Position Title: Registered Nurse - Circulator/Scrub
Supervisor: Director of Nursing
Supervises: None
Mission and Values:
In the performance of one’s job, the employee reflects the Company Mission by participating in the provision of convenient cost-effective, quality surgical care.
Values: Confidentiality
Quality
Teamwork
Trust
Respect
Job Summary:
Utilizes the nursing process to provide comprehensive nursing care during the peri-operative phase. Coordinates total patient care in coordination with other health team members particularly the Center’s team. Functions as a patient advocate utilizing the Patient’s Bill of Rights. Demonstrates professional growth and development by accepting responsibility and accountability for one’s nursing practice.
Key Areas of Responsibility:
A. Assessment
- Competency to assess the physiological health status of the patient.
- Verifies the operative procedure using the consent form, the patient’s statement and if needed the surgeon’s verification prior to procedure.
- Notes the condition of the skin for rashes, bruises, lesions, and previous incisions.
- Determines mobility of the body using the patient’s statement, range of motion, and the history and physical.
- Reports deviation of diagnostic studies such as lab or radiology reports.
- Checks pre-operative vital signs upon admission to surgery: blood pressure, pulse, respirations, and temperature.
- Notes nutritional status such as patient has been NPO.
- Verifies allergies to medication, food, or chemicals.
- Communicates and documents physiological data to other members of the surgical and health care team in verbal or written report, including data which might be relevant to discharge planning.
- Competency to assess the psychological health status of the patient/family.
- Elicits patient expectations of care and outcome of surgery.
- Determines level of knowledge and ability to understand, such as language barrier and seeks assistance as necessary.
- Identifies philosophical, religious, and cultural beliefs concerning the intraoperative phase, such as blood transfusions, disposition of limbs, and sacraments.
- Communicates and documents psychological data to other members of the surgical and health care team in verbal and written report, including data which might be relevant to discharge planning.
3. Formulates nursing diagnosis based on health status data.
B. Planning
- Competency to establish realistic and attainable goals based on nursing diagnosis and to develop a plan of care based on nursing actions to achieve patient goals.
- Provides positioning aids during the intraoperative phase to prevent skin breakdown or impairment of the nervous or vascular system.
- Provides equipment to insure patient safety in regard to electrosurgery and laser.
- Coordinates use of supplies and equipment for intraoperative care.
- Organizes nursing activities in logical sequence, prioritizing nursing actions.
- Coordinates patient care needs with other members of the surgical and health care team.
- Assigns activities to appropriate personnel based on their qualifications and patient needs.
- Maintains required certifications (CPR) and performs effectively in an emergency situation.
- Communicates and documents patient’s plan of care to other members of the surgical and health care team in verbal and written report, including that which might be relevant to discharge planning.
C. Implementation
- Competency to implement nursing actions in transferring the patient according to the plan of care.
- Confirms the patient identity using bracelet and patient’s statement.
- Selects appropriate personnel for transport as determined by patient acuity and number of staff needed.
- Determines appropriate and safe method of transport.
- Provides for emotional needs during transport.
- Communicates and documents method of transport.
- Competency to participate in patient/family teaching.
- Participates in pre-operative teaching as needed, such as explanation of surgical routine and environment.
- Communicates and documents patient/family teaching.
- Competency to create and maintain a sterile field.
- Uses principles of aseptic technique in varying situations, such as infection control practices, skin preps, demonstrated knowledge of clean vs. sterile.
- Initiates corrective action when breaks in technique occur.
- Maintains sterility while opening sterile items for procedure, including pouring solutions.
- Inspects sterile items for integrity of package, sterile indicator and/or outdate prior to delivery to the field.
- Adheres to dress code policy for peri-operative area(s).
- Monitors suite to ensure that movement around the sterile field is appropriate at all times.
- The R.N. circulator duties include being in the OR suite during the intra-operative phase.
- Communicates and documents maintenance of / compromise of sterile field.
- Competency to provide equipment and supplies based on patient needs.
- Anticipates needed equipment and supplies, utilizing the surgeon preference card.
- Selects equipment and supplies in an organized, timely and cost-effective manner throughout the peri-operative phase.
- Assures all equipment is functioning before use.
- Operates mechanical, electrical, and powered equipment according to manufacturer’s instructions and the Center policy.
- Removes malfunctioning equipment from service, tags it appropriately and initiates repair.
- Uses supplies judiciously and in a cost-effective manner.
- Communicates and documents provision of equipment and supplies including charges.
- Competency to perform sponge, sharps and instrument counts.
- Follows policies for sponge, sharps, and instrument counts.
- Initiates corrective action when a count is incorrect.
- Communicates and documents results of counts according to policy.
- Competency to administer drugs and solutions as prescribed.
- Administers medications according to policy.
- Communicates and documents administration of medications and solutions according to policy, including medication errors.
- Competency to physiologically monitor the patient during the peri-operative phase,
- Assists/monitors physical symptoms, behavioral changes, intake and output, and vital signs.
- Initiates nursing actions or obtains physician order as appropriate, based on interpretation of physiological data/changes.
- Communicates and documents patient’s physiological response to other members of the surgical and health care team in verbal or written report, including that which might be relevant to discharge planning.
- Competency to monitor and control the environment.
- Controls the environment to provide ultimate patient care, such as temperature of room, sensory stimuli, and traffic and noise level.
- Adheres to all safety policies and procedures.
- Maintains appropriate traffic pattern in the peri-operative environment.
- Adheres to sanitation policies for infection control including confine and contain and waste disposal.
- Communicates and documents environmental controls or breaks in technique promptly and appropriately.
- Competency to respect patient’s rights.
- Demonstrates awareness and practices according to the Patient’s Bill of Rights and Center policy.
- Provides for patient safety and maintains patient confidentiality.
- Communicates and documents provision for patient’s rights as appropriate.
D. Evaluation
- Competency to perform nursing actions that demonstrate accountability.
- Exercises safe judgment in decision-making.
- Demonstrates flexibility and adaptability to changes in nursing practice.
- Responds in a positive manner to constructive criticism or recommendations for improvement.
- Demonstrates tact, understanding and good guest relations when dealing with patients, visitors, team members, and other units.
- Practices within ethical and legal guidelines.
- Seeks opportunities of continued learning.
- Communicates and documents nursing actions.
- Competency to evaluate patients.
- Develops outcome criteria and measures degree of achievement.
- Communicates and documents degree of goal achievement to other members of the surgical and health care team in verbal and written report, including that which might be relevant to discharge planning.
- Competency to evaluate effectiveness of nursing care. Continuously evaluates the patient’s needs, plan of care, and nursing actions, adjusting the plan as required to provide optimum patient outcomes.
- Assesses the patient post-operatively and determines the effectiveness of care to desired patient goals.
- Communicates and documents effectiveness of care and results of nursing care to other members of the surgical and health care team in verbal or written report, including that which might be relevant to discharge planning.
- Participates in the Quality Improvement Program activities including identification of aspects of care, collection and analysis of data, formulation of recommendations, implementation of an improvement plan and evaluation of the process.
- In keeping with the teamwork philosophy, acts as a resource person to other staff.
- Adheres to OSHA guidelines for Universal Precautions for exposure to blood and body fluids, using appropriate personal protective equipment (PPE).
- Participates in the orientation of new employees, students and approved program participants.
- Attends Center staff and unit meetings, and educational opportunities.
- Demonstrates flexibility in meeting the needs of the Center.
- Follows AORN Recommended Practices and the Center’s policy at all times.
- Assists visitors, staff and physicians, utilizing good guest relations.
MINIMUM KNOWLEDGE, SKILLS, AND ABILITIES REQUIRED:
- Current State of New York nursing license.
- Current CPR licensure / ACLS.
- Required to successfully complete facility-wide competencies and medication administration exam provided.
- Demonstrated interpersonal communication skills.
- Prior knowledge of surgical instrumentation and peri-operative equipment or ability to learn same.
- Requires prolonged periods of standing and walking.
- Requires ability to perform lifting and transport of patients; and lifting of instrument trays and equipment weighing up to 40 pounds.
- Ability to work with a minimum of supervision and to organize work in order of importance.
- Ability to work effectively in stressful situations and in a variety of peri-operative environments.
- Requires manual dexterity to operate equipment and handle instrumentation, hearing to understand verbal instructions and near vision to distinguish supplies and instrumentation.
WORKING CONDITIONS:
- Accountability to OR Supervisor/Director of Nursing with indirect accountability to Management team.
- Normal peri-operative environment with exposure to chemical odors, cleaning solvents and other hazardous materials. Must follow established procedures to ensure safety.
- Exposure to possible injury when working with electrical equipment and lasers which require care and following proper safety procedures.
Based on the OSHA guidelines for protection against exposure to Hepatitis and HIV, this position is described as Category I. This means that this position has exposure to blood and body fluids. Policies are in place for Universal Precautions identifying exposure risks and appropriate barrier protection.
The above is intended to describe the general content and requirements for the performance for this position. It is not to be construed as an exhaustive statement of duties, responsibilities or requirements.
Pay: $52.00 - $58.00 per hour
Work Location: In person
