibly and together, with both people seeing each item as it is counted. A count performed silently or alone is not a count.
• Never remove counted items from the room during a procedure.
• A discrepancy stops the process. Recount, search the field and the floor, notify the surgeon, and an X-ray is taken if the item is not found. This is not negotiable and not a judgement call.
• Do not let pressure shorten the count. The end of a long case, an impatient team, and an urgent turnover are exactly the conditions under which retained items happen.
• Account for every needle and every blade fragment. Broken instrument tips count too.
• Document counts accurately — the record is the evidence that it was done.
• Emergencies do not remove the obligation; they change how it is managed, and the policy covers that.

⚠⚠ Sharps and bloodborne pathogens — your own safety

• The scrub role handles more sharps than anyone else in the room, and passing them is the highest-risk moment of a procedure.
• Use the hands-free or neutral zone technique. Sharps are placed in a designated basin or magnetic pad rather than passed hand to hand, and both people announce the transfer. This measurably reduces injuries and is the standard of practice.
• Never recap a needle by hand, and never reach into a basin blindly.
• Announce every sharp — "sharp back," "needle," "blade" — every time.
• One sharp on the field at a time where practical, and keep them contained rather than loose.
• Load and unload blades with an instrument, never with fingers.
• Standard precautions apply to every patient, because you do not know who is infectious and neither does the chart.
• Wear the protection: eye protection every case, plus double gloving, which is standard practice in many services and substantially reduces exposure.
• Report every exposure immediately. Post-exposure prophylaxis is time-critical, and students under-report injuries out of embarrassment — do not be one of them.
• Know the surgical smoke and radiation hazards too — evacuate plume, and wear lead when imaging is in use.

⚠⚠ Certification and accreditation — verify before you enrol

• The recognised credential is the CST — Certified Surgical Technologist, awarded by the National Board of Surgical Technology and Surgical Assisting (NBSTSA).
• ⚠⚠ Eligibility to sit the CST examination generally requires graduation from a programme accredited by CAAHEP (through the ARC/STSA) or ABHES. Confirm a programme's accreditation before enrolling — this is the same trap as CAPTE for physical therapist assistants, and it is unrecoverable after the fact.
• Accredited programmes require a documented minimum number of surgical cases before graduation, commonly cited as 120, distributed across specialties and roles. Keep your case log meticulously and from the first day — reconstructing it later is difficult and sometimes impossible.
• Most employers require certification even where the law does not, and many require it within a set period after hire.
• Certification is maintained by continuing education or re-examination on a defined cycle.
• ⚠ State regulation of surgical technologists varies and has changed in several states. Florida has not historically licensed surgical technologists as a separate licensed profession in the way it licenses nurses or physical therapist assistants, but requirements set by statute, by facility, and by accreditor do change.
• ⚠ Rule 11 applies. Verify current certification, accreditation, and any state requirements directly with NBSTSA, the accreditor, and the Florida Department of Health rather than relying on any course guide, including this one.
• Background screening and drug testing are required for clinical placement, and a criminal record can end a career pathway before it starts — raise any concern with the programme early and privately.

⚠ The physical and psychological demands are real

• You stand still for hours. Long cases mean sustained standing in one position, frequently with arms elevated, and it is more fatiguing than moving work. Supportive footwear and compression stockings are a genuine professional investment.
• You lift. Instrument trays are heavy, and patient positioning and transfers are part of the job — use the equipment and the team.
• Operating rooms are cold, and you will be gowned and gloved for hours without the ability to adjust anything.
• Bathroom and meal breaks are constrained by the case, which surprises students more than anything else. Hydrate and eat before a long list, sensibly.
• Radiation exposure occurs when imaging is used intraoperatively — wear lead, use distance, and monitor with a dosimeter where provided.
• Latex and chemical sensitivities matter here; disclose them to the programme early.
• You will see trauma, and some cases end badly. Paediatric cases and unexpected deaths affect experienced staff, and it is normal to be affected. Know what support the programme and the facility provide, and use it.
• The culture can be blunt under pressure. Sharp instruction during a critical moment is about the case, not about you — but genuine abuse is not acceptable, and there is a route to report it.

STS0256L is 375 clock hours — the largest course in the programme — offered spring, alongside STS0121 (88.2 hours) and STS0008. ⚠ Clock hours carry no college credit.

This is the middle rotation of three: STS0255L (192) → STS0256L (375) → STS0257L (156). Most of your required case log will be built here.