* Serves as a consultant in all aspects of patient care, policies, procedures, equipment operation, instruments and supplies in the Main OR.

* Seeks out additional educational opportunities to increase current clinical expertise related to various surgical procedures.

* Maintains proficiency in the roles of the RN circulator, scrub, 1^st and 2^nd assistant roles.

* Promotes clinical and professional leadership growth within the department.

Job Requirements

* BSN, CNOR, RNFA certificate

* Prior experience preferred

Preoperative Duties Performed to Assist the Surgeon for Maximum Patient Care, Safety, and Economy of Time

1. STERILE TECHNIQUE:

A. Perform the appropriate preoperative skin scrub for the particular procedure

and circumstance.

B. Demonstrate the understanding of aseptic technique and sterile vs.

non-sterile areas.

C. Display surgical conscience for the safety of the patient, other employees

and themselves.

D. Wear appropriate barriers as outlined in the Infection Control Manual for

protection against blood and body contamination of patient and self.

2. PREOPERATIVE PREPERATION OF THE PATIENT

A.Demonstrate timely movement of the patient to the OR.

B.Properly identifies the patient:

1.Verbally check with the patient (patient name, surgeon,

and procedure)

2.Visually checks the ID band, chart, surgery schedule and bed tag.

3.Display a professional and courteous manner while reassuring

the patient that asks questions; give support to the patient.

4.Respect the patient's confidentiality.

C.Facilitate voluntarily in an assistant or non-assistant room, and work

efficiently with the OR team, performing duties in an efficient and safe

manner, proceeding smoothly throughout the day.

D.Collect and properly display the appropriate x-rays.

E.Properly measure patients for intra-operative procedures.

F.Review patient chart.

G.Assist anesthesia under direct supervision, if time permits.

H.Properly bi-valve any cast that needs to be removed, having patient

safety in mind at all times.

I.Position the patient properly, being aware of and padding areas that

require special protection, making adjustments for surgeon's preferences.

J.Prepare and properly perform surgical preps and urethral catheter insertions.

1.Routinely inspects the surgical site to insure that a proper shave

prep was performed according to the type of surgery and

surgeon's preference.

2.Routinely verify any patient allergies and changes the prep

solutions accordingly.

3.Display knowledge of the surgeon's preferences and prepare

the prep tray in a sterile, economical, and uniform manner with the

supplies needed.

4.Ready to insert the catheter and/or perform the skin prep when

anesthesia permits.

5.Following skin preparation, checks that there is no pooling of fluids beneath the patient or near the Bovie pad.

INTRA-OPERATIVE: The Ability to First or Second Assist Any Surgeon on Any Case With Minimum Difficulty

1. KNOT TYING

a.Knots are square, secure and they approximate the tissue, do not slip, and have

the correct number of knots required for that particular tissue.

b.Is familiar with tensile strength using appropriate tension for the

type of suture.

c.Demonstrates dexterity and knowledge of one handed and two handedties,

surgeon's knot, and instrument ties in a smooth and efficient manner.

2. EXPOSURE OF INCISIONAL SITE

a.Demonstrates skill and knowledge of maintaining hemostasis by proper use of

pressure, clamps, ties, suture ligatures, clips or electrocautery according to

surgeon's preference.

b.Provides and maintains the proper exposure necessary to perform the

operative procedure while protecting vital organs, tissues and other structures.

c.Sponges and suctions at the appropriate time without interfering with the flow

of the surgery in order to allow a clear and unobstructed view of the

operative field.

3. KNOWLEDGE OF EQUIPMENT AND INSTURMENTATION

a.Demonstrates the proper use of equipment in a smooth, safe, and

efficient manner.

b.Demonstrates proper use of instrumentation at the field:

1.Selects appropriate instrument according to need and

doctor's preference.

2.Operates instrumentation in a smooth, safe, and efficient manner to

achieve the desired result.

c.Practices care and economy in the use of equipment and materials.

4. CUTTING SUTURE

a.When cutting suture, the assistant demonstrates promptness, proper

handling of scissors, and safe cutting techniques.

b.Assistant displays ability to adjust cutting length to various suturesand doctor's preference.

5. WOUND CLOSURE

a.Assistant closes the proper anatomical layers with the appropriate type

of suture and stitch according to the surgeon's preference.

b.Demonstrates knowledge of suture material, various types of stitches,

and properly closes the incision in a smooth and efficient manner