duties and responsibili5ties of OT incharge

DUTIES AND RESPONSIBILITIES OF OPERATION THEATRE CHARGE NURSE AND PERIOPERATIVE NURSE:

Introduction:

Nurses play an important role in maintaining the health and well-being of patients. One type of nurse in particular is the perioperative nurse, which is commonly referred to as the operating room nurse. They are registered nurses who take care of patients before, after and during surgery. OT nurse is responsible to the Medical Coordinator, who is in charge of the management and organisation of patient care.

Charge nurses are experienced registered nurses who have displayed leadership, management and communication skills. They are responsible for managing, supervising and assisting the nursing staff, providing administrative support and patient care. A hospital, clinic or health care facility may have several charge nurses, each responsible for a different shift, department or specialized unit.

OT in charge nurse is acting as a coordinator and their main goal is to provide, safe, and effective care of surgical patients. The charge nurse is integrally involved in insuring that staff, patients, and equipment come together seamlessly to move patients through the surgical process. It essential to understanding operating room coordination is an examination of the communication of the OR charge nurse. Communication provides a basis for judgements that are supported by a social network of nurses, surgeons, anaesthesiologists, technicians, and auxiliary staff. The OR charge nurse then becomes a conduit for information flow, receiving, processing, and communicating this information to others for the coordination of patient care. The purpose of OR charge nurse communication is to coordinate the activities of the operating room. Coordination of staffing is usually face-to-face and with OR nurses.  

DUTIES AND RESPONSIBILITIES OF OT CHARGE NURSE

All emergency personnel are expected to know and follow the hospital admissions criteria, guide lines, protocols, and the diagnosis and treatment standards in use in the Centre, and to ensure the correct compilation of clinical records and statistics in both computer and paper formats.
The main duties and responsibilities of the OT in charge is

1.      Management and supervision of sterilisation services;

2.      Preparation of the theatre for operations and organisation of the work of the national team in theatre;

3.      Direct participation in surgical procedures;

4.      To assist with clinical research and record keeping as required by the scientific programmes of the specialist sector of the Medical Division of emergency.

The areas in which OT charge nurse may be required to work are:

·         sterilisation;

·         operating theatres 

·         Training programmes

·         Administrative duties.

The workload and rota are variable, depending on the needs and organisational set-up of the hospital; usually have at least one day off a week, with on-call 24/7 in case of surgical  emergency..

Sterilisation services 

Each Centre is equipped to carry out the following procedures: 

• Steam sterilisation via autoclave, including very basic models;
• Chemical sterilisation using formaldehyde, glutaraldehyde...;
• Quality control of the sterilisation processes in use, via the appropriate tests (Bowie-Dick, biological and chemical tests).

Management and orders of stocks and supplies

The OT in charge is responsible for checking that levels of supplies of materials and equipment are always adequate in terms of quantity and quality, and for informing the Medical Coordinator of any requirements. 

Management and training of local personnel 

Clinical activities and patient care are always carried out alongside and in collaboration with local personnel, who thus benefit from training in the field. There is also provision for more specific teaching activities, managed by the international specialists, in accordance with the individual needs of each hospital. As there is a high turnover of nursing staff, there will be a particular need to provide training to these personnel.

Administrative Duties and Responsibilities

In charge nurses perform administrative duties including creating schedules, maintaining adequate supplies and informing staff of changes to protocol.

Staff appraisal:  In charge nurses document the performance of nurses, perform evaluations and counsel nurses on unsatisfactory performance. In addition, they meet with upper management to discuss personnel and administrative issues and address and solve problems among staff.

ROLES AND RESPONSIBILITIES OF PERIOPERATIVE NURSE

A perioperative nurse is a registered nurse who, using the nursing process, develops a nursing care plan, and coordinates and delivers care to patients undergoing operative or other invasive procedures.”Perioperative nurses work closely with surgeons, anaesthesiologists, nurse anaesthetists, surgeon's assistants, surgical technologists, and nurse practitioners.

Preoperative nurses assume many roles within the operating room that involve both sterile and unsterile activities. Perioperative nurses can be divided into three main groups according to their roles and responsibilities within the operating room. The three main groups are circulating nurses, scrub nurses, and registered nurse first assistants.
1. Circulating Nurses: In the operating room, circulating nurses remain in the unsterile field .These nurses are not scrubbed, and do not wear gloves or a gown. Their role is to monitor and document the procedures taken during the operation. Circulating nurses also function to promote the sterility of the operating room. They inform operating room staff of anything that may cause contamination. They are also responsible for opening autoclaved packages, which are packages that hold sterile objects, so that the operating room staff may easily access the sterile equipment.

2. Scrub Nurses: Scrub nurses remain in the sterile field of the operating room and follow the designated scrub procedure, wear gloves, a mask and gown. Scrub nurses aid surgeons by handing them equipment, sponges and other necessary instruments needed during the operation. They also help the surgeon by monitoring the patient’s condition during the procedure.

3. Registered Nurse First Assistant (RNFA): RNFA nurses have had additional education and training in surgical care. These nurses have more responsibilities within the operating room and work directly with surgeons. Their job is to help surgeons by controlling patient bleeding, use instruments and medical devices during the operation, perform invasive procedures such as cutting tissue, and suture the patient when the operation has finished.

Practice Settings: Perioperative registered nurses work in a wide array of urban and rural settings, such as:

·         Hospital surgical departments 

·         Ambulatory surgery centres (also known as Day Surgery units)

·         Clinics 

·         Physicians’ offices

Education: RN license with a Bachelor’s of Science degree in nursing (BSN), associate degree in nursing (ADN), or hospital diploma. 

Personal qualification:  Generally, registered nurses obtain general nursing experience before entering the specialty area of Perioperative Nursing. Two areas that can provide applicable experience are critical care and emergency room care. They are fast-paced, sometimes stressful environments where life-saving decisions that make a difference in a patient’s life are routinely made. 

Perioperative registered nurses must be able to interact well with all kinds of people in difficult situations. They need emotional stability to cope with human suffering and frequent emergencies. They must be able to accept responsibility, provide direction to others, coordinate a patient’s health care plan, and collaborate with other health care professionals. 

Career opportunities: Perioperative registered nurses also may work as an O.R. Director, managing budgets, staffing, and other business aspects of the operating room. Some perioperative registered nurses may later consider a career in business as a management consultant, clinical educator, researcher, or medical sales professional.

Reference:

1.      Association of periOperative Registered Nurses. (2009). Retrieved December 2, 2009

2.      Israel Institute for Occupational Safety and Hygene. (2000). Retieved

3.      Lewis, S.M., Heitkemper, M.M., & Dirksen, S.R. (2006). Medical Surgical Nursing in Canada. Toronto, MO: Mosby.

4.      Nurses for a healthier tomorrow. (n.d.). Retrieved November 25, 2009.

5.       Operating Room Nurses Association of Canada. (n.d.). Retrieved December 2, 2009.

6.       Smith, S.E.(2009). What is a Circulating Nurse?. Retrieved December 2, 2009 from