Promoting a Positive Environment in the Operating Department Ivana Stojkovic AP&SN Serbia

Perioperative nursing is a nursing specialty that works with patients who are having operative or other invasive procedures. Perioperative nurses work closely with surgeons, nurse anesthetists, surgical technologists, and nurse practitioners. They perform preoperative, intraoperative, and postoperative care primarily in operating theatres, stress test evaluations, cardiac monitoring, vascular monitoring, and health assessments.nursingsurgeonsnurse anesthetistssurgical technologistsnurse practitionersoperating theatres

Perioperative nursing roles Perioperative nurses may perform several roles, including circulator, scrub nurse, pre-op nurse, PACU nurse, OR Director, Registered Nurse First Assistant (RNFA), and Patient Educator

Circulator A circulator is a perioperative nurse that manages the nursing care of a patient during surgery. The circulator observes for breaches in surgical asepsis and coordinating the needs of the surgical team. The circulator is not scrubbed in the case, but rather manages the care and environment during surgery. Scrub nurse A scrub nurse is a perioperative nurse that works directly with the surgeon within the sterile field. The scrub nurse passes instruments, sponges, and other items needed during the procedure. The title comes from the requirement to scrub their hands and arms with special disinfecting solutions.

Today's surgical teams made of professionals of different profiles play a vital role in achieving successful management of patients during surgical procedures. Teamwork model is based fundamentally on preserving the integrity of the patient's life by all team members. This synergy of teams, each in their own areas of activity provide a safe environment which is conducive to restoring the patient in optimal condition and the absence of symptoms.

CRITICAL THINKING DURING PERIOPERATIVE PROCEDURES Model of good communication, assessment, recommended standards and guidelines, enforcement procedures, demonstrating the interactive relationship between the various members as they carry out their duties in order to provide the best services. Fundamental to the nursing professions is our ability to honor, respect and value each other, as well as the inter-personal and inter-professional relationships.

The existence of the list of orders and collecting data that are specific to each surgeon For each member of the team preparation is adequate for certain procedures. List of orders also may contain a demand for specific materials (mesh prostheses, orthopedic prostheses, microscopes, various holders...) Only in emergencies can happen that the team absolutely does not answer all the requirements of the list of orders previously given. Once the patient is introduced into anesthesia is considered to be unproductive, inappropriate and unprofessional to find that particular item from the list of orders are missing. Surgical procedure can be stressful for the surgeon and patient, if there is lacking of good communication, planning and evaluation, and if the surgical intervention should be postponed or canceled. Planning includes the preparation of specific operating room space. During the start of the daily activities responsibility of the team lies in the fact that all materials must be checked.This also applies to the specific materials, where we compare a list of orders with OR shedules in order to determine all requested requirements are fulfilled.

Developing a relationship of trust and support we can overcome anxiety by presenting all team members, focusing on patient needs, providing the patient the benefit of the mental and verbal support. We look at each patient as a unique individual. Information regarding the patient's height and weight can also influence the course of surgical procedures in connection with the type and length of surgical instruments, sutures, and other necessary materials. The next step in the successful care of patients is recommended guides of good practice. Guides cover the written aspect of the methods and standards of work within the operation ward. The existence of these standards are intraoperative socially responsible. By following the principles of good practice it is possible that professionals carry out their decisions based on research and professional standards. Lack of information or disagreement on some results must be submitted to the team before starting the procedure. The result of good action, collaboration and synergies lead us to safe and successfull intraoperative environment.