Perioperative nurses care for patients before, during and after surgery or interventional procedures.
Click here to view 'A day in the life of a perioperative nurse'.
Click here to view 'We are perioperative nurses'.
Perioperative nursing encompasses a range of specialised roles including, but not limited to:
- Preoperative patient assessment and education nurse
- Anaesthetic nurse
- Circulating nurse (scout)
- Instrument nurse (scrub)
- Post Anaesthesia Care Unit nurse (recovery)
- Perioperative Nurse Surgeon's Assistant (PNSA)
- Nurse practitioners.
Other roles, which support perioperative nurses, include perioperative nurse educators and researchers.
Preoperative patient assessment and education nurse
This role encompasses two main areas.
- Patient advocacy: the preoperative patient assessment and education nurse
thoroughly assesses the patient’s needs and communicates these and patient requests to the surgical team to ensure an optimal patient outcome.
- Patient education: the preoperative patient assessment and education nurse provides education to the patient before and after the surgery or procedure so they are better informed and well prepared for their surgical intervention and rehabilitation.
The anaesthetic nurse provides the primary support to the patient and the anaesthetist throughout the anaesthetic process. With the anaesthetist's supervision, the anaesthetic nurse ensures the safety of the patient during the course of the anaesthetic. Outcomes are optimised through the astute situational awareness of the anaesthetic nurse, who monitors the patient’s status, surgical equipment and pharmacological management as well as communicating with the perioperative team. In the true spirit of teamwork, in facilities where the workflow requires, the anaesthetic nurse may undertake some circulating nursing activities. Within the Australian health care system, suitably qualified anaesthetic technicians, whose only role is to support the anaesthetist, may also undertake this role.
The circulating nurse ensures that the items needed to achieve the best outcome for the patient are delivered aseptically onto the surgical field. The circulating nurse monitors the environment and manages associated risks to ensure patient safety. Other activities carried out by the circulating nurse include patient positioning, documenting accountable items, collecting specimens, confirming consent and managing equipment.
The instrument nurse assumes primary responsibility for all items used within the surgical field. The instrument nurse assesses the surgical team's requirements, with the aim of anticipating the team's needs, and provides sterile supplies and equipment required for the procedure. The instrument nurse must remain vigilant throughout the procedure in order to recognise intraoperative complications or changes in the patient's condition and respond promptly.
Post Anaesthesia Care Unit (PACU) nurse
The PACU nurse provides holistic care for patients immediately following an anaesthetic, surgery or procedure. Following a comprehensive handover from the surgical team, the PACU nurse monitors the patient until discharge criteria are met thus ensuring the safety of the patient through to the next phase of their perioperative journey. Patients arrive in the PACU in an attenuated state and the PACU nurse augments their homeostatic condition.
Perioperative Nurse Surgeon's Assistant (PNSA)
The PNSA provides extended perioperative nursing care before, during and after surgery or a procedure. The PNSA has, through postgraduate studies, acquired the knowledge, skills and attitudes necessary to competently perform the role of assistant to the surgeon.
These perioperative nursing roles work together as an inter-disciplinary team with the aim of applying best practice and achieving optimal patient outcomes. The perioperative patient’s journey is optimised when all team members work in unison with a systematic approach.
Health service organisations have detailed descriptions of the above-mentioned roles and provide education programs to help individual perioperative nurses identify and meet their learning needs. Comprehensive orientation and induction packages and encouragement for nurses to pursue lifelong learning assists them to develop as perioperative professionals.