ROLES AND RESPONSIBILITIES OF HEALTH CARE TEAM Who do each of these characters represent? Anesthesia and Anesthesiologist Surgeon Charge Nurse Housekeeping Scheduling Who else is part of the Perioperative Team? X-ray Lab including Pathology Blood Bank Anes. Tech RN Circulator Scrub PACU (post anesthesia Care Unit) Residents Pharmacy Equipment Tech Turnover Team SPD Vendors/Reps Describe the roles and responsibilities of other health care team members

Roles and Responsibilities Define Health Care team Read Job Descriptions Know what role each member plays at your facility Goals of this presentation…

The Surgical Team For every patient who comes to our OR, a team of little as 4 to as high as 6 to 7 highly trained professionals with a wide range of specialties is present to offer more comprehensive care. There may be more members to a team, depending on the complexity of the operation. A team of highly trained professionals with a wide range of specialties who is present to offer comprehensive patient care.

Role of the Circulator Video Must be an RN Plans patient care Communicates patient’s needs to the health care team Manager of the Operating Room Suite, the “Watch dog” The circulator must be a registered nurse. As stated in the video: The first perioperative nurses participated in the Crimean War dealing mostly with cleanliness and the comfort of the patient. In the 19th century the OR environment changed due to: Control of bleeding Sterile vs non-sterile fields 2 roles were developed-the sterile instrument nurse and the circulating nurse Are the voice for the pt. Pt. advocate. This role is the most important one to me. You are the eyes, ears and voice for the patient.

Role of Scrub Person Video Is scrubbed in at the field Set up sterile supplies and instrumentation Assist the surgeon as needed during the operative procedure Performs all needed counts with the circulating nurse Knowledge of aseptic technique A surgical technician. He or she knows aseptic technique, instruments and details of surgical procedures. He/she prepares the sterile field and passes instruments to the surgeon. Surgical Technologist CANNOT manipulate tissue, cut, sew, cauterize etc. This person can be a scrub tech, certified or not, trained on the job or went to a surgical tech school, RN or LPN. There is no surgical tech school in Alaska. Economically better to pay a scrub tech wage vs. an RN wage. They can make or break your day….. Story time

Role of the Surgeon Video . Requests the surgery Provides consent and history and physical Communicates exact procedure, operative side and any special needs prior to surgical case. Assists in positioning patient Performs surgical procedure A surgeon, who after graduating from medical school has gone through years of residency training in his specialty area. Most surgeons have spent another 2-3 years of fellowship to be trained in a more specific areas within their specialty, i.e. An orthopedic surgeon specialized in shoulder or knee surgeries. Remember, the surgeon is the only one who knows exactly what the planned procedure will be or completed. Never be afraid to ask questions or clarify.

Role of the First Assistant/Resident Video . Surgeon, Physicians Assistant, Nurse Practitioner, CRNFA Have completed extended training. Assist the surgeon in manipulating tissue and wound closure. An assistant who can be either another surgeon, a physician’s assistant, P.A.., trained after 2 years of special PA school to assist in surgery, a nurse practitioner who is also trained to assist after his/her specialty education, or a Certified Registered Nurse First Assistant (CRNFA.) Assistants are involved in performing surgery through close cooperation with your surgeon

Role of the Anesthesiologist/CRNA Video Assesses patient’s risk for receiving anesthesia Assesses need for appropriate anesthetic during the surgical procedure Communicates equipment needs to the Anesthesia tech or circulating nurse An anesthesiologist who upon graduating from medical school has undergone 3-4 years of residency training in the field of anesthesiology. Many anesthesiologists have a few more years of training to learn a subspecialty within the anesthesia specialty; like pain management, regional blocks, cardiac, pediatrics, etc. A CRNA is a registered nurse, with 2 years critical care experience, then takes a 2 year CRNA course. They are supervised under an MD but perform almost all of the same duties. An Anesthesia MD supervises up to 3 CRNAS at a time…. They administer anesthesia and maintain the anesthesia until procedure is over

Role of the Anesthesia Technician Video Knowledge of equipment used by the Anesthesiologist Assists with the set-up of equipment , medications and supplies and clean-up in assigned operating rooms May assist Anesthesia Provider during induction of anesthesia An anesthesia technician, trained to provide technical support to the anesthesiologist. He or she prepares the needed supplies for anesthesia and may assist the anesthesiologist at the time of induction and throughout the operation. In surgery, much like airplane travel, the takeoff and landing (or induction and emergence) are 2 critical times during any operation. Not all facilities have anesthesia techs, not in Fairbanks. Circs do it all, or the Anesthesia drs. Do it for themselves.

Role of the Surgery Assistant/Medical Assistant/Hospital Assistant Video Some ordering and stocking of supplies Assist with room turnover and related housekeeping Assist the nurse in patient care activities Transportation of patients A surgery assistant, OR assistant, trained to perform some duties in the OR. He/she is in charge of a lot of behind-the-scenes work, such as housekeeping,transportation, pickups and deliveries. Check with your facility regarding this job classification and name

Role of Charge Nurse Video Facilitates staffing needs Role model and clinical resource Facilitates communication within the health care team Organizes patient assignments to give optimum care Usually a senior member of the OR team. Handles the schedule and staffing. Books add ons, emergencies. In close communication with Anesthesia with regards to changes in their schedule, OPS, PACU, the floors etc

Role of the Health Unit Coordinator Video Direct telephone calls Communicate information to health care team Order supplies and forms Schedule cases Other names: Pt Service Coordinator, Unit Secretary, Unit Clerk, Surgery Scheduler

Additional Roles Equipment Technician: Video OR Manager: Video SPD Technician: Video Part 1 Part 2 Video PreOp RN: Video

The Patient is the Focus CIRCULATING NURSE SURGEON SCRUB PERSON Other services that indirectly affect perioperative patient care: a 2nd layer of team members Materials management (Coordinator), surgery clerks Director of the Department Admissions Staff Sterile Processing Department, Instrument Room Outpatient surgery staff SURGERY ASSISTANT CHARGE NURSE ANESTHESIOLOGIST Or CRNA PATIENT ANESTHESIA TECH