Jeff Magtira, RN, MSN

A. Circulating Nurse

The one who is responsible for attending to the needs of the surgeon, his or her assistant, the anesthesiologist, scrub nurse and patient and acts as a member of the sterile team. He or She is responsible for the management and delivery of patient care utilizing the nursing process. Performs other duties as assigned. Adheres to the standard practice of the institution as appropriate based on the level of patient contact this position requires:

1. Reads schedules and notes time, type of case and anesthesia to be used.

2. Prepares rooms and arranges equipment and supplies.

3. Tests lights, suction machines, and oxygen apparatus to be used.

4. Receives patient by checking and verifying identity with patient, patient's relatives, and/or nurse assigned.

5. Assists the anesthesiologist in anyway required.

6. Assists in positioning the patient on the operating room table, fracture table, and others.

7. Exposes and assists in preparation of operative field in patient.

8. Sees that all individuals coming in the operating room are wearing the proper apparel.

9. Verifies site of the procedure with the surgeon and anesthetist.

10. Assists the scrub nurse and surgeon with their sterile gowns.

11. Initiate “Time Out” a universal protocol in preventing wrong site, wrong person, and wrong surgery prior to cutting time.

12. Gives any medications and solutions ordered by the attending physician.

13. Keeps floor clean of soiled sponges, linens and other materials throughout the case.

14. Labels all specimens with patient's full name and leaves in the room until recorded in the specimen logbook, and sends to the laboratory department.

15. Checks sponge count with the scrub nurse as soon as the surgeon is ready to close the wound.

16. Prepares stretcher and have all things ready for dressing, dry gown, and blanket.

17. Enters patient's name and type of operation on record slip or in record book and documents necessary data on the patient's chart.

18. Gives patient's chart to recovery room nurse and calls his or her attention for any special orders.

19. Prepares room for the following case.

B. Scrub Nurse

Responsible for attending to the surgeon and his or her assistants needs intra-operatively by maintaining standard aseptic technique in the sterile field. Assume responsibility for the management and delivery of patient care utilizing the nursing process. Performs other duties as assigned. Adheres to the standard practice of the institution as appropriate based on the level of patient contact this position requires:

1. Reads schedule and notes time, type, case, and anesthesia.

2. Checks and prepares instruments to be used during the procedure.

3. Scrubs hands and arms according to required time and scrub procedure, dry thoroughly, and puts sterile gown and gloves.

4. Carries out proper technique throughout the operation systematically, accurately, aseptically and conscientiously.

5. Maintained aseptic surgical technique throughout the case.

6. Handles all instruments, needles, and sponges during the operation responsibly.

7. Places instruments within reach and places all contaminated instruments in basin and removes from operative field.

8. Keep instruments and mayo stand and back table clean, neat, and in order.

9. Checks sponge count with circulating nurse and reports the count to the surgeon as soon as he is ready to close the wound.

10. Prepare the final dressings, aseptic sponge, and gauze dressings.

11. Removes needles and knife blade from handle and places in sharp dispenser.

12. Anticipates needs for the case to follow and re- scrubs according to scrub procedure.

13. Assists the circulating nurse in replacing sterile and unsterile materials used during the day, leaves the operating room in an orderly arrangement.

C. Recovery Room Nurse/ Post Anesthesia Care Unit (PACU) Nurse

Responsible in providing constant care to patients immediately following surgery from recovery room until the patient is stable enough either to be transported to his or her room or discharged from the facility. Assumes the responsibility for the management and delivery of patient care utilizing the nursing process..Perform other duties as assigned. Adheres to the standard practice of the institution as appropriate based on the level of patient contact this position requires:

1. Receives patients straight from the operating room after having anesthesia.

2. Monitors patient's vital signs, intake and output, oxygen, and intravenous fluids.

3. Recovers the patients until they may safely be discharged.

4. Checks over post- operative prescriptions.

5. Perform all discharge teachings with family members and caregivers that will be providing post-operative care to the patient. This includes medication teaching.

6. Re- stocks the recovery room and makes sure all equipment are in safe working condition.

7. Checks E- cart weekly to ensure the medications are current. Checks equipment daily to ensure that suction or defibrillator are working properly.

8. Performs within the established standard of post anesthesia and critical care nursing.

9. Formulates care plans based on individual assessment of physiologic functions and problems identified pre-operatively and intra- operatively.

10. Provides nursing care utilizing clinical knowledge and expertise, reacting immediately to adverse physiological changes within seconds, to reverse and revive the patient's physiological functions.

11. Renders nursing care following aseptic technique.

Assistant Ancillary Head

1. Directs and implements rules and regulation in accordance to the existing protocols of ancillary departments.

2. Act as a representative of Ancillary office in the absence of the Head.

3. Designated person for approval of various diagnostic test and procedures.

4. Ensure that all ancillary services are promoting patient’s safety and in compliance to the minimum health standards set forth by the respective implementing rules and regulations of each department especially hospital protocols.

5. Distribute hospital memorandum and policies and ensure that each department will follow and observe such.

6. Coordinate and communicate with other department such as nursing service, administrative and medical for ancillary concerns and new regulations.

7. Act as coordinator to outside institutions and other referrals seeking ancillary services.

Cases Handled

General Surgery

1. Modified Radical Mastectomy

2. Exploratory Laparotomy

3. Wound Exploration

4. Colon Surgery

5. Hemicolectomy

6. Appendectony

7. Laparoscopic Cholecystectomy

8. Cholecystectomy, with intraoperative common bile duct exploration

9. Biliary Surgery

10. Thyroidectomy

11. Herniorrhaphy/Mesh Herniorrhaphy

12. Fistulotomy, Fistulectomy

13. Hemorrhoidectomy

14. Fistulectomy

15. Circumcision

16. Excision of Breast Mass

17. Excisions of ( ganglion cyst, dermoid cyst, baker’s cyst, sebaceous cyst, mole)

Obstetric and Gynecology

1. Cesarian Section (Low Transverse, Pffaneinsteil )

2. Bilateral Tubal Ligation

3. Total Abdominal Hysterectomy and Bilateral Oophorectomy (TAHBSO)

4. Extrafascial Hysterectomy and Bilateral Oophorectomy (EHBSO)

5. Oophorectomy with Frozen Section

6. Endometrial Biopsy

7. Curettage (Dilatation, Fractional, Completion)

8. Cystoscopy

9. Culposcopy (w/ cervical punch biopsy, vaginal mass biopsy)

10. Perineorrhaphy

11. Hysteroscopy (w/ polypectomy, resection of polyps)

Urology

Transurethral Resection of the Prostate (TURP)

1. Orchiectomy

2. Orchidopexy

3. Nephrectomy

4. Cystolithotomy with Dilatation

Ophthalmology

1. Cataract Removal (Phacoemulsification)

2. Trabeculectomy

3. Extra-Capsular Cataract Extraction with Posterior Chamber Intraocular Lens

4. Incision and Curettage (Chalazion)

5. IOL implantation

ENT

1. Thyroidectomy (Total, Sub total, Isthmusectomy)

2. Parotidectomy

3. Tonsillectomy

ThoracoVascular Surgery

1. Intrajugular (IJ) Catheterization

2. Arteriovenous Fistula (AVF) Creation with Gore Tex Implantation

Orthopedic

1. Close Reduction External Fixation

2. Open Reduction Internal Fixation

3. Below Knee Amputation (BKA)

4. Total Hip Replacement

5. Ray Amputation

6. Release of Carpal Tunnel

7. Release of Trigger Finger

8. Achilles Tendon Repair

9. Fasciectomy

10. Neuroplasty