2-3. SURGICAL TEAM
Nowhere is a smoothly functioning team of more importance to the patient than in the operating room. Respect for others' expertise, the ability to work harmoniously, and the art of communicating effectively are necessary ingredients for a well-functioning team. Each surgical procedure will dictate the number of members on the surgical team; however, there are at least four members as a minimum.
a. Surgeon. The surgeon is the leader of the surgical team and has the ultimate responsibility for performing the surgery in an effective and safe manner. He is dependent upon other members of the team for the patient's emotional well-being and physiologic monitoring.
b. Anesthesiologist/Anesthetist. The anesthesiologist/anesthetist must be constantly aware of the surgeon's actions. He must do every thing possible to ensure the safety of the patient and reduce the stress of the operation.
(1) Anesthesiologist. The anesthesiologist is a physician who is trained in the administration of anesthetics.
(2) Anesthetist. The anesthetist is a registered professional nurse who is trained to administer anesthetics.
(3) Responsibilities. The responsibilities of the anesthesiologist and the anesthetist include:
(a) Providing a smooth induction of the patient's anesthesia in order to prevent pain.
(b) Maintaining satisfactory degrees of relaxation of the patient for the duration of the surgical procedure.
(c) Continuous monitoring to the physiologic status of the patient, to include oxygen exchange, circulatory functions, systemic circulation, and vital signs.
(d) Advising the surgeon of impending complications and independently intervening as necessary.
c. Scrub Nurse (or Scrub Assistant).
(1) The scrub nurse or scrub assistant prepares the setup and assists the surgeon by passing instruments, sutures, etc.
(2) In the Army, the operating room specialist (91D) will often help to fill this role.
d. Circulating Nurse.
(1) The circulating nurse is a professional registered nurse who is free to obtain supplies, answer the anesthesiologist/anesthetist requests, deliver supplies to the sterile field, carry out the nursing care plan, etc.
(2) The circulating nurse does not scrub or wear sterile gloves or gown.
(3) The circulating nurse is the professional nurse liaison between scrubbed personnel and those outside of the operating room.
(4) Responsibilities of the circulating nurse include:
(a) Providing for psychological comfort of the patient prior to and during induction of anesthesia.
(b) Making initial assessment of the patient and continued monitoring.
(c) Saving all discarded sponges; during surgery, participates in the sponge count to ensure that no sponge is left in the patient.
(d) Observing the surgical procedure and anticipating the needs for equipment, instruments, medications, and blood units.
(e) Preparing labels for the patient specimens for their submission to the laboratory for analysis.