Circulating Nurse (RN) - Operating Room

Provide direct patient care to pediatric through geriatric patient populations. Address the psycho-social, physical, and general aspects of care related to the surgical environment. Communicate with surgeon/physician and anesthesia personnel continuously and as needed about patient condition. Assist with the maintenance of surgical equipment and inventory. Participate in performance improvement activities. Assess operating room for equipment functioning and readiness; obtain supplies for individual cases, and ensure all appropriate needs of the surgical operating team are met. Monitor, position, and assist patient during procedures. Provide scrub skills for required procedures as needed. Provide conscious sedation for appropriate procedures and patients. Function as first license in pre-op/post-op area and as "second" scrub as caseload requires.

Pre-Operative:

Procedures

• Adapt procedures to meet individual needs of pediatric, adolescent, adult, and geriatric patients.

Standard Procedures

• Follow standard procedures for surgical/procedural intervention, adapting for surgeon and anesthesia preference.
• Use preference cards, as needed, updating regularly as changes occur.

Teaching/Education

• Coordinate and supervise patient care; provide patient and family with teaching/education as necessary.

Pre-Op Checklist

• Ensure pre-op checklist is complete and all consents are signed before patient is taken into surgical suite.

Patient and Family

• Approach patient/family in a kind, gentle, and friendly manner while protecting patient sensitivities and right to privacy. Compassion and caring should be demonstrated at all times.

Intra-Operative:

Behavior and Physiologic Changes

• Observe behavioral and physiologic changes due to medications; take appropriate actions and document.

Medication Knowledge

• Demonstrate knowledge of anesthetic drugs, actions, and side effects; and knowledge of IV conscious sedation/or medications (actions and delivery).

Surgical Knowledge

• Demonstrate thorough knowledge of location, care, and operation of all surgical equipment/instruments.

Positioning of Patient/Draping/Asepsis

• Position patients safely; pads and protects bony prominence and protect nerves.
• Prep and drape patients correctly for all procedures. Carry out medical and surgical asepsis during all procedures.

Intra-Operative Care Documentation

• Document intra-operative care; be clear, concise, accurate, and timely. Note unusual occurrences and initiate variance report if required.

Post-Operative:

OR Suites

• Demonstrate competence in preparing and cleaning of OR suites before and between cases and after terminal cases, based on patient's infection class.

Patient's Condition

• Give thorough report of patient's intra-operative condition to PACU nurse.

Instrument Knowledge

• Demonstrate thorough knowledge of instrument processing, sterilization, and biological monitoring. Actively participate in instrument processing.

Narcotics

• Count narcotics at end of shift with another RN, or other appropriate licensed personnel, per facility policy.

Emergency Situations

• Recognize and respond to emergency situations in an appropriate and timely manner.