The role of a nurse during surgery, often referred to as perioperative nursing, is critical to ensuring patient safety and positive surgical outcomes. As a future nurse preparing for the NCLEX, understanding the responsibilities and best practices during the intraoperative phase is essential. This blog post will cover the key aspects of handling a patient during surgery, including preparation, intraoperative care, and post-operative considerations.

Preoperative Preparation

Effective perioperative nursing begins with thorough preoperative preparation. Key steps include:

1. Patient Assessment

• Review Medical History: Understand the patient’s medical history, allergies, and any previous surgical experiences.
• Physical Assessment: Conduct a comprehensive physical assessment to establish a baseline for intraoperative and postoperative monitoring.
• Psychosocial Assessment: Assess the patient’s emotional state and provide support to alleviate anxiety.

2. Informed Consent

• Ensure that the patient has given informed consent for the surgery. Verify that they understand the procedure, potential risks, and expected outcomes.

3. Preoperative Instructions

• Provide the patient with preoperative instructions, including fasting guidelines, medication adjustments, and pre-surgery hygiene practices.

4. Verification

• Participate in the surgical time-out procedure to verify the patient’s identity, surgical site, and planned procedure.

Intraoperative Care

During surgery, the nurse’s role is crucial in maintaining a sterile environment, monitoring the patient, and assisting the surgical team. Key responsibilities include:

1. Maintaining Sterility

• Aseptic Technique: Follow strict aseptic techniques to prevent infection. Ensure that the surgical field remains sterile at all times.
• Sterile Equipment: Prepare and handle sterile instruments and supplies.

2. Monitoring the Patient

• Vital Signs: Continuously monitor the patient’s vital signs, including heart rate, blood pressure, oxygen saturation, and respiratory rate.
• Anesthesia Monitoring: Assist the anesthesiologist in monitoring the patient’s response to anesthesia and be alert for signs of complications.

3. Surgical Assistance

• Instrument Handling: Provide surgical instruments to the surgeon promptly and accurately.
• Specimen Handling: Properly label and handle any specimens collected during the procedure.
• Suction and Sponging: Assist with suction and sponging to maintain a clear surgical field.

4. Patient Safety

• Positioning: Ensure the patient is positioned correctly to prevent pressure injuries and facilitate surgical access.
• Thermal Regulation: Monitor and maintain the patient’s body temperature using warming devices if necessary.
• Fluid Balance: Assist in monitoring and managing the patient’s fluid balance during surgery.

Postoperative Considerations

After the surgery, the nurse’s role shifts to ensuring a smooth transition to the recovery phase. Key steps include:

1. Immediate Postoperative Care

• Vital Signs: Continuously monitor vital signs as the patient emerges from anesthesia.
• Airway Management: Ensure that the patient’s airway remains clear and assist with any necessary interventions.

2. Pain Management

• Assessment: Regularly assess the patient’s pain level using appropriate pain scales.
• Medication Administration: Administer prescribed pain medications and monitor their effectiveness.

3. Wound Care

• Dressing Changes: Inspect and change surgical dressings as needed, following sterile techniques.
• Wound Assessment: Monitor the surgical site for signs of infection, bleeding, or other complications.

4. Patient Education

• Discharge Instructions: Provide the patient with clear instructions regarding wound care, medication management, activity restrictions, and follow-up appointments.
• Signs of Complications: Educate the patient and their family about signs of potential complications, such as infection or deep vein thrombosis (DVT).

Best Practices for Perioperative Nursing

To excel in perioperative nursing and ensure patient safety, consider the following best practices:

1. Communication

• Maintain clear and effective communication with the surgical team, the patient, and their family.
• Use standardized protocols, such as the surgical safety checklist, to ensure critical information is conveyed.

2. Continuing Education

• Stay current with best practices, new surgical techniques, and advancements in perioperative care through continuing education and professional development.

3. Attention to Detail

• Pay close attention to details, such as instrument counts, sterility, and patient positioning, to prevent errors and enhance patient safety.

4. Compassionate Care

• Provide compassionate and patient-centered care, addressing the emotional and psychological needs of the patient and their family.

Conclusion

Handling a patient during surgery requires a combination of technical skills, attention to detail, and compassionate care. By understanding the key responsibilities and best practices in perioperative nursing, you can ensure patient safety, promote positive surgical outcomes, and excel in your NCLEX preparation. Remember, thorough preoperative preparation, vigilant intraoperative monitoring, and attentive postoperative care are the cornerstones of effective perioperative nursing.