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Perioperative Nursing

Last Updated: 27-11-2014
 
Perioperative nurses provide care for patients in the period prior to and right after surgery or intervention procedures.  Perioperative nursing encompasses a variety of specialty roles including holding bay, circulating, anaesthetic, Instrument or scrub nurse, and recovery room. Other roles include patient evaluation and education and surgeon’s assistant.  Some perioperative nurses may fill more than one of these roles during a particular procedure depending on the nature and complexity of the procedure.  And some of the nurse role titles are used interchangeably in different hospitals and medical settings.


Pre-operative Patient Evaluation and Education

This role includes two main areas of responsibility involving patient preparation or surgical intervention. Patient assessment
involves the provision of critical patient medical history to the surgical team to ensure that team is famliar with the patient's medical history. The second area involves the provision of pre- and post- surgery education to both patients and their families to ensure they are well informed and prepared for the procedure and the post-operative care that will be provided.


Holding Bay Nurse 

The holding bay nurse is responsible for the admission and care of patients who are brought into the pre-operative environment. They are responsible for obtaining vital medical information relevant to preparing patients for surgery and communicating this information to the surgical team.  Such information can include fasting status, any patient allergies or sensitivities to medication, pathology reports, radiological testing, and administration of medication.


Anaesthetic Nurse

The anaesthetic nurse is trained to provide support to the patient and anaesthetist prior to and during the surgical procedure.  They assist the anaesthetist in the administration of anesthetic during surgery, and tasks include the preparation of equipment, monitoring the patient's condition, and reaction to instructions from the anaesthetist. The anaesthetic nurse works under direct supervision of the anaethetist. They may also assume some circulating nurse duties as needed.  Within the Australian health care system, this role may be assumed by properly trained anaesthetic technicians who sole role is to support the anaethetist.


Circulating Nurse

The role of the circulating nurse is to be alert to the needs of the surgical team and ensure that all surgical supplies are correctly and promptly provided to the operating theatre.  They are also responsible for the management and documentation of all supplies used in the surgical area.  Other responsibilities include collection of patient specimens, verifying patient consent forms, preparation of surgical equipment, and ensuring an accurate count of instrumentation.


Instrument Nurse

The instrument nurse is primarily responsible for all supplies used within the surgical theatre with the goal of anticipating the needs of the surgical team.  They ensure that all needed surgical supplies and instruments are sterile and functional. They remain vigilant throughout the surgical procedure in order to recognize the patient’s changing condition or intra-surgical complications and responding appropriately.


Scrub Nurse

Scrub nurses, often also an instrument nurse, ensure the equipment in the theatre is clean and set-up in readiness for use.  The scrub nurse is responsible for handing equipment or tools to the surgeon upon request.  They must be able to respond quickly and efficiently to the doctors requests, often responding to hand motions from the surgeon, and also be able to assess the patient's condition and safety.


Post-Surgery Recovery Nurse

The role of this nurse is to provide patient care immediately post-surgery. They are responsible for ensuring the patient’s airway passage remains open, making and recording results from regular observations of the patient and responding to changes in the patients condition, as well as taking corrective action for any post-operative complications, post-operative pain and nausea relief, and the administration and documentation of all medication ordered by the physician.


Perioperative Nurse Surgeon Assistant (PSNA)

Perioperative nurses should have completed a post bachelor’s course that will qualify them to perform the role of surgeon’ assistant.  The PNSA has acquired the skills, knowledge and experience to provide competent care to patients, pre-surgery, intra-surgery, and extended care post-surgery. 

All of the above perioperative nursing roles work in collaboration in a multidisciplinary effort.  The goal is to provide best practice and an optimum level of care to patients at each stage of the surgical procedure to ensure a successful outcome.

The movement of the patient through the perioperative process ensures that one nursing role meshes with the next in line smoothly and without incident.  The focus of each nursing role is on taking a systemic approach to perioperative care with each taking on the role of patient advocate during the surgical experience.


Education of Perioperative Nurses

In most cases those who aspire to work in this field will need to be registered nurses.  To become a registered nurse it will be necessary to complete a three year Bachelor of Nursing degree program.  The Bachelor of Nursing can be pursued either as first degree or post-registration/professional entry.

The post-registration/professional entry degree is studied on a full-time basis over an 18 month period (or equivalent part time study). To gain admittance to a post-registration/professional degree program, candidates must be a registered midwife and hold a current practicing certificate.

Upon successful completion of the Bachelor of Nursing degree, the graduate will have attained the competency level set by the Australian Nursing and Midwifery Council (ANMC) and be eligible to apply to the Nursing and Midwifery Board (of) Australia (NMBA) for entry into the register. Following registration the nurse has the opportunity to apply for a nursing position or choose to enter a professional practice program (Graduate Nurse Program).


Working Conditions and salaries

The salaries and working conditions of nurses in Australia are regulated by various awards and agreements. The article What do Nurses Earn provides a guideline as to what nurses across Australia and at different career levels earn.


Job Outlook

There is a severe nursing shortage in Australia across all nursing specialties.  This is due to the aging of the nursing workforce, nurse recidivism, and the smaller number of nurses entering the profession. Arising from this situation, the nursing sector is expected to grow faster than the average for all occupation through to the year 2020.
 
 
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