Registered Nurse - Surgery

Job Title

Provides direct and indirect care of patients in preoperative preparation area, surgery suites and recovery room. Provides nursing care according to the physician or surgeon's orders complying with hospital policies and procedures and in conformance with recognized nursing techniques and procedures. Helps maintain and update physician preference cards as necessary. Packages and processes instruments and supplies in the central sterile area as directed and as necessary.

Job Description

Skills:

• Demonstrates ability to give and follow instructions accurately
• Demonstrates effective interpersonal skills necessary to interact with various levels of health care personnel

Knowledge:

• Hospital administrative and nursing policies and procedures
• Perioperative and central sterile procedures

Education:

• Graduate of accredited school of nursing
• Current registration as a Registered Nurse with the state of Indiana Health Professions Bureau

Experience:

• Minimum of two (2) years of related experience preferred

Authority and Accountability:

• Extensive exposure to confidential information or matters
• Frequent contact with various persons or groups within and outside of the hospital including employees, department managers, physicians, patients, visitors and outside agency personnel
• Must be able to work with and communicate with different types of people

Aptitudes:

• Must be able to prioritize, utilize critical thinking, and adjust to change
• Must be able to reason and use logical problem-solving skills
• Performs duties that require some latitude for independent judgment and initiative in handling situations out of the ordinary
• Must be self-directed, flexible and willing to assume additional responsibilities as needed

Physical and Mental Effort:

• The physical and mental demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
• Regular requirement to sit, stand, bend, kneel, crouch, and move intermittently; use hands to handle, or feel; reach with hands or arms; talk; and hear
• May have prolonged periods of standing
• Frequent requirement to lift 25-35 pounds
• Occasional requirement to assist with lifting 35-100 pounds
• Specific vision requirements include close vision, distance vision, color vision, peripheral vision, depth perception, and the ability to focus
• Speaking and listening skills are essential; must be able to hear and be understood on the telephone
• Must be able to work under a moderate amount of stress

Environmental and Working Conditions:

• The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform essential functions.
• The noise level in this work environment is usually moderate
• Work is performed in a clean, well-lighted and ventilated building
• Could be subject to infectious diseases, cuts, abrasions, burns, and punctures
• Work schedule may vary mostly day shift
• Participates in call rotation schedule as assigned

Accountability:

• Reports to the Surgical Services Manager

Quality Assurance-Key Responsibilities:

Circulator Responsibilities:

1. Demonstrates knowledge of procedures checks physician preference cards and updates as needed
2. Cleans room prior to and between cases
3. Opens supplies as needed utilizing sterile technique
4. Checks room and equipment prior to case ensures it is in the room and is available and working
5. Receives patient identifies patient (ID band; asks in layman's terms what is to be done; checks for jewelry and prosthetic devices (false teeth); checks patient record for consent and patient signature, lab reports, EKG, chest x-ray, and history and physical
6. Demonstrates proper positioning of patient
7. Final positions are accomplished after anesthesia has been induced check to insure that the patient is protected against pressure on nerves or impaired circulation skin must not touch metal of table
8. Has equipment ready for use
9. Arms are secured by draw sheet or arm board
10. Cautery pad on patient
11. Catheter bag is in accessible place
12. Knee strap secure but not too tight and placed above the knees
13. Operative site exposed
14. Adjusts light

Preps patient knows area to shave if necessary and prep

Assists with draping as necessary

Demonstrates proficiency with duties at start of case

Helps rearrange back table and ring stands as needed

Arranges step stools or sitting stools as necessary

Notes time of incision

Attaches suction and/or cautery

Has sterile warm saline and water in proper basins

Arranges floor drape and/or kick bucket to receive used sponges

Demonstrates proficiency with duties during case

Remains within hearing distance at all times, unless relieved tells scrub where he/she is going if he/she can't see circulator

Guards safety of patient, watches for and corrects any factor that could mean harm to the patient (fire, electrical, contamination)

Controls traffic and noise in the room avoids unnecessary movement and conversation

Watches the field anticipates needs of the sterile team - replenishes supplies before they are depleted adjusts light as needed

Keeps room in order collects equipment used and puts in one area ready to be removed at one time

Has sponges ready for count at any time makes sure no counted sponges leave the room

Does not remove any sponges, instruments and needles from room until all counts are correct

Keeps accurate and legible records

Pre-op and post-op diagnosis

Identifies procedure

Completes all records

Prepares specimens for pathology

Correctly identifies specimens obtained

Has labels and containers ready

Completes log book

Identifies exempt specimens

Prepares charges in an appropriate and timely manner

Demonstrates anticipation of completion of case

Dressings ready to place on sterile field following final count

Tape ready

Drainage bottles, cast material as needed

Sponges may be disposed of after the final count and are cleared with anesthesia

Demonstrates proficiency in duties at completion of case

Notes time of end of case

Removes drapes and secures dressing

Obtains stretcher and assists with transfer of patient

Takes all records and chart with patient to room or Recovery Room

Places original copies of the operative record and anesthetic record on patient's chart

Documents all orders received during the surgery on Doctor's order sheet

Conscious sedation monitors patient

Sets up monitoring devices

Obtains medications, sets up, and labels as needed

Keeps reversal agents available

Documents needed information

Constant observation of patient

Recovery Room Responsibilities:

1. Has all emergency equipment, supplies and drugs ready and available for use
2. Provides optimum quality of post-operative care
3. Maintains record of vital signs and recovery record
4. Provides for physical and emotional support for the patient
5. Demonstrates ability to recognize basic cardiac rhythms and arrhythmias

Scrub Nurse Responsibilities: