RNSA - Certified Operating Room Memorial Hospital

Position: RNSA - Certified -- Operating Room -- Memorial Hospital
Job Summary

Demonstrate advanced clinical skills to meet needs of patient groups; formulate plans of care that have long range effect on patient care; assist unit staff members to perform advanced skills; act as a role model which facilitates positive behavior in dynamic group setting; recognize need for change in nursing practice and initiate change process on unit; proactive to identify potential legal/ethical/safety issues and implement strategies to prevent problems.

Functions under direct supervision and direction of the surgeon in the expanded perioperative nursing role of surgical assistant. Performs all nursing activities in the pre-operative, intra-operative phase of the surgical procedures, but does not concurrently function as the scrub nurse.

Responsibilities

* Expedites the operative procedure by anticipating the needs of the surgeon.

* Demonstrates advanced knowledge of normal and pathological anatomy and physiology.

* Demonstrates knowledge of emergency situations, organization skills, and professional attitude.

* Assist the operating room team by preparing the OR suite for surgical procedures in a timely manner.

* Practice aseptic and sterile techniques.

* Apply appropriate cleaning techniques in the operating room.

* Participate during the procedure by handing instruments and supplies to the surgeon.

* Anticipate the needs of the surgeon during the procedure.

* Assist with applying the dressing to the incision.

* Clean and restock the room assigned.

* Assist with in-service and training of new personnel.

* Take call as assigned.

* Positioning the Patient The surgeon shall convey the exact position that will give the best exposure for the surgical procedure. The surgical assistant will carry out this order. Points of pressure shall be padded: elbows, heels, knees, eyes, face, and auxiliary region. Circulation shall not be impaired. (A tourniquet may be required for some procedures.) Nerve damage shall be guarded against.

The temperature of the patient should be discussed with the anesthesia personnel and methods employed to maintain the desired temperature range. The surgical assistant shall be familiar with common positions as they relate to the surgical procedure and will be able to use the equipment necessary to provide the position. Competencies will include the following:
1)
Fracture Table,
2) Head stabilizer,
3) Body stabilizers,
4) C-arm extensions,
5) Any other equipment needed Upon completion of the procedure, the patient shall be evaluated for any possible damage from positioning, which shall include assessment of the skin. The abnormal condition shall be reported to the surgeon and treatment and documentation shall be carried out.

* Under the direct supervision of the surgeon: uses appropriate tissue dissection techniques to facilitate an optimum surgical outcome. If established competencies exist, this may include:
Trocar Placement Preparation of Allografts Saphenous Vein Harvesting:
Endoscopic and Open (Open EXCLUDES Femoral Triangle) (see Institutional Criteria) Radial Artery Harvesting:
Endoscopic and Open (see Institutional Criteria) Ultrasound Guided Femoral Arterial Line Insertion (see institutional Criteria) Knot Tying Closure of Layers
• Providing visualization of the operative site by the following:
Appropriate placement and securing of retractors with or without padding. Packing with sponges. Digital manipulation of tissue. Suctioning, irrigating, or sponging. Manipulation of suture materials (e.g., loops, tags, running sutures). Proper use of body mechanics to prevent obstruction of the surgeon's view.
• Utilizing appropriate techniques to assist with homeostasis. Permanent • •
• Clamping and/or cauterizing vessels or tissue. • •
• Tying and/or ligating clamped vessels or tissue. • •
• Applying hemostatic clips. • •
• Placing local hemostatic agents. Temporary • •
• Applying tourniquets and demonstrating awareness of indications/contraindications for use with knowledge of side effects of extended use. • •
• Applying vessel loops. • •
• Applying non-crushing clamps. • •
• Applying direct digital pressure.
• Participating in volume replacement or auto transfusion…