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OR Circulator Registered Nurse

Position Summary:

The Circulator RN is the surgical team member who is responsible for coordinating and controlling the multi-disciplinary activities required to provide a safe environment for patients undergoing surgical intervention.

Responsibilities:

Performance of the duties of the Circulator, according to the set standards, is crucial to the smooth flow of events before, during, and after a surgical procedure.  The Circulator should:

• Be thoroughly familiar with and totally comfortable in the role of patient advocate, as applied to Operating Room nursing.
• Assume the responsibility for Improvement of patient safety during the state of enforced dependency created intra-operatively.
• Responsible for creating a safe, therapeutic environment in which the patient's psychological, physiological, and physical needs are identified, anticipated, and met.
• Provide a channel of communication between events and team members in the operating room and persons who may not be in the immediate area, but who are concerned with the patient's operative status.
• Make provisions for instrument, supply, and equipment requirements of surgical procedures, as assigned.
• Responsible for documenting accurate, timely data appropriately.  (This includes documentation of Charge sheets, Incident Reports, Nursing Notes and Surgical Logs.)
• Must file an incident report for any unusual event that occurs to a patient or member of staff; this would include, but not be limited to, falls, needlestick injuries, aspiration of gastric contents, allergic reactions, and disruptive behavior by staff or patients. Also required to report any incidences or alleged incidences of abuse, harassment, or injury to self, other employees, or patients occurring at the Center or relating to the Center. Further specifications can be found in the Abuse Reporting documents and Code of Safe Practices, provided by the Director of Nursing.

Pre-Operative

• For proper identification of patient and plan of action intra-operatively, check O.R. schedule to determine patient's name, Surgeon, Anesthetist, and the nature of the surgical intervention.
• Requests drugs as required by Anesthetist or Physician.
• To ensure the patient’s safety and comfort and smooth flow of procedure, inspect the O.R. to be certain it is clean, complete, and safe.  All equipment, to include lights and suction, should be checked for safety, functioning capability, and complete assembly.
• Direct and assist surgical technician in preparing for the surgical procedure according to established procedure and the Surgeon's preference card.
• Conduct surgical Count s with the surgical technician and document.
• To decrease patient's anxiety and help plan nursing actions intra-operatively, greet the patient in Pre-Op Holding Area for the purposes of identification, physical/psychological assessments.
• To ensure patient safety, accompany patient to the O.R. and assist in the transfer to the operative room table.
• From this point on, the Circulator remains at the patient's side during the induction of anesthesia until the patient is anesthetized, positioned safely, and fastened securely to the operating room table.  Activities include, but are not limited to:
  • placing and securing the safety belt.
  • placing monitor electrodes per established procedures.
  • assures that oxygen flow alarm is turned on at time oxygen is turned on.

Intra-Operative

• Anticipate the needs of the surgical team and provide supplies and equipment as requested.
• Coordinates all activities within the O.R. to provide for a non-eventful, safe, effective and timely surgical intervention.
• Provides for patient's needs, both physiologically as well as psychologically.  Maintains an environment free of disturbing sounds and statements.  Is ever alert for any break in technique which may contaminate the operative field.
• To provide safe patient care, maintains a running tally of sponge count materials and needles, and documents, informing surgeon of discrepancies.
• Be responsible for specimen handling -- to include accurate and complete identification on labels and tickets, placement in appropriate containers/solutions – and dispatch to laboratory per established procedures.
• For medico-legal indices, maintains accurate records of patient-oriented data during the surgical procedure, i.e., vital signs.
• Assist with dressing.

Post-Operative

• To provide assistance as needed for delivery of patient care, remain at patient's side and assist Anesthesiologist as required with suctioning, extubating, etc., transfer to post-op gurney or wheelchair if patient receives only local anesthesia.
• Deliver a patient condition report to the nurse in the Recovery Room area to identify problems or potential problems, as well as identify any dressings.
• For purposes of evaluation of patient care, complete documentation and distribute to designated area.
• To ensure that appropriate specimens are identified and delivered to appropriate area, make certain that all specimens have been placed for dispatch and entered in Specimen Log.
• Direct and assist with between case clean-up to provide smooth flow of to-follow cases.
• To promote safe patient care delivery, inspect the room and proceed to prepare for the next case, as assigned.
• If last case of day, is responsible to direct or perform all terminal cleaning activities.
• Turns off oxygen at the end of surgery day.
• Assures that sufficient sterile packs are prepared for the following day's surgery.

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Qualifications:

• Graduate of an accredited school of nursing.
• Current RN (Registered Nurse) licensure in the State of California.
• Current BLS, ACLS, PALS (if applicable) certification.
• Maintains current RN licensure and BLS, ACLS, and PALS (if applicable) certification.
• 2 years of OR Circulator nursing experience.
• Thorough working knowledge of surgical and aseptic technique.
• Ability to interpret diagnostic measures such as labs, chest x-ray, and EKG.
• Full command of the English language, both verbal and written.
• Ability to serve as a patient advocate throughout the (perioperative and postoperative phases).
• Ability to problem-solve and exhibit solution-based thinking.
• Must possess the physical ability and perceptive acuity (e.g., visual, hearing) to satisfactorily perform all direct and indirect care functions.
• Must be able to lift up to 25 pounds independently.
• May need to push patients in wheelchairs or on gurneys and should seek assistance whenever necessary.
• Assistance is required when moving patients who cannot assist themselves, except when using a wheelchair or gurney.
• Meets the needs of the center as demanded by the surgical schedule, including flexibility for overtime or schedule changes.
• Assists in the O.R. as necessary.