questions

Running head: OPERATING ROOM 1

OPERATING ROOM 5

The operating room was an excellent experience. I was a bit nervous because it was the first time to observe a surgical procedure. However, I was able to learn more about the operating room. The operating room has various health care professionals such as circulating nurse, scrub tech, CRNA, assistant, and surgeon. In the operating room, the circulating nurse has several roles such as setting up the operating table by making sure that everything that required during the procedure is available, acquiring pre-operative information of the patient, filling the charts and also making sure that the patient receives post-anesthesia care unit safety.

Time out referred to as a pause which is called by a designated member of the surgical team in order to verify the patient’s information, the surgical site, and the procedure to be undertaken. Everyone in the operative room is ready to start the surgical procedure, but they all have to stop for this vital process to complete. A nurse gives information about the patient, including the date of birth, the procedure which is being performed, history of medication and allergy. The vital process because it ensures that the safety of the patient is maintained. The surgeons beings the procedure once the information of the patient has been verified to be correct. Timeout process is comparable with safety checks when administering medication to patients in the wards in order to ensure that patients receive the right drug.

There are various safety guidelines which must follow in the Operating room. When the patient transferred from the operation room. They help in preventing wrong-site surgery, retained foreign bodies or wrong-procedure errors (Redley et al., 2016. These guidelines included counting the instruments and materials which are being used for the surgery before and after the surgical procedure, maintaining sterility of all the surfaces, checking the armband and date of birth of the patient, removing all the contaminated materials, gloves and clothing immediately and time out. Sterility is maintained throughout the surgical procedure to protect the patient from acquiring hospital-related infections which cause poor recovery outcomes.

Before the surgical procedure, the nurse will arrange the operating room, bring the patient from pre-operative and take a brief history of why the patient is here, who is their doctor, history of any allergies, site of surgery and if the patient has any concerns or question about the surgical. Also, the CRNA (Certified Registered Nurse Anesthetists) explained to the patient about the anesthesia procedure then the patient move to the operative room. The circulating nurse starts to clean the site of surgery. Also, the circulating nurse will count all the materials such as gauzes and instruments which will be used to perform the procedure and writes them down on aboard. Before the surgeon stitches the patient, the nurse counts the materials and instruments again to ensure that there were no foreign materials which have left in the patient’s body. When the surgical procedure is underway, the circulating nurse undertook various responsibilities during the procedure, such as opening the packs which contain sterile materials for the procedure without touching them, turning the lights and other machines on, recording the charts and performing all other activities which are not sterile.

The nursing diagnosis is impaired skin integrity related to the surgery as evidenced by the open wound as a result of the surgical incision, redness and warmth around the wound. The interventions for this diagnosis would be to clean the wound antiseptically, keeping it dry in order to prevent infection, preventing physical strains and also adequate hydration and nutrition care for wound healing. Reducing physical strains is vital because it helps in preventing the stitches which have been put to open and also ensures that the newly formed skin integrity is maintained. This is accomplished by positioning and teaching the patient on various techniques to enable them to tolerate activities. The goal is the patient will be able to verbalize skincare including dressing change and sign and symptoms of infections by 1700. In evaluation, the goal was not met because there was evidence of redness and warmth around the wound, the patient was unable to perform activity daily level by self which increases the straining due to the invasive procedure.

An ethical dilemma is the minors not having a chance to give their opinion about the surgical procedure. It is established that before any surgical procedure, healthcare practitioners must obtain informed consent to the patient (Grady, 2015). However, when it comes to minors, consent is obtained from their parents or guardians. Obtaining consent from parents or guardians may seem to be straight forward but the issue raises when the minor patient has a different opinion about their opinion or when they want different treatment option other than what their parents or guardian wants? This raises the ethical dilemma because I would suggest than the surgical decision making for minors to be an interdisciplinary and collaborative approach. The law considers minors to be incapable of giving consent except on specific occasions like when the court has ordered a discharge. This becomes an ethical dilemma for health practitioners because their principal role is to the individual patient and not to the community or healthcare system.

Personally, I found this rotation to be exciting and I enjoyed it. I observed various surgeries such as panniculectomy/abdominoplasty, hysterectomy and Incision/drainage lower extremity. I enjoyed the role of the circulating nurse rather than the role of the scrub tech. I would rather be charting and gathering all the supplies needed for the procedure instead of being involved much in the surgical procedure. Also, I found it easier to offer care to patients for a few minutes as a circulation nurse is better than offering bedside care to patients every day.

References

Grady, C. (2015). Enduring and emerging challenges of informed consent. New England Journal of Medicine, 372(9), 855-862.

Redley, B., Bucknall, T. K., Evans, S., & Botti, M. (2016). Inter-professional clinical handover in post-anaesthetic care units: tools to improve quality and safety. International Journal for Quality in Health Care, 28(5), 573-579.