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Theatre Nurses need their work 'family', amid specialist shortages and lack of continuity of care

Photo: Theatre Nurses need their work 'family', amid specialist shortages and lack of c....
Theatre nurses are particularly reliant on their nursing ‘family’ as they manage the challenges of their field, such as lack of continuity of care and low numbers of specialist perioperative nurses.

As the title suggests, Theatre Nurses work in an operating environment, but their specific duties vary depending on where they work and what speciality they choose.

Generally, they have exceptional skills in the areas of scrubbing, scouting, anaesthetics and recovery.

“Their knowledge and ability extends to expertise in instruments, implants, sterilisation, ordering, coordination, problem solving, critical thinking, clinical judgement, education and leadership, to name just a few,” says Fiona Sewell, Adjunct Associate Professor, Executive Director of Nursing & Midwifery Services.
“Theatre nurses have close relationships with surgeons, anaesthetists and theatre wardsman, forming a mutually respected and highly valuable part of the perioperative team.”

The requirements of a theatre nurse differ from that of an acute care inpatient unit nurse.

“Nursing is such a diverse occupation with many roles differing in knowledge, skills and flow.

“Registered nurses working in theatre receive the same initial training and education as all registered nurses.

“They are registered to work in any nursing role, however have chosen the speciality of theatre.

“As such, they have undertaken additional training in the area of perioperative nursing.”

Whilst a beginning registered nurse specialising in theatre requires the same degree as all other RN’s - Bachelor of Nursing, they will receive ‘on the job training and development’, as well as opportunities to attend a PIP course (perioperative intensive program - 5 day intensive perioperative training).

“And it is highly desirable that they undertake a post graduate certificate or masters in the field of perioperative education,” says Associate Professor Sewell.

A typical day for a Theatre Nurse might start at 8am and begin with scrumming at the coordination board followed by a discussion around any new or revised internal processes.

“They will then be allocated a theatre and theatre team; once in the theatre, they’ll plan the session, check equipment, call for first patient, prepare for first case, do the case, clean the theatre and prepare for next case and so on.

“During each case the scrub nurse prepares the instruments, ensuring all are working, in good condition, sequenced appropriately, counted and passes the instruments as required to the surgeon.

“A good scrub nurse anticipates what the surgeon requires and has it prepared and ready for them before and most often without being asked.

“This saves time and uses the collective knowledge of all team members to achieve the best patient outcomes.”

Unfortunately, there’s a national shortage or trained and experienced perioperative nurses – one of several challenges faced by Australian Theatre Nurses.

“There are also operational challenges with ensuring the most effective and timely use of the theatre suite, ensuring the most emergent patient receives their required procedure at the appropriate time.

Associate Professor Sewell says the perioperative suite is a close working environment, meaning everyone has an absolute reliance on every other team member.

“As such the ‘family’ within the perioperative suite know each other well and quickly work out how best to work with each other’s skill set and personalities.

“Frequent changing of the team creates a change in the team dynamic’s and challenges with building those critical relationships.”

It also results in a lack of continuity of care for patients, posing challenges for both the patient and the nurse.

“Continuity of care provides the patient with a familiar nurse. The nurse gains a deeper understanding of the patient and the needs and goals of the patient.

“Continuity of care within a perioperative setting is a little more challenging.

“Continuity of care within a theatre setting is most likely in relation to having the same nurses work within a particular speciality for example, orthopaedics.

“This enables a highly specialised nurse for each area, enabling the anticipation of challenges and problem solving to be exceptional and expert mentoring, coaching and educational development of other nurses learning this speciality.

“However, in non-tertiary hospitals, it also creates a challenge operationally, as smaller perioperative suites have a smaller number of nursing staff and therefore they are required to have expert knowledge and be able to efficiently work in all areas.”

Due to the vast challenges and special requirements of a Theatre Nurse, those who choose to enter the field should be flexible and adaptable.

“They should have the ability to manage a multitude of differing personalities at close range, excellent problem-solving skills, be honest, reliable, have high integrity and accountability, be able to work on little sleep and have a large bladder!

“Self-leadership with emotional intelligence is the key to navigate the challenges present along with responsibility and accountability.”

While there are challenges, Associate Professor Sewell says the profession is also extremely rewarding due to the involvement of total patient care and caring for the most vulnerable patients.

“They are asleep and put their total trust in your hands.

“You work closely with the medical team, very team orientated.

“It’s highly specialised, so there’s a degree of respect given to you.

“Theatre nurses are very proud people, they sincerely care beyond their duty requirements - after all people’s lives are in their hands.”

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Nicole Madigan

Nicole Madigan is a widely published journalist with more than 15 years experience in the media and communications industries.

Specialising in health, business, property and finance, Nicole writes regularly for numerous high-profile newspapers, magazines and online publications.

Before moving into freelance writing almost a decade ago, Nicole was an on-air reporter with Channel Nine and a newspaper journalist with News Limited.

Nicole is also the Director of content and communications agency Stella Communications (www.stellacomms.com) and a children's author.