SURGERY
Means the branch of medicine that comprises of preoperative care, intraoperative judgement and management and postoperative care of the patients.
OPERATION
Operation is a discipline for correction of deformities and defects, repair of injuries diagnosis and cure of disease processes relief of suffering and prolongation of life.
The patient come to operation room (OR) for following reasons:
- To preserve life, e.g. a relief of intestinal obstruction, decompression of a skull fracture.
- To maintain dynamic bodily equilibrium or balance, e.g. removal of a diseased kidney.
- To undergo diagnostic procedures like laparoscopies.
- To prevent infection and to promote healing, e.g. debridement in burns and wounds.
- To obtain comfort and to ensure the ability to earn a living, e.g. elective herniorrhaphy.
So regardless of the circumstances that bring the patient to the OR, the intraoperative care becomes an integral part of nursing service, filling a need that cannot be met by the individual patient or his family. So the care in OR depends upon the ultimate care given to the patient.
NURSING IN SURGERY
This is carried out in two levels: (i) professional and (ii) technical.
Professional Nursing
Professional nursing is the identification of the physiological, psychological and sociological needs of the patient and the implementation of an individualized programme of nursing care, that co-ordinates the nursing actions based on the knowledge of the natural and the behavioural sciences, in order to restore, maintain the health and welfare of the patient before, during and after surgical intervention.
Characteristic of Professional Nursing
These are:
- It defines its own rules and code of ethics.
- It sets its own standard and conducts. It's own affairs and self-regulation.
- It identifies and develops it's own body of knowledge through research.
- It engages the self evaluation and review control and alter it's practices and behaviour.
Thus professional nursing also is—a combination and co-ordination of knowledge skills and ideals to that are communicated through a highly specialized educational discipline. So proper education in this field sets the standards.
Professional nurses or OT nurses: They should have the ability, knowledge, commitment and compulsion and compassion.3
They should be committed to life, health and deaths, with dignity.
They are morally and legally accountable for their quality of service.
An educated and talented professional nurse is an indispensable member of the OR team.
As changes occur with saprising rapidity the nurse's responsibility to the patient, operation itself and to the profession to increases. Professional nursing—comprises, the care both in conscious and unconscious state providing continuity of care through preoperative assessment and planning, intra-operative intervention and postoperative evaluation.
Nursing Actions
Nursing actions depend upon:
- What actions are to be performed?
- How the nursing actions are to be done?
- When these actions are to be performed?
- Where these actions are to be performed?
- Who is to perform the nursing actions?
What are these Nursing Actions?
- These are execution of Doctor's orders.
- Observation of the patient's symptoms and reactions.
- Supervision of the patient.
- Supervision of others.
- Reporting and recording.
- Execution of nursing procedures and techniques.
- Promotion of patient's physical and emotional health by directing and teaching.
Intraoperative means—From the time he enters inside an OR till he is wheeled out to the recovery room or postanaesthetic room.
Postoperative means—From the recovery room to the ward and till he is rehabilitated.
The OR nurses is responsible for the total care and life of the patient.
The patient realies on the nurse for:
- To provide competent, skilled, trustworthy care during operation.
- To mitigate anxiety and pain.
- To meet aggregate needs.
With this, he hands over his whole body to the care of the nurse.
Technical Nursing
Technical nursing means to prepare and handle supplies and equipment to maintain a safe and therapeutic requirement through a system of specific techniques and practices, to exclude all pathogenic microorganisms from the operative wound.
No operation is minor – hence undivided attention to the patient at all times is necessary.
Qualities of OR Nurse
They are:
- Empathetic or compassionate
- Conscientious
- Efficient and well organized
- Flexible and adaptable
- Sensitive and perseptive (interested)
- Understanding, reassuring and supportive
- Skilled listeners, keen observer, and able communicator.
- Considerate to all.
- Informative and sincere.
- Aware of individuality.
- Manually and intellectually dexterous. This means, quick hands, sharp minds and keen eyes.
- Objective—means views situation from all sides before taking action.
- Impartial, non-judgemental, open minded.
- Versatile—means extensive knowledge of the operations, instrumentation and equipment handling.
- Analytical—means knows why and how.
- Creative—means creating effective methods.
- Humanistic.
- Sense of Humor.
- Enduring—means ability to bear a prolonged period of time.
- Intellectually—eager and curious in everything to learn.
- Ethical—a person with good moral values.