Nevill Hall Hospital STUDENT NURSE HANDBOOK THEATRE NAME: INTRODUCTION Welcome to your theatre placement. Your time in theatre is an excellent opportunity for learning new skills and gaining new information, both of which will enhance the care you offer to patients as you progress in your career. It is important that you see this experience as part of a bigger picture of care. Many patients that you will care for will undergo some sort of surgical intervention. By working in main theatre and day surgery you will better understand the patients experience and be able to give more accurate information and support. You will also have the opportunity to practice skills that you may not have had the chance to be involved with before. These skills such as insertion of an airway or scrubbing for a procedure will enhance your care on the wards. For example, observe a procedure and see how the scrub practitioner maintains a sterile field, this will enhance your own practice when performing a dressing on the wards. Philosophy of care The patient focused, holistic care is delivered in a seamless, timely, coordinated manner to all patients in a non-judgemental way. The care given will be evidence based and clinically effective at all times. All staff trained, untrained and students will be encouraged to deliver the most appropriate care in an atmosphere dedicated to learning and development. Main theatre general information Your first day Please report to main theatre, you do not have to come in uniform arrive in main theatre at 08.15hrs you will be given footwear and shown where to find theatre blues. A timetable for your 1 week’s placement will be given to you this is not written in tablets of stone if you have a specific procedure you would like to see we will do our best to accommodate you. A tour of the department will be given for you to become orientated to the surroundings. Shift Pattern Our day shift starts at 08.15hrs -16.15hrs. If you have any specific requests we will do our best to accommodate these. Sickness If you are ill during your placement it is extremely important that you inform the unit, please call 01873 73282 and tell the person answering who you are supposed to be working with so that the message can be passed on. You must also keep in touch if you are ill for more than one day. Lunch You will have ¾ hour for lunch you can either bring Lunch with you or you can change and go to the dinning room. Jewellery Jewellery is not allowed the only exception being a wedding ring. Education & Teaching We have a small resource room providing computer facilities with access to internet and Intranet which will give you access to Trust Policies and procedures. A variety of books and Journals to help with current perioperative practises. Finally To ensure that you make the most of this short placement, ask lots of questions join in and enjoy it!! We hope that we can make you feel welcome as you visit our department. If you do experience any problems with this placement please feel that you can discuss these with us. This is only a short placement so it is important that you have a positive learning experience. UNIT STRUCTURE Day surgery and main theatre have different management structures with dedicated staff to each unit. However staff do work in both areas as the need arises. Theatre This department is split in to three areas, anaesthetics, scrub side and recovery. The scrub side then divides into general, gynaecology and orthopaedics. The senior nurse is Kevin Jones. There are six theatres and an eight bedded recovery unit in this department. Each of our theatres are identified by colour Yellow / Green Theatre are dedicated to general surgery. Blue Theatre is dedicated to gynaecological surgery. Red Theatre is dedicated to elective Orthopaedic surgery. Orange Theatre is dedicated for elective Orthopaedic surgery in the morning and every afternoon it is used for Trauma. Jade Theatre is dedicated to elective Orthopaedic surgery only. Day Surgery Theatre 2 is also used for Orthopaedic surgery Wednesday, Thursday morning and Tuesday Thursday and Friday afternoons. Day Surgery Theatre 1 is used by all specialitities. Day surgery (Llanwenarth suite) In this unit there are two theatres, two endoscopy rooms, as well as a four bedded recovery area with an attached ward. Specialities in this area Plastic surgery Orthopaedic surgery General surgery Ophthalmology Gynaecology Community sexual health Pain Clinics Pre assessment Gastroenterology Endoscopic procedures Who works where? Each area within main theatre and day surgery is led by a specific Team leader; Theatre manager Kevin Jones Day surgery manager Diane Fraser Anaesthetic main theatre Archie Cameron Recovery main theatre Julie Morgan General team main theatre Steph Petrie CEPOD (emergency surgery ) Jan Harrod Gynae team main theatre Kath Pulman Orthopaedic team main theatre Nicola Merry Endoscopy Cath James Recovery day surgery Jayne Rist Anaesthetics day surgery Kath Jones Theatre day surgery Vivienne David The various disciplines within the theatre teams include anaesthetists and surgeons , RGNs, operating department practitioners (ODP), trainee ODP’s, nursing auxiliaries, theatre assistants and theatre porters . Theatre and Surgeons Day/Theatre Speciality Surgeon Yellow General surgery Mr Blackett Green Breast surgery Miss Lefemine Yellow Colorectal Mr Delicata Yellow Upper GI Mr Edwards Green Urology Mr Pandali Green Urology Mrs Hart-Prieto Yellow Colorectal Mr Arun Yellow Breast Surgery Mr Gomez Green Upper GI Mr Samaseker Blue Gynaecology Miss S Bell-thomas Blue Gynaecology Mr El Hamamy Blue Gynaecology Mrs Pinto Blue Gynaecology Mr G Edwards Blue Gynaecology Mr Stokes Red Orthopaedic ALL Orange/Jade/DSU Orthopaedic Mr Walker Orange/Jade/DSU Orthopaedic Mr Yogesh Orange/Jade Orthopaedic Mr Parfitt Orange/Jade Orthopaedic Mr Rice Orange/Jade Orthopaedic Mr Davies Orange/Jade/DSU Orthopaedic Mr Mackie Orange/Jade/DSU Orthopaedic Mr Baker Orange/Jade Orthopaedic Mr Metha Consultant Anaesthetists Dr Dr Dr Dr Dr M Martin Morgan-Jones Bhanu S Edwards Summors Dr Dr Dr Dr Dr K Jenkins Billing-John Rouse S Jeffs Janossy Dr Lacquiere Dr Sreekumar Dr M Byrnes Dr L Evans The anaesthetists work in all areas and also cover ITU being supported by a number of staff grades and senior house officers. Mentors You will be allocated a main mentor. However, due to the nature of the work in theatre and the fact that we want you to have as many opportunities to see different areas of practice as possible, it will not always be practical for you to work with that same practitioner however we will ensure that you will be allocated a team member for each session. Mentor Area of practice Steph Petrie General surgery – main theatre Jan Harrod CEPOD Theatre Jill Jones Ron Ocampo Sue Goff Christian Orthopaedics – main theatre Archie Cameron Luke Bryan Vicky Prasol Anaesthetics –main theatre Julie Morgan Recovery – main theatre Cath James Lindsey Coffey Endoscopy Kath Jones Anaesthetics – DSU Diane Fraser Theatre – DSU Jayne Rist Recovery/ward DSU Kath Jones Pre admission clinic COMPETENCIES In the following pages some suggestions have been made as to some of the competencies you could work towards during your time in theatre. Prior to your allocation think about what you want to experience and achieve. It is your responsibility to work with your mentor and arrange to produce evidence from different areas. PRE ADMISSION SKILLS THAT CAN BE PRACTISED Completion of admission procedures. Taking of baseline observations Communication with patients and relatives. POTENTIAL COMPETENCIES Professional and ethical practice; D2ii, E2iii, F2iii Care delivery; A2ii,iii, B2i,ii,iii, F2I,ii,iii,iv, WAYS OF GENERATING EVIDENCE Work along- side pre-admission nurse observing practice and taking part where appropriate. ANAESTHETICS Skills that can be practised Checking in of patients – the student will observe and participate in the checking in procedure and be able to discuss the associated clinical risks and management. The student will be able to discuss the importance of the theatre/ward checklist and describe the fasting and consent policies. The student will be able to demonstrate the ability to communicate with patients, relatives and carers in an appropriate manner The student will participate in the communication process between theatre and recovery and members of the multidisciplinary team. The student will be able to describe different types of anaesthetic and its effects on patients. The student will observe airway management and assist where possible Potential competencies Professional and ethical practice, B2iii, C2ii, C3iii, E2i, F2i, Care delivery, B2i, C2i, iii, E2i, iii, F2 iv, J2ii, Care management, C2 iii, D2i, How can evidence be generated Work with a qualified anaesthetic nurse or operating department practitioner at all times in order to care for patients undergoing anaesthesia, support the patient during this period and communicate with carers as necessary. Observe and take part in communication with other areas and members of the multidisciplinary tea, THEATRE Skills that can be practised The student will have the opportunity to learn how to scrub and maintain a sterile field by observing and taking part in operative procedures. The student will have the opportunity to act as a “circulating nurse” by helping to give the scrubbed practitioner the equipment and supplementaries needed for each case, this will give chance to help maintain a sterile field The student will have opportunities to take the skill of handwashing one step further in to the skill of scrubbing The student will be able to observe how infection control is applied to practice and to dispose safely of body fluids The student will have opportunities to deal with surgical specimens The student will be able to support patients undergoing local procedures and communicate with them. The student will have the opportunity to take part in multidisciplinary care of patients The student will have the opportunity to complete documentation and pass on information to other areas of care. Potential competencies Care delivery; E2i,ii,iii, F2ii, Care management; C2ii, iii, D2i,ii, Suggestions for evidence generation The student will work along side the scrub team and have the opportunities to take part under supervision in aspects of patient care. They will be given the opportunity to scrub and watch or assist in an operative procedure, help in the care of specimens, maintain infection control etc. RECOVERY AND WARD AREA (DSU) Skills that can be practised Maintain a patients airway Care of drains, catheters, IVI Maintain patients fluid balance Care for a patient following different types of anaesthetic Take and record observations Communicate with other members of the multidisciplinary team Pass on information regarding the plan of care Change the plan of care if necessary Overcoming barriers to communication caused by anaesthetics Potential competencies Professional and ethical practice C2ii,iii, D2ii, Care delivery C2i,iii, E2i, F2ii,iv, H2i,ii,iii,iv, Care management C2ii,iii, D2i,ii, Suggestions for evidence generation The student nurse will work alongside the recovery and/or ward staff to care for the patient following anaesthesia, opportunities will be given to maintain airways, monitor and record patients vital signs, communicate with patients and family members. If the nurse is working on the ward they will have the opportunity to be involved with the discharge process. ENDOSCOPY Skills that can be practised Support the patient undergoing endoscopic procedures and maintain dignity at all times. Observe the anatomy and physiology associated with endoscopic procedures Take the opportunity to be involved with the admission of patients on the endoscopy list Observe and record any changes in the patient’s condition and be involved with changes in to the plan of care Spend time in the wash room and take part in the health and safety considerations of caring for scopes. Potential competencies that could be gained Professional and ethical practice A2i,ii,iii, C2ii,iii, D2ii, Care delivery C2i,iii, F2iv, Care management D2i,ii, Suggested ways to generate evidence Spend time observing in endoscopy and take the opportunity to watch all parts of the area, admission, procedures and the wash room. University of South Wales Link lecturer Cheryl Phillips Tel: 01443 483818 E.mail: cphilli1@glam.ac.uk Cardiff University Link lecturer: Anna Jones Tel: 02920 91 7769 E.mail :jonesa23@cf.ac.uk