The Clinical Nurse I is specially trained to practice nursing during the perioperative/procedure period. The dimensions of practice range from preoperative/procedure assessment to intra operative intervention to postoperative/procedure evaluation. It is practice designed to meet a patient's needs through the nursing process, ensuring continuity of care during the surgical experience.

Typical Duties

Day of Surgery

• Performs in scrub or circulating role.
• Checks the following day's assignments so as to be prepared in anatomy, the surgeon's preference, and sequence of procedure. If special instrumentation or prosthetics are requested, ensure they have arrived and familiar with usage
• Attends report at scheduled time
• Damp dusts operating room surfaces
• Checks supplies against preference cards, obtaining any missing items
• Ensures that required blood products are readily available in the Blood Bank
• Opens sterile supplies with scrub staff
• Performs initial baseline counts according to Cook County Health (CCH) Policy and Procedures
• Checks spotlights, connects suctions, and electrical equipment
• Greets patients in Pre-Op area and receives hand-off communication from Pre-Op nurse/Procedure; refers the Pre-Op/Procedure admission policy; assures patients are in operating room fifteen (15) minutes before scheduled start of surgery
• Checks patient documentation preoperatively/pre-procedure to ensure that chart is complete with: all appropriate consents signed, proper patient identification and verified with Pre-Op/Procedure during hand off; Labs/X-ray, etc. (refers to policy)
• Assesses the physical and psychosocial needs of the patient; provides physical and emotional support, as needed; explains routines and procedures to patients, as needed
• Assists patients in moving to the O.R. table; requests assistance if necessary for moving and/or positioning; secures safety belt
• Keeps noise level to a minimum
• Assures surgeon/physician and assistant (if applicable) are present in the operating room before anesthesia begins; remains next to the patient during anesthesia induction; assists anesthesiologist, as needed
• Performs pre-induction and pre-incision time out, checks with surgical team and anesthesia staff
• Assesses patient skin integrity on arrival to and prior to transfer from O.R.
• Assists in positioning of the patient
• Properly places grounding pad; refer to Electrosurgical Policy
• Performs skin prep per departmental policy
• Assists in gowning surgeons, assistants, etc.
• Connects suction and electrosurgical unit
• Pours medications on back table: ensures labels on all solutions and medications are to be checked by both scrub and circulating staff ensures expiration date is reviewed by both the scrub and circulating staff; ensures Anesthesiologist is notified whenever Xylocaine, Cocaine, Neosynephrine, or other similar drugs are on the field
• Maintains an ongoing assessment of supplies needed on the surgical field vs. supplies in the room
• Ensures instrument, needle, and sponge counts are performed in the event of permanent relief of either the scrub or circulating staff
• Contacts Holding area to call for the next scheduled case prior to closure of case in progress
• Notifies Control Desk if room is running late and may delay the next scheduled surgery
• Documents all supplies, implants and medications used during procedure
• Remains in the operating room at all times unless properly relieved by another Registered Nurse (if case in progress mandates leaving OR to secure additional supplies, notifies scrub staff prior to exiting the room)
• Prepares tape for dressings, gurney, and suction towards the end of procedure
• Accurately performs and documents final sponge, needs, and instrument count with scrub staff according to CCH Policy
• Cleans patient, applies dressings, and connects drains
• Assists anesthesiologist (i.e., extubation)
• Completes and documents all nursing interventions performed in the operating room
• Transfers patient to gurney

End of Procedure

• Cleans and stocks room
• Ensures all sutures, and supplies are returned to their proper place
• Returns furniture to its designated area
• Returns equipment to its designated storage area
• Ensures specimen(s) and slips have been transported to, and placed in, the specimen refrigerator
• Assists in collecting equipment for workroom
• Assists in cleaning of operating room
• Completes documentation and submits to Main Operating Room Office
• Signs out of Operating Room
• Documents time next case is scheduled in the room
• Performs special weekly assignments, as needed

Clinical Work Activities

• Supports the CCH and Department of Nursing Philosophy and goals
• Assumes responsibility of individual clinical competence and continuing education
• Participates in educational activities to increase competency
• Acts as a role model/preceptor for staff, orientees, and students in collaboration with other nursing staff and the clinical instructor
• Participates in staff nurse meetings, unit conferences, patient care conferences, etc., to coordinate nursing and medical management of patient care
• Seeks involvement in committees and professional organizations
• Provides care that demonstrates ethical beliefs and respect for patient rights
• Incorporates current research into nursing practice
• Supports research efforts conducted within the division/department
• Contributes to the efficient management operation of the Perioperative area

• Licensed as a Registered Professional Nurse in the State of Illinois
• Two (2) years of Operating Room experience
• Current Advanced Cardiac Life Support (ACLS) certification (Must provide proof at time of interview)
• Current Basic Life Support (BLS) certification (Must provide proof at time of interview)