I’m three weeks in to my DILP block placement of second year and thought I’d write a few words on placements at surgical theatres as they have a completely different atmosphere and routine to a ward environment. The role of the nurse within theatres covers three main areas; scrub, anaesthetics and recovery. While I’m here I have been given two mentors; one who mainly works as a scrub nurse and the other who covers anaesthetics and recovery, this really helps to get the most out of each mentors expertise in a specialist area.
For me the main difference has been that for most of the time the patient is in your care they are unconscious! Care of the anaesthetised patient is an important skill to learn but the dynamic between the nurse and the patient definitely changes when they can’t reply to you! This is why it’s so important to advocate for the patient when they can’t speak up for themselves. Of course it’s also crucial that you gain consent from the patient before their procedure to ask them if it’s okay for you to be there. Many patients are more than happy for you to be involved in their care to aid your learning but don’t take it personally if a patient would prefer if you weren’t present for their surgery.
Key topics I’ve covered with my scrub mentor are ANTT; one of the scrub nurse’s main responsibilities is to maintain the sterile field around the patient and the instruments used, theatres now use the WHO surgical safety checklist to ensure patients safety during surgery, particularly for instrument counts and checking the patient identity. Scrubbing in and gowning up will mean you can stand within the sterile field and you will be able to get a better view what’s going on- it can really help you brush up on your anatomy and physiology, especially as real organs aren’t as neat and colour coded as in your textbook!
Anaesthetics and recovery is a fantastic place to brush up on BLS skills, particularly airway management. The nurses and ODPs (Operating Department Practitioners) use an ABCD approach to focus their care and it’s also a great environment to learn more about pharmacology related to anaesthetic and analgesic drugs.
Some spoke ideas related to this area could be to follow the patient’s journey from their admission to discharge; spending time on the ward inpatients are transferred from prior to surgery and in critical care following their initial post op care in the theatre recovery area. Follow up clinics, related specialist areas and other aspects of their care surrounding surgery also make interesting spokes related to a surgical hub placement.
If you have a surgical placement or are spending time in theatres on a spoke, make the most of your time there and enjoy not having to wear your uniform! Once you’ve tried scrubs on, you won’t ever want to wear your uniform again- especially in summer!