OR Circulator

Position Title: OR Circulator
Department: Southeastern Surgery Center
Reports To: Director of Nursing
Supervises: n/a

Summary

The OR Circulator is a clinically competent nurse who is responsible for incorporating current knowledge with established nursing practice in delivering compassionate care to each patient, has excellent customer service skills with good organization skills and keen attention to detail. He / She is able to follow direction quickly and efficiently with varying workloads and interruptions and must be able to work well under pressure and deal with co-workers in a courteous and cooperative manner.

Principal Responsibilities

• This individual is accountable to the Director of Nursing.
• Report to duty on time.
• Don proper OR attire (Scrubs provided by SSC or clean scrubs from home, fluid repellent footwear, head cover and mask if open case.
• Wash hands with antimicrobial of choice.
• Communicates problems with the patients and visitors, workflow, failure to understand directions or procedures, conflicts and other concerns encountered in the work day to the Director of Nursing.
• Request for vacation or time away from work for personal illnesses, doctor?s appointments, or family emergencies are handled through the Director of Nursing according to the policy on absence and the unit specific protocol.
• Identifies patient care requirements by establishing personal rapport with potential and actual patients and other persons in a position to understand care requirements.
• Establishes a compassionate environment by providing emotional, psychological and spiritual support to patients, friends, and families.
• Promotes patient?s independence by establishing patient care goals; teaching patient, friends and family to understand condition, medications, and self-care skills, answering questions.
• Assures quality of care by adhering to the therapeutic standards; measuring health outcomes against patient care goals and standards; making or recommending necessary adjustments; following Southeastern Urological Center philosophies and other governing agency regulations.
• Wipe room furniture and equipment with antimicrobial before opening for first case and after each case.
• Assemble the necessary instruments, supplies and equipment for the surgical procedure according to the standard operating procedure and the surgeon?s preference card
• Open sterile supplies with the scrub nurse.
• Check the working order of the room equipment.
• Evaluate the patient?s status. Greet the patient in the pre-op area. Verify the patient?s identity, operative procedure, site, surgeon and consents are signed.
• Check for the presence of bridgework, contact lenses, prosthesis and implants.
• Evaluate the patient?s psycho-social status including level of understanding, perception of surgery, anxiety level, religious and cultural beliefs. Assess the physical and psycho-social needs of the patient and provide physical and emotional support as able.
• Verify patient?s allergies, NPO status and whether or not the patient has voided.
• Check the current history and physical and laboratory results, the execution of the preoperative orders and results of diagnostic tests.
• Verify that the surgeon is in the building and available before transfer of the patient to the OR.
• Assist the patient in moving to the OR table and check positioning
• Secure safety belt (on stirrups if cysto case, on OR bed if open case). Apply warm blankets to keep patient normothermic.
• Keep noise level to a minimum.
• Remain next to the patient during anesthesia induction. Assist anesthesiologist/anesthetist as needed, i.e. cricoid pressure during intubation, remove stylet, inflate cuff). Assist during extubation.
• Complete count with scrub nurse, if applicable
• Place grounding pad if required for case (check skin first-best on non hairy muscular area such as lower abdomen and mid to upper thigh) check for correct settings
• Perform skin prep (use prep tray for open cases). For cysto cases, the scrub nurse will complete Skin prep.
• Assist in gowning surgeon
• Connect suction, electrocautery unit, cysto tower, and/or other equipment as needed for case.
• Perform the Golden Moment according to policy.
• Check medication name, dosage and expiration date with surgeon and scrub nurse and pour on back table into a labeled container.
• Monitor the principles of aseptic technique throughout the intraoperative period.
• Keep an ongoing assessment of supplies needed versus supplies in the room. clean and restock room.
• Complete OR record accurately documenting the care given, the patient response to the care and other observations made.
• Remain in the OR at all times unless properly relieved by another RN.
• Toward the end of the procedure, prepare supplies for the dressing (circumcision, scrotal surgeries, inguinal approach).
• Complete count and notify surgeon if count is incorrect.
• Collect and accurately label specimen(s) (blue and green sheets, ID numbers, date demographics sheet).
• Apply dressings, connect drains and clean patient.
• Transfer patient to stretcher.
• Accompany the patient and anesthesiologist or anesthetist to PACU.
• Take specimen(s) with requisitions to designated area for specimens.
• Wash hands and change mask between cases and more often as needed.
• Bring clean stretcher back to OR hallway.
• Set up for subsequent surgeries or close down the room (OR must be terminally cleaned each day, if utilized)
• Check the crash cart, both refrigerators, narcotic cart and sign the checklist (Responsibility of the 7:30 nurse)
• Check the OR schedule for any additions or Cancellations, Pediatric, IVCS cases for the day
• Aware of closing and downtime unit responsibilities
• Be aware of and proficiently practice PACU patient care guidelines
• Check with DON or Charge Nurse during down time. Restock anesthesia workroom and sterile storage workroom.
• Appropriately cleans, and/or supervises cleaning of room and equipment.
• End of the day room checks, turning off oxygen on anesthesia machine and locking anesthesia cart after restocking.
• Follows procedures for laser cases.
• Resolves patient problems and needs by utilizing multidisciplinary team strategies.
• Maintains safe and clean working environment by complying with procedures, rule, and regulations; calling for assistance from health care support personnel.
• Protects patients and employees by adhering to infection-control policies and protocols, medication administration and storage procedures, and controlled substances regulations.
• Documents patient care services by charting in the patient?s medical record and other records.
• Answers the telephone or returns phone calls to patients taking care of the patient?s needs by either scheduling an appointment, calling refills on medications or answering patient and family questions.
• Reports off to the Director of Nursing or designee at the end of each day.
• Maintains continuity among nursing team members by documenting and communicating actions, irregularities, and continuing needs.
• Maintains patient confidentiality and protects operations by keeping information confidential and only accessing information on a need to know basis to maintain patient continuity care.
• Ensures operation of equipment by completing preventive maintenance requirements; following manufacturer?s instructions; troubleshooting malfunctions; calling for repairs; maintaining equipment inventories; and evaluating new equipment and techniques.
• Maintains nursing supplies inventory by checking stock to determine inventory level; anticipating needed supplies; placing and expediting orders for supplies as needed to accomplish job results.
• Maintains professional and technical knowledge by attending educational workshops; reviewing professional publications; establishing personal networks; participating in professional societies and maintain adequate CEU?s for re-licensure.
• Maintains and cooperative relationship among health care team members by communicating information; responding to requests; building rapport; participating in team problem solving methods.
• Contributes to team effort by accomplishing related tasks as needed.
• Understands and performs accurately responsibilities and duties assigned during Fire, Disaster, and Bomb drills and/or actual events.
• Abides by all regulatory agency guidelines including but not limited to OSHA, AHCA HIPAA, state and federal guidelines and laws delineating health care in the physician office practice, and reports issues to non-compliance matters to the Clinical Services Director.