To receive a clinical placement in theatres during your Bachelor of Nursing degree can be the luck-of-the-draw. There are sometimes more students than there are places in this elective specialty, so the truth is, many of us will go through our undergrad degree never having had the experience – and I was one of them.
After graduation, I found myself researching what a job in theatres may be like – but surprisingly, there wasn’t much information out there! Despite this, I decided to apply for (and obtained!) a position, because I was keen to experience a different aspect of nursing.
Reflecting back on it, I’m proud that I had the courage to take the leap and begin my journey in periop nursing. It’s a steep learning curve, but a worthwhile one.
Here is my experience and view on working in the theatres as a Scrub/Scout Nurse.
What happens behind closed doors?
Theatre nurses (also referred to as perioperative nurses) are Registered Nurses who are part of the perioperative surgical team. Inside theatre, nurses are usually referred to as “Scrub/Scouts”. The Scrub/Scout nursing team provide care to the patient before, during and after surgery.
Before the surgery
Prior to the surgery, the Scrub/Scout team work with the anaesthetic nurse to ensure:
- That the patient has consented for surgery;
- That the patient does not have any unknown allergies; and,
- That the surgery site is marked on the patient.
As most patients have a general anaesthetic, this is often the only interaction a Scrub/Scout nurse has with the patient! From the anaesthetic bay, the patient is wheeled into the theatre.
During the surgery
During the surgery, a periop nurse takes on one of the two roles; either the scrub nurse or the scout nurse.
Scrub nurses “scrub up” by performing a hand wash to disinfect themselves before donning a sterile gown, mask and gloves. Scrub nurses also work closely with the surgeon/s during the procedure to ensure the surgery goes as smoothly as possible while maintaining the sterile environment. Scrub nurses handle instruments, specimens, tissue, implants and sometimes even assist with the surgery itself!
On the other hand, scout nurses work with the scrub nurse to ensure that all the safety checks have been performed, all specific instruments are available and all appropriate documentation is complete. They are also there to assist with anything else the scrub nurse or surgeons may need.
One important task the scout nurse has is ensuring a “time out” is performed before the procedure is initiated. A surgical “time out” is the recapitulation and reassurance of accurate patient identity, surgical site, and planned procedure. As scout nurses do not “scrub up”, they can move around the theatre, ensuring the space remains clear and communicating between the rest of the perioperative team.
After the surgery
Once the surgery is finished, the scrub nurse will help to apply dressings and do their best to clean the patient from the surgery by removing the prep solution, which is usually betadine (this is so the patient does not wake up yellow!).
The scrub nurse hands over the patient to a nurse in Recovery, highlighting any complications or post-op care for the patient.
Sometimes, the turnover between surgeries is fast. After the patient leaves the theatre, we clean, go to the bathroom, have a drink of water and set up for the next procedure. Then, it all happens again!
So, what more is there to know?
Generally, most theatre lists start at 8am and run through to about 9pm at night. However, these times can vary depending on the hospital you work in and if the hospital is public or privately run. Night shifts and weekend shifts are voluntary only in private hospitals whereas in public hospitals, this is an expectation of the job.
There are a few differences between working as a periop nurse and a nurse in the wards. As a periop nurse, we aren’t allowed to wear scrubs outside of the hospital for hygiene reasons, both for ourselves and the patient. Therefore, we must get changed at work before our shift into hospital provided scrubs.
We also spend hours in the same room with the patient; however, we have very few interactions with them – which is a strange concept to wrap your head around at first. This is where some nurses may find they really value the nurse-to-patient relationship.
However, multi-tasking, ensuring person-centered care and working with people at their most vulnerable are some of the many similarities to working as a nurse outside of the theatres.