Operating Room Circulator

The Operating Room Circulator is responsible for the nursing care of patients while in the operating room. Participates as a team member or team leader in the planning and implementing of patient care. Able to utilize a body of nursing knowledge while giving direct and indirect patient care. Directs and assists in carrying out safe aseptic technique and procedures as adopted by the Clinical Administrator. Offers leadership to O.R. technicians, medical assistants, aid central service technicians.

A. Objectives :

• Exhibits ability to coordinate the general flow of activities during case.
• Is conscious of the patient as an individual and behaves with courtesy, kindness, and discretion.
• May be able to function in roll of scrub nurse when needed.
• Knows basic principles of sterilization and disinfecting instruments and equipment; understands aseptic technique.
• Has ability to explain .and demonstrate new procedures and techniques.
• Secures emergency equipment and supplies when and as needed.
• Know the equipment and instruments necessary for specific procedures.
• Be able to assist in positioning the patient properly.
• Be able to assist the anesthesiologist / anesthetist.
• Recognize emergency situations and initiate proper action.
• Be able to complete forms and reports correctly.
• Be alert, calm and courteous at all times.
• Conforms to all rules and regulations governing the operating room.
• Assists in maintaining and processing supplies and instruments required in the operating room.
• Assists with obtaining special instruments, sets, and equipment as necessary from off-site locations. Assists with tracking equipment and instruments that have been loaned or harrowed.
• Assists with the training of new employees through mentoring.
• Demonstrates interpersonal skills that promote a team concept, resolves problems through the appropriate chain of command, is positive and professional, and can communicate effectively with surgeons, peers, and other health care members.
• Be able to anticipate future needs of the surgical team. Follow your case.
• Anticipate the needs of the team and be observant for breaks in technique.
• A RN will be assigned as a circulating nurse for each room.
• Follow pharmacy sen-ice policies in accordance with all federal, state and local laws.
• Performs all other duties assigned.

B. Before Surgery :

a) Identify the patient, verbally and with the armband.

b) Check the patient's chart for all necessary papers.

c) Ask the patient what procedure is to be done and which anatomical site.

d) Ask the patient about dentures, jewelry, metal, allergies, etc. Check the chart. Report at once anything unusual about the chart or patient.

e) Make sure a headcover is on the patient and proceed to the room.

f) Assist the patient onto the OR table. Untie gown strings, secure knee straps above the knees (if appropriate). and position on the table. Cover with warm blankets.

9. Assist the Anesthesiologist / CRNA as needed. Never leave the room during induction; remain with the

patient at his / her side.

10. Check to see if the patient was properly shaved. Adjust the spotlights and proceed with skin prep.

11. Place cautery ground pad on the patient after positioned.

C. Responsibilities during any Operation :

a) Bring in and arrange additional equipment that will be needed.

b) Make sure equipment is functioning properly.

c) Set up needle and instrument counts.

3. Obtain sterile supplies for procedure provided if scrub nurse has not done this.

4. Prepare and open equipment and supplies for the scrub nurse / tech.

a) Set up scrub nurse's gown and gloves.

b) Set up prep trays.

c) Open sterile supplies.

5. Receive your patient.

a) Talk with the patient soon after he / she arrives in the OR-

b) Re-identify and ask patient what procedure is to be done and which anatomical site.

c) Again ask the patient about dentures, jewelry, metal, allergies, etc. Check the chart. Report at once anything unusual about the chart or patient.

d) Assist to OR table as necessary.

6. Prepare to assist the Anesthesia Department :

a) Never leave the patient alone once he / she is on the table.

b) Assist Anesthesia personnel with IV's and be available during induction to assist as needed.

7. Positioning the patient :

a) Final positioning is accomplished after anesthesia.

b) Have positioning accessories, cautery plates, etc., in readiness and follow the procedure for proper positioning.

c) Make sure all tubes are properly connected, lights positioned. Make final check to ensure that the patient is protected against pressure on nerves or impaired circulation.

8. Prep the patient according to specific procedure and Parkwest Surgery Center policy.

9. Assist and obser'1e for proper draping technique.

D. Duties at the Start of the Case :

a) Avoid unnecessary talk and movement.

b) Make sure persons entering your room are properly attired.

9. Watch the field

10. Keep the room in order.

a) Keep suture ends, sponges, etc., picked up off the floor.

b) Retrieve sponges and place in bags for counting as they are thrown in the kick buckets.

11. Keep sponges readily to count.

a) Make sure all sponges added to the case are properly counted.

12. Keep accurate and legible records.

a) Spell correctly.

b) Know the surgeon and assistant's names.

c) Ask surgeon what the preoperative diagnosis is. (It should be on the chart, but double check).

d) As surgeon begins to close, ask what the operative diagnosis is and what the procedure was. Make sure your records correspond with anesthesia records.

e) Ask the scrub tech / nurse or surgeon what the specimen is if you are not positive of its identity. Have labels ready for specimen containers

13. Be aware of emergence procedures should unforeseen situations arise.

14. Secure a suitable position so that all team members are visible-to be certain that aseptic technique is maintained throughout the procedure.

E. Duties after Surgery :

a) Give sterile dressing materials to the scrub tech / nurse.

b) Have appropriate tape available.

c) Assist in securing the dressing.

d) Assist with casting materials when required.

2. Assist scrub team in taking off their gowns.

3. Bring recovery stretcher into the room.

4. Assist anesthesia personnel as needed.

a) Call the anesthesiologist to inform him / her that the case is finished.

b) Be available during extubation.

c) Have suction apparatus within reach.

d) Restrain the patient if necessary.

5. Keep patient from interfering with anesthesia equipment.

6. Maintain a safe position for the patient on the OR table.

7. Assist in moving the patient onto the recovery room stretcher.

a) Obtain patient roller and place on the recovery stretcher.

b) Secure help if required to move the patient safely.

c) Check to see that any catheters, suctions, LV. solutions, etc., are moved with the patient.

d) Obtain a warm blanket for the patient if necessary.

8. Assist the Anesthesiologist to move the patient to the post anesthetic recovery room.

9. Complete all paperwork and place in the appropriate area.

a) Record of surgery

b) PACU record

c) Implant sheet

10. Remove specimens to proper area, being sure all labels are filled out properly.

a) Include appropriate specimen slips.

11. Assist in cleaning up the operating room.

a) Remove all linen and trash.

b) Use germicidal solution to wash all furniture that was soiled or what came in contact with the patient.

c) Wet-mop floor with a germicidal solution.

d) Clean and make ready any equipment used.

12. Re-assemble and make ready all O.R. furniture.

13. Wash hands.

F. Performs all other duties as assigned.

Requirements

Education / Training

Graduate of an accredited school of nursing. Current Tennessee state license. Registered Nurse licensure

Membership in a professional organization preferred. Current BCLS and ACLS certified within six months of hire.

Preferably two plus year experience in the operating room .

Knowledge / Abilities

Comprehensive knowledge of modern nursing concepts. Working knowledge of Center policies which govern the activities of nursing division. Has ability to act efficiently and rationally in emergency situations. Functions as a team member with strong interpersonal communication skills. Demonstrates attention to detail and in meeting the needs of the surgeons.