RN -OR Circulating Nurse*

Circulating Nurse

Cherry County Hospital is seeking an experienced Operating Room Registered Nurse to join our surgical services team in our critical access hospital located in Valentine, NE. This position is ideal for a confident, adaptable RN who thrives in a collaborative environment and is prepared to respond to a wide range of patient procedures and emergent situations.

The OR RN functions at the level of RN circulator, providing direct patient care to pediatric through geriatric populations. On-call responsibilities are shared and rotated with equitable distribution of weekends and holidays.

Key responsibilities include:

• Providing safe, high-quality perioperative nursing care as an RN circulator
• Collaborating with surgical technologists to assemble, open, and manage sterile supplies and equipment
• Managing the non-sterile field and monitoring the sterile field throughout surgical procedures
• Assisting with endoscopic and arthroscopic procedures and troubleshooting equipment as needed
• Responding effectively to surgical emergencies and changing patient needs
• Practicing within AORN standards and State Board of Nursing rules and regulations

This is an excellent opportunity to practice broad-based perioperative nursing, develop strong clinical autonomy, and make a meaningful impact in a supportive rural healthcare setting.

Candidate must demonstrate aptitude for proper operation of OR equipment/technology in multiple specialties:

• Individual must be well organized, with exceptional skill in planning and preparation for expected events
• Knowledge of surgical procedure and ability to access and research appropriate knowledge bases for information
• Ability to quickly adjust to changes in patient focused events
• Solid understanding of patient safety and precautions
• Candidate must possess general clinical competency in circulating nursing for Ophthalmology, Orthopedics (total joint replacements and arthroscopic procedures), Urology, ENT, General Surgery, GI (Endoscopy), Podiatry, Pediatric Dental procedures, Cesarean Sections and related OB/GYN procedures
• Experience in Post Anesthesia Care and Recovery of surgical patients preferred
• Current Nebraska Registered Nurse license; ACLS & BLS required certification, PALS preferred or competent in the care of

Essential duties and responsibilities Pre-Operative: Procedures

• Follow standard procedures for surgical/procedural intervention, adapting for surgeon and anesthesia preference.
• Adapts procedures to meet individual needs of pediatric, adolescent, adult, and geriatric patients.
• Verifies all patient information; name procedure, equipment, allergies, implanted devices, implants, correct position, side and surgical site
• Use preference cards, as needed, updating regularly as changes occur.

Readiness

• Ready and prepared consistently for assigned cases; does not cause delay of case; minimize turnover time.
• Assists in opening surgical supplies in a sterile fashion, observes sterile field for breaks or contamination and assists the scrub personnel to be gowned and ready for patient arrival.
• Assures that the surgical scrub is prepared with appropriate instrumentation, medications and surgical counts are completed

Pre-Op Care and Preparation

• Ensure pre-op checklist is complete and all consents are signed, lab results are documented, site is signed-if appropriate, review history and physical and confirm it is within 30 days of procedure before patient is taken into surgical suite.
• Confirm availability of blood products if ordered
• Coordinate and supervise patient care; provide patient and family with teaching/education as necessary. 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.

Essential duties and responsibilities Intra-Operative: Initial Assessment

• Brings patient to the OR suite and introduces patient to staff, assists patient to OR table and completes initial timeout.
• Demonstrate knowledge of anesthetic drugs, actions, and side effects; and knowledge of IV conscious sedation/or medications (actions and delivery). Understands induction process, complications of anesthesia, malignant hyperthermia risks and treatment.
• Identifies induction and intubation supplies used and their location. Stays with patient at head of bed, assisting with anesthesia until released from duty by provider.

Surgical Knowledge

• Demonstrate thorough knowledge of location, care, and operation of surgical equipment/instruments.
• Positions patients safely; pads and protects bony prominences and protecting nerves.
• Performs skin shave and prep according to surgeon preference, observes and assists surgical scrub to drape correctly for all procedures. Carry out medical and surgical asepsis all procedures.
• Has a strong knowledge of procedure and is able to anticipate needs of the surgical team.
• Communicates calmly and professionally to the entire staff at all times.
• Monitors placement of equipment, fire hazards, observes for maintained sterility of field, back table and surgical personnel throughout the procedure, professionally addressing any breaks and takes immediate action to remedy equipment or instrumentation concerns or issues.
• Documents and initiates counts at appropriate wound closure and immediately addresses any discrepancies.
• Documents intra-operative care in EHR; be clear, concise, accurate, and timely. Note unusual occurrences and initiate variance report if required.
• Collects, labels and documents all specimens. Fills out all laboratory paperwork and takes to lab in a timely manner.

Post Procedure

• Verifies implants and chargeable goods used with surgical scrub,
• Assists with dressing and securing with appropriate material, tape.
• Documents intakes and outputs, foley, drains and specimens.

Essential duties and responsibilities Post-Operative

• Demonstrate competence in preparing and cleaning of OR suites before and between cases and after terminal cases, based on patient's infection class.
• Gives thorough report of patient's intra-operative condition to PACU nurse, if necessary, performs duties as PACU nurse.

Essential duties and responsibilities-PACU Nurse

• Observe patients for side effects of anesthesia
• Monitor and record patient vital signs as per protocol
• Monitor, record and report s indicated, incisional drainage, bleeding, urinary, NG and drain output
• Monitor patient's level of consciousness throughout recovery
• Recognize condition and status that deem need to administer oxygen, pain management initiatives and document, monitor response to treatments
• Perform post-operative tasks, such as administering medication or change/reinforce dressings per provider orders
• Document and update patient files, charts and medical records
• Collaborating with surgeons, anesthesiologists, physicians and other members of the patient's care team any changes in patient status from preoperative, anticipated recovery progress or decline in patient's condition
• Providing comfort and answering questions when patients wake from sedation

Essential duties and responsibilities General: General Nursing Care

• Competent in IV skills and general nursing skills such as foley and nasogastric tube insertion. Care of Chest tubes, drains and recognizing emergency signs such as but not limited to cardiac events, embolism-various types and signs of deterioration of patient status. Able to care for immediately post-cesarean section patients.

Emergency Situations

• Recognize and respond to emergency situations in an appropriate and timely manner, including but not limited to cardiac events, malignant hyperthermia, hemorrhage, changes in LOC, fire and weather emergencies

Information Processing: Language Use Skills

• Skill in language use, including reading and comprehending instructions, short correspondence, and memos, constructing correspondence, and presenting information in one-on-one, small group situations, in person and electronically.

Computer Use

• Appropriate and timely documentation in the EHR, surgical and procedural tracking books and delivery summary.
• Use computer to perform department functions, i.e. forms, data entry, e-mail.

Interpersonal Skills

Cherry County Hospital & Clinic