OR Nursing Personnel

 ADVANCED NURSE PRACTITIONER

Advance Nurse Practitioners are nurses who hold the title of team leader, resource clinical nurse, nurse clinician, clinical nurse specialist or nurse practitioner. These personnel are capable of organizing and providing complex care while using their initiative and independent judgment.

Requirements of an Advanced Nurse Practitioner:
  1. Has acquired a degree in nursing (BSN)
  2. Must pass the licensure examination (RN)
  3. Graduate of master’s program in nursing (MN or MAN)
  4. Expert in a clinical specialty
Functions of an advanced nurse practitioner:
  1. Coordinates plan of care for each patient surgical patient with the surgeon, other professional nurses and other allied health care staff who will assist in the performance of the functions that are related to the plan of care.
  2. Decides what needs to be done in an operating room set-up with the coordination of the surgeon and other OR personnel. The decision is related to the direct and indirect nursing care of the patient in the operating room set-up by utilizing his or her specialized judgments and skill acquired.
  3. Coordinates nursing and supportive services.
  4. Directs and determines the nursing implementations that will be done by others.
  5. They may fulfill the circulating nurse duties in one operating room or serve as a consultant coordinator for several rooms in which patients are being operated by a surgeon within a given surgical specialty.
  6. Evaluates the quality of nursing care postoperatively through direct [patient interaction.
REGISTERED NURSE OR STAFF NURSE

The entry into the operating room personnel is as a staff nurse with license or registered nurse. Before exposed and allowed to work in an actual operation, a structured orientation program is done to develop basic competencies in both scrub and circulating duties of a nurse.

Functions of a registered nurse or staff nurse:
  1. Should have the ability to perform either the scrub or circulating nurse duties. In most cases, the more experienced nurse (RN) functions as the circulator and oversees the activities in the OR and the OR team. The nurse functions as patient’s advocate.
  2. Works in collaboration with the surgeon and the anesthesiologist in identifying the needs of the patient during the operation or surgical procedure.
  3. Assumes responsible for patient care during surgical operation.
  4. Document and evaluate the effectiveness of nursing interventions performed.
  5. Visits patients before the operation to assess their individualized needs and plan nursing care that will be carried out during the surgical procedure.
  6. Conducts postoperative follow-up directly with patients. The rationale for doing this is to provide opportunities to evaluate the outcomes of the nursing care planned and implemented.
Standards of Professional Performance of Registered Nurses in Operating Room

The entry into the professional operating room (OR) nursing as the clinical practice setting of choice is as a staff nurse. A staff nurse should have a degree in Nursing (Nursing) who has successfully passed the nursing licensure examination (registered nurse or RN). A registered nurse should be competent to provide nursing care for all surgical patients and to ensure a safe environment to achieve desired outcomes of surgical interventions.

Eight standards of perioperative practice has been identified that may be used to measure professional performance of registered nurses (RNs) in the operating room (OR).

  1. Quality of Care. The perioperative nurses are expected to systematically evaluate the quality and appropriateness of nursing practice. It is anticipated that RN’s in the OR should participate the quality assessment and improvement programs to promote a quality care.
  2. Performance Appraisal. The practice of a perioperative nurse evaluates his or her own performance in context with the professional practice standards and relevant statutes and regulations. Defining and evaluating professional practice behaviors is an ongoing process. To provide a framework for future growth and development self-assessment and feedback from the health care team members should be gathered.
  3. Education. The perioperative nurse acquires and maintains current knowledge in the nursing practice.
  4. Collegiality. It is expected that a perioperative nurse contribute to the professional growth of his or her peers, colleagues and others by sharing knowledge and expertise through preceptor program, role modeling and mentorships. This assists the colleagues to attain a broader base knowledge.
  5. Ethics. The decisions and the actions of a perioperative nurse on behalf of the patients are determined by the governing ethical principles. Delivery of care and services should be within the practice parameter of not violating the basic rights of the clients.
  6. Collaboration. It is a standard obligation of a perioperaive nurse to collaborate not only with the patient but also with the significant others and health care providers in providing care. To attain the expected outcomes patient care should be a unified effort that is supported by internal and external forces that follows the same goal.
  7. Research. The perioperative nurse uses research findings in carrying out his or her practice.
  8. Resource Use. In the planning and the implementation of the patient care the perioperative nurse should consider factors relating to safety, effectiveness, efficiency, environmental concerns and cost.