scrub nurse is a specially trained nurse who

scrub nurse is a specially trained nurse who works with surgeons and the medical team in the operating room. Scrub nurses are extremely valuable members of the surgical team, providing support in the operating room and patient care outside of it as well. This career can be very demanding, but also quite rewarding, and careers in nursing are constantly expanding due to the rising need for these crucial health care professionals. Some scrub nurses even become highly sought after members of surgical teams, especially experienced scrub nurses who are familiar with a wide range of procedures

• Scrub nurses are more formally known as peroperative nurses. Peroperative nursing involves patient care before, during, and after surgery. There a number of different peroperative nursing positions; the scrub nurse is actually fulled “scrubbed in” for the surgery, meaning that he or she has used special soaps and wears sterile garments so that the nurse can work next to the operative field. A scrub nurse hands instruments to the surgeon and helps to keep an eye on the patient's condition. Scrub nurses are also familiar with the operation of emergency room equipment

DUTIES OF SCRUB NURSE • Duties of a Scrub Nurse. The duties of a scrub nurse may not seem that difficult to individuals looking at surgery from the outside. . What Are the Duties of the Scrub Nurse During Surgery?

Before an operation • • • Ensures that the circulating nurse has checked the equipment Ensures that theater has been cleaned before the trolley is set Prepares the instruments and equipment needed in the operation Uses sterile technique for scrubbing, gowning and gloving Receives sterile equipment via circulating nurse using sterile technique Performs initial sponges, instruments and needle count, checks with circulating nurse

When surgeon arrives after scrubbing • Perform assisted gowning and gloving to the surgeon and assistant surgeon as soon as they enter the operation suite • Assemble the drapes according to use. Start with towel, towel clips, draw sheet and then lap sheet. Then, assist in draping the patient aseptically according to routine procedure • Place blade on the knife handle using needle holder, assemble suction tip and suction tube • Bring mayo stand back table near the draped patient after draping is completed • Secure suction tube and cautery cord with towel clips or allis • Prepares sutures and needles according to use

During an operation • Maintain sterility throughout the procedure. • Awareness of the patient’s safety. • Adhere to the policy regarding sponge/ instruments count/ surgical needles. • Arrange the instrument on the mayo table and on the back table.

Before the Incision Begins • • • Provide 2 sponges on the operative site prior to incision Passes the 1 st knife for the skin to the surgeon with blade facing downward and a hemostat to the assistant surgeon Hand the retractor to the assistant surgeon Watch the field/ procedure and anticipate the surgeon’s needs Pass the instrument in a decisive and positive manner Watch out for hand signals to ask for instruments and keep instrument as clean as possible by wiping instrument with moist sponge Always remove charred tissue from the cautery tip Notify circulating nurse if you need additional instruments as clear as possible Keep 2 sponges on the field Save and care for tissue specimen according to the hospital policy Remove excess instrument from the sterile field Adhere and maintain sterile technique and watch for any breaks

End of Operation • Undertake count of sponges and instruments with circulating nurse. • Informs the surgeon of count result. • Clears away instrument and equipment. • After operation: helps to apply dressing. • Removes and siposes of drapes. • De-gown. • Prepares the patient for recovery room. • Completes documentation. • Hand patient over to recover room.

ROLE OF SCRUB NURSE • • Works directly with surgeon within the sterile field, passing instruments, sponges and other items needed during the procedure. Members of the surgical team who prepares and preserves a sterile field in which the operation can take place. Responsible for the sponge counts, the blades and needles and instruments check throughout the operation. Has a job requiring anticipation, quick reaction and conscientious observation as well as knowledge of anatomy and of operative procedures.

circulating nurse • A circulating nurse, another type of operating room (OR) nurse, works on the perimeter of the operating room, monitoring patient care, ensuring that the room stays sterile, and keeping track of instruments and sponges. Perioperative nurses also help to prepare patients for surgery, and they provide valuable care and monitoring for patients when their surgeries are over. Surgeons may do the cutting, but a scrub nurse is every bit as important.

circulating nurse is a type of surgical nurse who circulates in the operating room to monitor the procedure. He or she acts as a patient advocate, ensuring that the conditions in the operating room remain safe and sterile. Circulating nurses also perform a wide variety of other tasks, which range from helping to set up the operating room for surgery to filling out paperwork which pertains to the surgery. This nursing career requires a very fine attention to detail, and a lot of stamina, as circulating nurses must be present and active throughout a surgery.

DUTIES OF CIRCULATING NURSE Before an operation • Checks all equipment for proper functioning such as cautery machine, suction machine, OR light and OR table • Make sure theater is clean • Arrange furniture according to use • Place a clean sheet, arm board (arm strap) and a pillow on the OR table • Provide a clean kick bucket and pail • Collect necessary stock and equipment • Turn on aircon unit • Help scrub nurse with setting up theater • Assist with counts and records

During the Induction of Anesthesia • • • Turn on OR light Assist the anesthesiologist in positioning the patient Assist the patient in assuming the position for anesthesia Anticipate the anesthesiologist’s needs If spinal anesthesia is contemplated

After the patient is anesthetized • Reposition the patient per anesthesiologist’s instruction • Attached anesthesia screen and place the patient’s arm on the arm boards • Apply restraints on the patient • Expose the area for skin preparation • Catheterize the patient as indicated by the anesthesiologist • Perform skin preparation

During Operation • • • Remain in theater throughout operation Focus the OR light every now and then Connect diatherapy, suction, etc. Position kick buckets on the operating side Replenishes and records sponge/ sutures Ensure theater door remain closed and patient’ s dignity is upheld • Watch out for any break in aseptic technique

End of Operation 1 -Assist with final sponge and instruments count. 2 -Signs theater register. 3 -Ensures specimen are properly labeled and signed. After an Operation 1 - Hands dressing to the scrub nurse. 2 -Helps remove and dispose of drapes. 3 - Helps to prepare the patient for the recovery room. 4 -Assist the scrub nurse, taking the instrumentations to the service (washroom). 5 -Ensures that theater is ready for the next case.

ROLE OF CIRCULATING NURSE • • Responsible for managing the nursing care of the patient within the OR and coordinating the needs of the surgical team with other care provider necessary for completion of surgery Observes the surgery and surgical team from broad perspective and assists the team to create and maintain a safe and comfortable environment for the patient Asses the patient’s condition before, during and after the operation to ensure an optimal outcome for the patient Must be able to anticipate the scrub nurse’s needs and be able to open sterile packs, operate machinery and keep accurate records

coordination • In an operating room, there are two areas: the sterile operating field, and the nonsterile area. During the surgery, the goal is to keep the operating field totally sterile for patient safety. Circulating nurses monitor the sterile field, informing operating room staff when something might compromise the sterility. They also connect the people in the sterile field with the nonsterile area. For example, a circulating nurse can open an autoclaved package so that someone in the operating field can access the sterile tool inside.

• The other type of surgical nurse is a scrub nurse, a nurse who scrubs in so that he or she can work in the surgical field, assisting the surgeon. Scrub nurses also monitor patient safety and the safety of the sterile field while acting as assistants to the surgeon, and they generally work closely with the circulating nurse throughout the procedure. Keeping lines of communication within the surgical team open is critical, so that emergent problems can be quickly and professionally addressed.

• Because the circulating nurse works in the non sterile field, this member of the surgical team does not need to be sterile. For patient safety, however, the circulating nurse and other staffers in the non sterile area usually wear face masks, keep their hair contained under surgical caps, and take other measures to avoid compromising the clean conditions in the operating room.

Scrub Surgical Technologist The scrub surgical technologist handles the instruments supplies, and equipment necessary during the surgical procedure. He/she has an understanding of the procedure being performed anticipates the needs of the surgeon. He/she has the necessary knowledge and ability to ensure quality patient care during the operative procedure and is constantly on vigil for maintenance of the sterile field. Duties are as follows: • Checks supplies and equipment needed for surgical procedure • Scrubs, gowns, and gloves • Sets up sterile table with instruments, supplies, equipment, and medications/solutions needed for procedure • Performs appropriate counts with circulator prior to the operation and before incision is closed

• • Gowns and gloves surgeon and assistants Helps in draping sterile field Passes instruments, etc. , to surgeon during procedure Maintains highest standard of sterile technique during procedure Prepares sterile dressings Cleans and prepares instruments for terminal sterilization Assists other members of team with terminal cleaning of room Assists in prepping room for the next patient

Circulating Surgical Technologist The surgical technologist assisting in circulating obtains additional instruments, supplies, and equipment necessary while the surgical procedure is in progress. He/she monitors conditions in the operating room and constantly assesses the needs of the patient and surgical team. Duties are as follows: • Obtains appropriate sterile and unsterile items needed for procedure • Opens sterile supplies • Checks patient’s chart, identifies patient, verifies surgery to be performed with consent forms, and brings patient to assigned operating room • Transfers patient to operating room table • Assesses comfort and safety measures and provides verbal and tactile reassurance to the patient • Assists anesthesia personnel • Positions patient, using appropriate equipment

• Applies electrosurgical grounding pads, tourniquets, monitors, etc. , before procedure begins • Prepares the patient’s skin prior to draping by surgical team • Performs appropriate counts with scrub person prior to the operation and before incision is closed • Anticipates additional supplies needed during the procedure • Keeps accurate records throughout the procedure • Properly cares for specimens • Secures dressings after incision closure • Helps transport patient to recovery room • Assists in cleaning of room and preparing for next patient

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