Perioperative Nurse Circulator

Communication: Today I had the pleasure of being in both the pre-operative and post-operative units. Communication within the members of both the teams were very efficient. I noticed the nurses work much more independently and focus more on one on one patient care. However, the nurses in pre-op did communicate a great deal with members of the surgical team. The nurses would call and inform the surgical team when a patient was prepared to enter surgery. Also, the surgical team would contact the pre-op nurses regularly to give them an update on how procedures were going in the OR. For example, if a surgeon was ahead of schedule they would contact the pre-op nurses to inform them that they could begin preparing the next patient ahead of time. Or vice versa, in cases that the surgeon was behind schedule. On the other hand, in post-op the nurse was also very independent. She would wait for a phone call from the PACU nurse, to receive a quick SBAR report of the patient just a few minutes before the patient was transferred. Via the telephone, the PACU nurse would inform the post-op nurse of current vitals, along with the types of anesthetics the patient received and outcomes of the procedure. Mainly, the nurses communicated with the patient and their family. Along with performing full body assessments, the pre-op nurses spent most of their time asking patients detailed questions regarding their health history, current health status, and use of medications. In addition, the pre-op

* Personnel Issues: One of the key barriers to effective interaction for the pre-op nurses is that they are not getting any information from the registrar or the surgeon related to the patients unique circumstances. There is not a communication process in place for the pre-op nurse to actively communicate with the surgeon or his office regarding a patient’s care during their day of surgery. An additional factor in this situation was the pre-op nurse documented the mother’s contact information in her notepad, but not on the

VASNHS Surgical Specialty Outpatient department has a designated pre-operative management unit that oversees the patients undergoing surgery. The predicaments stem from various guidelines or protocol originating from numerous surgeons and clinics. At present, the pre-operative nurses abide simple pre-op instructions (NPO protocol, medications, what to bring, during the surgery, transportation, cancellation instructions) for the entire Surgical Specialty Outpatient department. Surgical procedures are being canceled due to lack of communications and cancelations of patients prior to surgery date.

During the pre-briefing, the group collectively discussed the patient’s history, presenting issues and other influences to the patient's care. As well, during this time, the group worked to identify role expectations, protocols, timelines and other presenting issues that would require consideration, including impaired circulation/post-op bleeding, mental status or hypoxemia. Decision-making in this aspect was based on the determined role and intended learning outcomes.

The skilled CRNA is not only proficient in the operating room, but also comfortable dealing directly with patients and their family members. Once in the operating room this is where their wealth of knowledge, experience, and critical thinking really comes into play. Taking into account the patient’s history and current medical issues, the CRNA lays out a plan of care for the patient and makes decisions regarding the type, dose, and rate of medications needed to induce a safe anesthetic effect for the patient during the procedure. While the procedure is underway it is the duty of the CRNA to keep the patient stable and successfully handle any bumps in the road that might occur. This is the role of the nurse anesthetist that I have been most impressed with. The time that I spent in the OR following a CRNA I witnessed him handle difficult situation after difficult situation. As the patient’s respiratory status started to decline, I watched as he manipulated the ventilator; switching between modes and changing settings until a safe respiratory rate and saturation level was achieved. Later the patient went into an adventitious heart rhythm that began to affect their

A Nurse Practitioners is a licensed registered nurse who has had advanced preparation for practice that includes 9to 24 months of supervised clinical experience in the diagnosis and treatment of illness. Most contemporary NP programs are the master’s degree level: graduates are prepared for primary care practice in family medicine, women’s health, neonatology, pediatrics, school health, geriatrics, or mental health Nurse practitioners may work in shared practice with physicians of indecently in private practice or in nursing clinics. (Taber’s Cyclopedic Medical Dictionary, pg 1646) There are a number of factors to consider such as industry, company size, location, years of experience and level of education. While putting into consideration

Nurse Salo’s performance in this area of providing programmatic leadership has been exemplary. He is consistently sought out as a resource and leader, by members of the interdisciplinary team, regarding ethical dilemmas, particularly issues surrounding surgical patients and their unique needs. He uses the ANA Code of Ethics, AORN standards and practice, and VHA Directives to guide his professional practice. He is a role model for patient advocacy and shares his perioperative knowledge and expertise beyond the medical center by being a resource and educating various professional/ medical vendors on surgical patient care and other health care issues. Specific exemplary sample of his contributions:

Thinking ahead contingency planning and managing the unexpected are core skills for a perioperative nurse. Alfredsdottir and Bjornsdottir (2008) describe how prevention is a core component of the perioperative nurses work. Perioperative nurses consider how the background of their patient may contribute to their susceptibility and instability and how these may be risk factors during their patients surgery, this means trying to imagine everything that could go wrong and taking reasonable steps to manage these scenarios.

A surgical nurse is responsible for monitoring and ensuring quality healthcare for a patient following surgery. Assessment, diagnosis, planning, intervention, and outcome evaluation are inherent in the post operative nurse’s role with the aim of a successful recovery for the patient. The appropriate provision of care is integral for prevention of complications that can arise from the anaesthesia or the surgical procedure. Whilst complications are common at least half of all complications are preventable (Haynes et al., 2009). The foundations of Mrs Hilton’s nursing plan are to ensure that any post surgery complications are circumvented. My role as Mrs Hilton’s surgical nurse will involve coupling my knowledge and the professional

Comfort and hope are important aspects when caring for perianesthesia patients (Seyedfatemi, N. Rafii, F. Rezaei, M. Kolcaba, K., 2013). My next article

Anxiety and stress have a negative impact on patients in multiple settings. Although this study is focusing on patients in the perioperative setting, patients experience stress and anxiety in various situations. This study can easily be implemented to reflect other health care settings. For example, working in the intensive care unit, numerous patients experience stress related to inability to cope with feelings of helplessness. Sampling ten practitioners limits the generalizability of this study and should be considered for further studies. Implementing supportive measures to reduce anxiety is imperative for optimal healing. The goal of the study determined the practitioners displayed knowledge and experience with vulnerable perioperative

The perioperative management of an elderly patient has received increased scrutiny as they undergo a variety of surgeries. Geriatric patients respond to anesthesia and stress of surgery to a lesser extent when compared to the younger patients that cause an increase in morbidity and mortality in the elderly patients (Singh and Antogini, 2010).

It is important that staff involved in caring for surgical patients understand PONV. A questionnaire-based study in 2000 demonstrated knowledge gaps, with only 60 per cent of ward nurses questioned giving correct responses. [1]

In the surgery department, I work as a circulator, scrub nurse, and a charge nurse. Using these different approaches, ideals, and standards of care are often needed and applied to my assessments. Being compassionate, respectful and honest to patients is a required principle our hospital expects in caring for each

First everyone had to put on a mask, wear surgical head covers, proper scrubs, and shoe covers. Inside the operation room, the surgeon and scrub tech had to put on a sterile attire, which included sterile scrubs,gloves, and equipment because they were the first people to have contact with patient. The circulator or documenting nurse and anesthesiologist were around the sterile field (aseptic technique) without any contact with the patient whatsoever. As you would have guessed, the surgeon was the one who performed the surgery with the help of the scrub tech and monitored by the circulator nurse and anesthesiologist. The main duties of the circulator nurse was to document everything during the surgery from what medications used to how many sterile dressings were used, proving supplies to the surgeon and the scrub tech as needed,and making sure the room was prepare for the assigned surgery. This nurse also provides conform measurements for the patient while in the operation room. For instance, there was a patient who was too big for the operation bed, so the circulator nurse had to find additional supplies that would prevent the patient from sliding down the bed. Nurses always provide the finest education towards their line of duty but also take the time to teach those people who starting the nursing