Upon observation of the circulating nurse, I noticed that she was very interactive and involved in the surgery. One of the responsibilities of the circulating nurse is to retrieve any surgical supplies that are not available in the operating room and to make or receive any calls for the surgeon. During the surgery, I noticed the nurse call for an x-ray for the surgeon, the laboratory for biopsy samples, and the operating room floor front desk to inform them that the surgery would be later than expected. This is her responsibility as the surgeon cannot break sterility by touching the phone and it is easier for him to communicate through her and not leave the surgical site. Also in the operating room, I observed the scrub nurses’ roles. Before the operation, the scrub nurse opened all of the sterile packages, arranged them on the sterile field, and took count of what was there along with the circulating nurse. The scrub nurse did this because she is sterile during the entire procedure, and once the sterile packs are opened, the contents can only be handled by sterile personnel. The scrub nurse also was ready and waiting at the sterile field at all times to get the surgeon any equipment needed from the sterile field. This is helpful to the surgeon because it enables the surgeon to stay at the surgical site and convenient for when
As a clinical requirement for my Adult 1: Medical-Surgical course, I had the opportunity to observe a patient in the Operating Room and in the Post Anesthesia Unit of Advocate Good Samaritan Hospital. The procedure that I observed was a left total knee replacement. The patient needed this surgery because she was experiencing osteoarthritis, and this surgery could alleviate her pain and discomfort. I was with the patient from the end of her stay in the pre-operative holding area to the Operating Room, and then to the Post Anesthesia Care Unit. This paper will include background inquiry, preoperative and operative
The role of the nurse anesthetist gradually developed as the demand increased for individuals who were highly and meticulously trained in anesthesia administration in an era where knowledge of germs, antisepsis and surgical interventions was emerging. During the 1800s, medical students were often responsible in the administration of anesthesia under the direct supervision of surgeons but the increased mortality rates in intraoperative patients suggested the need to reevaluate who would provide anesthesia. As a result of negative patient outcomes, surgeons turned to nurses, who served to be an adequate and reliable replacement. This trend proved to be catalytic in the movement of the nurse anesthetist.
They also take care of patients anesthesia before, during, and after surgery. They even give mothers epidurals during child birth for pain management. A CRNA can also perform physical assessments, participate in preoperative teaching, administer anesthesia to keep patients pain free, oversee recovery from anesthesia, prepare for anesthetic management, and follow the patients postoperative course from recovery to the patient care unit. These types of nurses are the only certified personnel to deliver anesthesia in most rural hospitals in the United States (Lippincott Williams & Wilkins 42).
Before a procedure begins, the nurse anesthetist will discuss with a patient any medications the patient is taking as well as any allergies or illnesses the patient may have. This must be done so anesthesia can be safely administered. Nurse anesthetists then give a patient general anesthesia to put the patient to sleep so they feel no pain during surgery or they may administer a regional
This clinical rotation I was assigned to observe at the operating room, where they conduct various surgical procedures. The night prior to the clinical, I have to admit, was every bit unnerving. Especially, the fear of not knowing what to expect was daunting. There must have been a thousand scenario of what to expect or what might possibly go wrong playing through my head that night. However, after being introduced to the nurse I would be following, and meeting the surgeon and the rest of the team; my nerves settled down. The surgery scheduled was for a ventral hernia, which seemed routine, but complicated by a previous bowel realignment previously. The whole operation, from beginning to end, lasted a little over four hours. Although, the procedure lasted that long, it did not bother me even bit. In spite of standing for the whole duration of the observation, I never felt tired nor gotten bored. Notably, watching the surgical team working cohesively is like watching an artists who have
* 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
Second, the nurse commences assessment with an evaluation of patient’s airway, breathing, and circulation for any signs of inadequate oxygenation and ventilation. One of the patients’ temperature was 102 F and the physician recommended pain medication (dilaudid) and it was administered instantly. The nurse gets vital signs and compare the result with intraoperative care. The nurse chart vital signs every 5 mins for the next 15mins, every 15mins for the next hour depending on the recovery state of the patient. I also noticed that for diabetic patients, the nurse checks for blood glucose and also compare result with intraoperative care unit result. Third, the nurse assess pain although the patients receive pain medication before surgery. Fourth, the nurse assess surgical site (dressings and drainage). Fifth, the nurse assess neurologic (level of consciousness, orientation, sensory & motor status, pupil size and reaction. Finally, the nurse assess gastrointestinal (nausea, vomiting, intake of
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.
The nurse is responsible for positioning the patient and should assess the patient throughout to see how well he is tolerating it. If the patient is on a heart monitor, the nurse should monitor vital signs and heart rate as the catheter is being put in for any fluctuations. Afterword’s, the nurse should assess for complications or adverse reactions like pneumothorax. Make the patient comfortable and listen to bilateral breath sounds. Obtain a stat XRAY to verify correct placement.
During my rotation in the operating room at Community medical center, I observed the preoperative, intraoperative, and postoperative care for a patient who underwent a laparoscopic hysterectomy. I believe that an appropriate preoperative plan of care for this patient would have included a full physical exam and an interview for patient history, a pelvic exam to look over and understand the nature of the patient’s complications, blood testing including a CBC and WBC to note any signs of infection or contraindications for the procedure, and a urine test to rule out any urinary tract infections or pregnancy. It would be important to interview the patient and ask questions to determine how the patient is feeling about their procedure and to better assist with any anxiety or pain they may be dealing with preoperatively. It is important to consult with the patient well before the procedure to ensure that she knows to refrain from smoking for at least 8 weeks before the procedure because this reduces the risks of complications such as infections, issues with blood pressure, heart rate, blood flow, and respirations when under anesthesia, and promoting overall health and risks associated with smoking after the procedure. (ASAHQ) It is also important to educate the patient to consume no food or drinks after midnight the night before the scheduled procedure. (Health Communities) During my rotation I observed that the patient did indeed have labs drawn and a urine test run. Her lab
The concept of perioperative surgical home has been around for last forty years in developed countries and with the recent boost by American Society of Anesthesiologists and also considering the advantages in implementing perioperative surgical home compared to conventional surgical practices, perioperative surgical home gained lot of interest and importance. Perioperative surgical home is a team-based, coordinated care provided by the physicians in surgical procedures to improve clinical outcomes and reduce the costs associated with them. Current trend in surgical care processes are highly expensive and lacks coordination between the different physicians from different specializations which is impeding
I feel that with experience and practice that any medical-surgical nurse can tackle any situation whether stopping fluid from leak out of an abdominal incision site to suctioning a tracheostomy patient. A nurse should address situation under pressure but remain calm and to be able to think of the next step.
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
Urgency of acute care varies depending on the situation but can range to anything from emergency surgeries, to injuries, chronic illnesses, and also for the recovery of those procedures. Majority of the patients in acute care settings are critically ill. Nursing responsibilities in acute care settings are vital to patient’s recovery due to the front line position nurses play as well as the wide variety of tasks carried out. Assessments are made during every encounter the nurse has with the patient along with monitoring the patient’s progress. Nurses are responsible for recognizing symptoms the patient may be experiencing due to illness or injury and whether they fall in the spectrum of normal reactions. Vital signs are measured routinely and can be indicators of the patient’s current status. When vitals are questioned diagnostic tests can be arranged to further assess possible comorbidities the patient may have. Care plans are made to plan interventions the health care team can take to help patients through challenges they face, both physical and mental. Nurses administer medications as well as first aid as needed. They are responsible for maintaining special equipment patients may require including monitors and ventilators are well.