Policy:
The Registered Nurse will act as the patient care supervisor.  The nurse is responsible for the direct supervision of any medical assistance or licensed practical nurses.  The nurse serves as the patient advocate and assures that quality of care is administered.  The Nurse will assess the needs of the patient, implement a plan of care, and evaluate the interventions and revise them as needed through all aspects of the patient’s surgical experience.

Procedure:
Preoperative:

1. Sets up for the morning including nourishments and eye drops

2. Assess the patient and assists in the admissions process in the pre-operative area

3. Initiates pre-operative teaching regarding the entire surgical process, alleviates patent anxiety, and addresses and concerns of the patient or family member

4. Records baseline vital signs, review history and physical

5. Administers medications as ordered by the physician

6. Inserts an Intravenous access port

7. Assists with pre-operative physical exam

8. Completes charting and documentation (cosign doctor’s orders for LPN)

9. Informs the surgeon and or anesthesia provider of any problems

10. Provides emotional support to the patient and family members.

11. Delegates appropriate tasks to assistants

12. Cleans up, restocks for the next surgical day

Intraoperative: (scrub and circulate)
See duties and responsibilities

1. Assess the patient and monitors vitals continually while in the surgical suite in absence of an Anesthesia provider

2. Assists the Anesthesia provider as necessary

3. Prepares the patient for the procedure

4. Monitors sterile technique on the surgical suite, and ensures patients safety, correct positioning, etc.

5. Provides emotional support for the patient during the procedure

6. Maintains adequate supplies and equipment are readily available for possible use during the procedure

7. Assists with the surgical suite turnover, setup, and breakdown as necessary

8. Assists patient to the recovery room and gives the appropriate report to recovery staff

9. Assures documentation is complete

Post-operative:

1. Performs complete assessment and monitors patient upon arrival from OR

2. Provide for the patient’s safety and comfort

3. Administers medications as ordered by the physician

4. Delegates appropriate tasks 

5. Assists in the discharge of the patient by ensuring the patient receives the following:

   1. adequate nourishment

   2. specific post-op instructions according to doctor’s orders

   3. medications/prescriptions as ordered 

   4. removal of IV access 

6. Completes charting and documentation (cosign doctor’s orders for LPN)

7. Cleans stretcher and equipment for the next patient
    

General Responsibilities:

1. Responsible for providing surgical patients a safe environment to include; but not limited to physical safety, medication safety, infection control.

2. Responsible for familiarizing oneself with the center’s policy and procedure manual

3. Attends all in-services and seeks relevant continuing education courses

4. Responsible for keeping the surgical suite  supply cabinets adequately stocked

5. Obtains and maintains valid BLS, ACLS, and PALS certifications

6. Prepares surgical center medications each surgical day assuring expiration date and multi-use vials are within 30 days.

7. Assures equipment in proper order before use and logs safety check in the appropriate log book.

8. Takes an active role in identifying issues for quality improvement

9. Attends at least 3 of 4 staff meetings per year

10. Serves as a patient advocate at all times
     

Minimum Qualifications And Working Conditions:

1. Graduate of an accredited school of nursing

2. Currently licensed to practice in the state of Maryland and practices in accordance with 

3. CPR certification

4. Can meet the physical demands of walking, sitting, standing, lifting, pushing of equipment, mental alertness, and help in the physical care of patients.  Requires good coordination and emotional stability.

5. Understands risks of exposure to blood, excrement, secretions, odors, and gases