Circulating RN, Operating Room

Job Summary

Provide direct patient care to pediatric through geriatric patient populations. Address the psychosocial, physical, and general aspects of care related to the surgical environment. Communicate with surgeon/physician and anesthesia personnel continuously and as needed about patient condition. Assist with the maintenance of surgical equipment and inventory. Participate in performance improvement activities. Assess operating room for equipment functioning and readiness; obtain supplies for individual cases, and ensure all appropriate needs of the surgical operating team are met. Monitor, position, and assist patient during procedures. Provide scrub skills for required procedures as needed. Provide conscious sedation for appropriate procedures and patients. Function as first license in pre-op/post-op area and as "second" scrub as caseload requires.

Essential Duties & Responsibilities – Pre-Operative

Procedures

• Adapt procedures to meet individual needs of pediatric, adolescent, adult, and geriatric patients.

Standard Procedures

• Follow standard procedures for surgical/procedural intervention, adapting for surgeon and anesthesia preference. 
• Use preference cards, as needed, updating regularly as changes occur.

Teaching/Education

• Coordinate and supervise patient care; provide patient and family with teaching/education as necessary.

Readiness

• Ready and prepared consistently for assigned cases; does not cause delay of case; minimize turnover time.

Pre-Op Checklist

• Ensure pre-op checklist is complete and all consents are signed before patient is taken into surgical suite.

Patient and Family

• Approach patient/family in a kind, gentle, and friendly manner while protecting patient sensitivities and right to privacy. 
• Compassion and caring should be demonstrated at all times.

Essential Duties & Responsibilities – Intra-Operative

Behavior and Physiologic Changes

• Observe behavioral and physiologic changes due to medications; take appropriate actions and document.

Medication Knowledge

• Demonstrate knowledge of anesthetic drugs, actions, and side effects; and knowledge of IV conscious sedation/or medications (actions and delivery).

Surgical Knowledge

• Demonstrate thorough knowledge of location, care, and operation of all surgical equipment/instruments.

Positioning of Patient/Draping/Asepsis

• Position patients safely; pads and protects bony prominences and protecting nerves. Prep and drape patients correctly for all procedures. 
• Carry out medical and surgical asepsis during all procedures.

Intra-Operative Care Documentation

• Document intra-operative care; be clear, concise, accurate, and timely. 
• Note unusual occurrences and initiate variance report if required.

Essential Duties & Responsibilities – Post-Operative

OR Suites

• Demonstrate competence in preparing and cleaning of OR suites before and between cases and after terminal cases, based on patient's infection class.

Patient's Condition

• Give thorough report of patient's intra-operative condition to PACU nurse.

Instrument Knowledge

• Demonstrate thorough knowledge of instrument processing, sterilization, and biological monitoring. Actively participate in instrument processing.

Essential Duties & Responsibilities – General

Narcotics

• Count narcotics at end of shift with another RN, or other appropriate licensed personnel, per facility policy.

Emergency Situations

• Recognize and respond to emergency situations in an appropriate and timely manner.

Required Education

Associate’s or Bachelor’s Degree in Nursing program

Required Certification(s) & Licensure(s)

• Current State of Wyoming RN License 
• Current BLS (Must be through the American Heart Association)
• Current ACLS (or obtain within one year of hire) (Must be through the American Heart Association)
• Current PALS (Must be through the American Heart Association)
• IV Conscious Sedation Course Work
• Course Work (i.e. A Competency-Based Orientation Program for the Registered Nurse in the Perianesthesia Setting)
• Orientation Packet and Competency Skills Checklist Within 90 Days of Employment
• Basic EKG competency on hire and annually thereafter (Basic EKG interpretation course is required for new grads and if competency cannot be shown on hire)

Physical Requirements

• Must be able to read patient charts and use a computer, as well as visually evaluate patient condition and environment
• Must be able to hear well enough to communicate with patient, physicians, medical staff, and co-workers
• Must be able to verbally communicate with patients, physicians, medical staff, and co-workers to convey and receive instructions
• Must be able to write and type to document patient condition, as well as perform duties requiring fine motor skills
• Must be able to lower oneself in order to facilitate patient care
• Must be able to stand and sit for extended periods of time

Weight Demands

• Must be able to lift 75 pounds or less
• Must be able to maneuver patients and equipment to facilitate patient care

Working Conditions

Environmental Hazards 

• The fast-paced environment may lead to increased levels of personal stress and demand high mental acuity.

Physical Hazards

• Physical harm is possible when performing physical requirements, as listed above.  
• Exposure to communicable disease, bodily fluids, and/or toxic substances is possible and can be physically harmful.

Unique Work Schedule/Travel 

• May be required to work after hours, on weekends, or holidays.  
• May be required to provide services outside the clinical setting (i.e. at University or High School athletic events), or travel to offices throughout the state.