Please see below Job Description/Person Specification and General Conditions of
Service
recruitment.tayside@nhs.net
www.dundeecity.gov.uk
www.angus.gov.uk
www.pkc.gov.uk
November 2009 1

JOB IDENTIFICATION Job Title Theatre Nurse /
Operating Department Practitioner
(ODP)
Band 5
Department(s)/Location Operating Department
Scrub/Circulating Service
NHS Tayside
2. JOB PURPOSE
As part of a multidisciplinary team primarily based within the Stracathro Regional Treatment Centre
(SRTC), NHS Tayside the post holder will have responsibility for assessment of care needs and the development of programmes of care, for patients following a broad range of surgical procedures and anaesthetic techniques, and the implementation and evaluation of these programmes of care ensuring the delivery of high quality care to patients.
3. ORGANISATIONAL POSITION
General Manager Access Directorate
SRTC Manager
Senior Charge Nurse/Team Leader
Director of Nursing
Acute Service Division
Directly accountable to
Charge Nurse/Team Leader
Specialist Theatre Nurse/ODP Scrub/Circulating (this post)
Nursing Auxiliary/Operating Department Support Worker
Professionally accountable to
4. SCOPE AND RANGE
The role of the Scrub/Circulating Nurse/ODP is to:

Work in conjunction with and anticipate the surgeon’s needs to ensure a high quality, safe and supportive environment for adults, including young adults, in order to care for patients/clients/carers/relatives/staff to meet identified care needs within the operating
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department.

On a rotational basis, provide scrub and circulating assistance to ensure a high quality, safe and supportive environment for adults, including young adults, during the intra-operative phase for patients of all needs within a broad range of diverse specialities. These areas currently include
General, Orthopaedics, Urology, Plastics and Community Dental. These specialties currently operate from 4 theatres.

Supervisory responsibilities for registered and non-registered staff as required.

Budgetary responsibilities - ordering of supplies, caring for patient’s valuables.

Safe use of all technical equipment including simple and highly complex expensive equipment.

Liaise with the multi-disciplinary team and external agencies to contribute to the effective running of operating lists.
5.
MAIN DUTIES/RESPONSIBILITIES
Care Delivery
1.
Provide emotional support and involve patients/client/carers and relatives in the planning and delivery of individualised care.
2.
Maintain effective communications with patients, relatives and other members of the multidisciplinary team on routine and daily activities to ensure that appropriate information is shared and patient needs are met.
3.
Responsible for the assessment of care needs and the development, implementation and evaluation of programmes of care for patients whose needs may be unpredictable in the pre, intra and immediate post-operative care period to ensure delivery of a high standard of care.
4.
Ensure operative safety checks are carried out on a daily basis for all surgical equipment e.g. diathermy machines, Endoscopy systems for use by the surgeon. Responsible for setting up the operating room, checking all equipment is in working order and safe to use in accordance with manufacturer guidelines. Ensure all equipment required for each individual patient is available.
5.
Ensure checks of all instruments, swabs, needles, blades, sutures and any other sharps and accessories are correct and accounted for before, during and after the procedure, and the surgeon is thus informed.
6.
Maintain an awareness of the risks and complications associated with the surgical practice, inclusive of instrumentation and other equipment and accessories being used, e.g. patient positioning, diathermy equipment, skin preparation solutions and dressings.
7.
Maintain the patient’s dignity at all times during the intra-operative episode.
8.
Responsible for maintaining intra-operative patient records within agreed standards to ensure the care management plan is communicated to patients and the healthcare team, and completion of all intra-operative checks, including patient identity, consent, allergies, skin integrity, proposed surgical procedure and surgical site in all patients undergoing surgery.
9.
Adopts a proactive approach to infection control actively contributing to infection control policy and practice, e.g. through donning the appropriate surgical attire and any additional Personal
Protective Equipment (PPE) necessary for the procedure, ensuring all surgical instruments are clean and in working condition, maintaining a sterile operative field, correct handling of specimens and disposing of all contaminated instrumentation, accessories, and associated equipment including linen and PPE in accordance with local decontamination guidelines.
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Management /Leadership
1.
Co-ordinate and prioritise own workload working as part of a team to ensure that the interest of patients/clients are met.
2.
Contribute to the effective use of physical, human and financial resources.
3.
Supervise junior staff, learners and support workers who are providing care to patients.
4.
Act as a source of specialised advice to support the delivery of safe and effective care for other nursing disciplines i.e. midwives.
5.
Contribute to effective teamwork and healthy working relationships.
6.
Assist in maintaining own and others’ health, safety and security.
Education/Continuing Professional Development
7.
Participate in personal development planning and formal/informal appraisal of junior staff e.g. student Cap Booklets.
8.
Participate in personal career development planning to develop aptitudes and specialised knowledge in order to maximise contribution to the area.
9.
Working towards/demonstrate specialised knowledge specific to the intra-operative management of patients across a broad range of surgical procedures and their associated anaesthesia.
10.
Undertake/complete Fitness for Practice Patient Care in the Intraoperative Environment. This programme is undertaken over 3 months and contains both a practical and theoretical component with formal assessment.
11.
Provide mentorship for learners, inexperienced staff, and students promoting the development of an effective learning environment to support their personal and professional growth.
12.
To undertake teaching of registered and non-registered staff, including basic and post basic students, support of medical students/staff and visitors, e.g. paramedics.
13.
Participate in and attend Clinical Effectiveness Sessions, formal teaching and lectures from surgeons, visitors, colleagues and peers.
14.
Undertake mandatory training relevant to the clinical setting, e.g. fire, CPR, manual handling and blood transfusion.
15.
Undertake any other training and education training considered appropriate to the scrub/circulatory role, and relevant to the clinical setting.
Quality/Research & Development
16.
Demonstrate audit and research awareness and knowledge of evidence underpinning practice.
17.
Work within an ethical and legal framework utilising defined policies, procedures, standards and protocols of the department, organisation and NHS Tayside to promote safe and effective care and report quality issues to senior nursing staff.
18.
Contribute through discussion in the development of policies and protocols.
19.
Work within the remit of the Clinical Governance framework.
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6.
COMMUNICATIONS AND RELATIONSHIPS
Patient

Communicate/liase with patient and relatives inclusive of on specialist, complex and highly emotional matters which require high levels of re-assurance and empathy, e.g. patients having removal of breasts, undergoing reconstructive surgery, bereavement or sudden death.

Overcome barriers to communication such as sedation, confusion, drug/alcohol withdrawal, sensory deficits, language barriers, pre-medication, high emotional state, learning difficulties and psychotic patients.

Communicate with all other relevant healthcare professionals involved in the provision and continuity of care which may also include external agencies, IT departments etc.

Manage complaints appropriately using organisational policies and procedures.

Have an understanding and respect of cultural, ethnic and religious differences of patients.

To provide nursing support to a range of patients undergoing a range of surgical procedures.
Professional

Provide appropriate specialist advice to other clinical areas.

Liaise with relevant departments and other service providers.

Communicate within the multi disciplinary team complex information from patient assessment through pre and intra-operative checks e.g. allergies and limb movement restriction.

Liaise with duty co-ordinator, charge nurses, medical staff, transplant co-ordinator, specialist pain nurses, infection control nurses, midwives, scrub staff, recovery staff, orderlies, porters, dentists, dental nurses, Accident and Emergency nurses, pharmacists, stores, laboratories and blood bank.

Act in the best interest of all patients undergoing surgical procedures.

Co-ordinate and organise own workload, anticipate any problems and liaise with the theatre team.

Responsible for the smooth running of the theatre list; communication and liaison with all perioperative team members, co-ordination of surgical equipment.
External

Establish and maintain relationships based on mutual respect communicating on a regular basis with external agencies involved in the provision of care.
7. KNOWLEDGE, TRAINING AND EXPERIENCE REQUIRED TO DO THE JOB
. KNOWLEDGE, TRAINING AND EXPERIENCE REQUIRED TO DO THE JOB

You must be registered on Sub-part 1: RN1 or RNA or Sub-part 2: RN2 of the NMC register or equivalent.

Evidence of on-going professional development

Current scrub/circulating skills essential
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8.
SYSTEMS AND EQUIPMENT
The registered nurse/ODP is expected to have the knowledge and skills necessary to safely use, store and maintain all equipment in the area in line with local policies and procedures.
Information Technology

Theatre planner.

Intranet/e-mail.

Telephone/paging system.

Laboratory blood sample vacuum delivery system.

Adverse Incident Management Reporting.

Any other information technology system required.
Moving and Handling

Safe use of moving and handling equipment e.g. hoists, maxislide, easi- slide, and spinal boards, lithotomy legs.

Understanding and safe use of numerous specialist beds, operating trolleys, theatre tables and attachments
(>15kg).

Responsible for the movement of surgical equipment within the department/hospital e.g. surgical instrument trays, diathermy equipment, Endoscopy equipment, and any other mobile pieces of equipment required for surgery.

Any other moving and handling equipment required.
Near Patient Testing

Non-invasive blood pressure, electrocardiogram , respiratory monitoring and neurological-observations.

Blood glucose monitoring e.g. glucometer.

Temperature, rectal, tympanic and naso-pharyngeal.

Oxygen saturation monitoring.

Capnography.

Sonosite for use prior to and during insertion of invasive monitoring e.g. arterial and central venous pressure.

Fluid balance.

Tourniquet pressure.

Any other near patient testing required.
Medical Devices and other equipment.
Responsible for setting up and loading of –

Various types of infusion pumps and local infusion devices.
Responsible for checking, setting up, basic maintenance, use of, decontamination and disposal of –

Table/patient trolleys and associated attachments.

Operating lights.

Instrument trays and associated consumables.

Diathermy machines.

Endoscopy/laparoscopy equipment and associated components (camera, light source and carbon dioxide insufflators)

Ultrasonic equipment.

Fume cabinets.

Operating microscopes.

Glue/cement guns.

Tourniquet machines.

LASER and associated components.

Flowtron boots.

Numerous patient warming devices e.g. Bair Hugger and Blood Warmer.

Defibrillator.

Chest drains.

Suction equipment.

Nerve stimulators/peripheral nerve stimulators.

Ambubags.

And any other medical device as required.
RESPONSIBILITY FOR RECORDS MANAGEMENT
All records created in the course of the business of NHS Tayside are corporate records and are public records under the terms of the Public Records (Scotland) Act 1937. This includes email messages and other electronic records. It
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is your responsibility to ensure that you keep appropriate records of your work in NHS Tayside and manage those records in keeping with the NHS Tayside Records Management Policy and with any guidance produced by NHS
Tayside specific to your employment.
November 2009 7

9. PHYSICAL DEMANDS OF THE JOB
PHYSICAL SKILLS

Have knowledge and skills to anticipate requirements for type of surgical procedure in order to provide individualised patient care for the many different types of surgery.

Prepare equipment and assist with positioning of patients requiring surgical procedures.

Anticipate the need for and be competent in the use of all surgical equipment required in an emergency e.g. managing cases which convert from laparoscopic to open surgery, and haemorrhage.

Set up any monitoring to allow surgery to proceed, e.g. tourniquet, diathermy plates, Endoscopy equipment etc.
 Tend to patients’ personal care needs e.g. incontinence, wound care, pressure care (patient positioning).

Preparation of instrument trays and surgical equipment.

Safety checking of all equipment for surgical purposes in accordance with local and national guidelines and manufacturer recommendations.

Assembly and use of surgical instrumentation including fine tools e.g. laparoscopic instrumentation, implants, drills, screws, staple guns etc. requiring a high level of precision, hand-eye co-ordination and speed.

Wearing of PPE e.g. lead aprons, surgical masks, safety glasses/visors, gloves, footwear, laser safety equipment etc.

Preparation for use of intra-operative drugs as required for surgical procedure.

Insertion of urinary catheters.

Management of unexpected/expected surgical difficulties.

Cardio Pulmonary Resuscitation.
TREATMENTS

Maintenance of intravenous fluids.

Oxygen therapy.

Temperature maintenance.

Open and closed suctioning.

Management of patients post-operatively without medical staff attendance.

Non-invasive ventilation e.g. bag and mask.

Assist in the resuscitation of patients for during/following elective procedures.
PHYSICAL DEMANDS

Push beds, trolleys and equipment.

Tilting beds/trolleys.

Manoeuvring patients with the use of aids e.g. pat-slide and easi-slide.

Positioning of unconscious patients for surgery using table adjustments, arm boards, leg supports for
Lloyd Davis, lithotomy, supine, prone and left/right lateral positions.

Positioning for epidurals, spinals, nerve blocks and invasive lines.

Maintaining the patient airway.

Standing and walking for most of the shift.

Applying tourniquet and diathermy pads.

Manage confused, agitated, aggressive and psychotic patients.

Positioning of patients on traction/fracture table for orthopaedic surgery.

Care of blocked limbs/elevation, colour, sensation and movement.

Concentration required when additional theatres required to be opened for emergency use exerting pressure on resources. (long)

Concentration required when caring for unstable/critically ill patients. (long)

Concentration required during quick turnover elective lists when speed is essential to ensure smooth running and completion of list in within time frame allocated.
(short and long)

Participation in intense physical activity whilst attending resuscitation attempts outwith operating department areas with limited equipment and resources.

Escort duties with critically ill patients within the hospital setting.

Escort duties with critically ill patients to other hospitals throughout Scotland.
EMOTIONAL DEMANDS

Cope with frequent interruptions in operating schedule from the multi-disciplinary team members
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relating to a change in list priorities, re-location of workload, telephone and pager requests and demands outwith the control of the operating theatre.

Supporting work colleagues.

Communicating with distressed/anxious/worried patients and relatives.

Caring for terminally ill patients undergoing palliative surgery.

Exposure to verbal/physical aggression from confused, agitated and sedated patients.

Identifying and managing emergency situations.

Coping with unexpected sudden death during surgical procedures involving all age groups.

Performing last offices.
WORKING CONDITIONS

Exposure to body fluids, faeces, vomit, emptying bed pans/urinals and catheter bags.

Exposure to high-risk body fluids.

Exposure to sharps e.g. blades, needles, instruments.

Working in an environment where temperatures can vary. High temperatures due to lack of windows and proper ventilation. The need for temperature to be increased depending on type of surgery. Cold temperatures due to regular air flow changes.

Exposure to hazardous materials e.g. anaesthetic gases, diathermy plumes, surgical skin solutions, bone cement

Working in a confined environment that has no natural daylight or ventilation for extended periods.

Exposure to blood during intravenous cannulations, blood transfusion and insertion of invasive lines.

Exposure to x-rays.

Exposure to LASER.

Exposure to latex.

Exposure to noise pollution e.g. electrical equipment, laminar air flow systems.

Exposure to infection e.g. MRSA, Hepatitis A, B and C. HIV and Aids and viral/bacterial meningitis.

Continual day/night rotation and weekend working if determined necessary by the organisation.

On-call overnight commitment if determined as necessary by the organisation.
November 2009 9

10 DECISIONS AND JUDGEMENTS

The Registered Nurse/ODP will be responsible to the Senior Charge Nurse/Charge Nurse for professional management, work review and formal appraisal of performance.

The Registered Nurse/ODP will have responsibility for managing a defined workload within professional guidelines, which has been allocated by the Senior Charge Nurse/Charge Nurse.

The Registered nurse/ODP will be responsible for the assessment, monitoring, evaluation and interpretation of patient condition and early detection of clinical deterioration using critical judgement and reasoning and respond appropriately.

Analysis of patient condition and subsequent planning of individualised care.

Work as skilled practitioner. Work under own initiative, often in isolated areas, demonstrating sound decision and judgement, within NHS Tayside Policies and Guidelines and in accordance with the Professional Codes of Conduct, and recognising own limitations, refer on as necessary.
11 MOST CHALLENGING /DIFFICULT PARTS OF THE JOB

Ensuring patient and environmental safety at all times.

Nursing potentially critically ill adult and young adult patients.

Nursing patients of all needs within a broad range of diverse specialities elsewhere in NHS
Tayside including Ninewells Hospital and Perth Royal Infirmary.

Working with many multi-disciplinary teams, adapting to not only different paperwork but also different layout of individual theatres/anaesthetic rooms and clinics.

Scrub/circulating nurse/ODPs also have to adapt to individual surgeon and surgical working practices.

Have the ability and experience to challenge decisions made by members of the multi-disciplinary team, which may be unusual practice, or, are not perceived to be in the best interests of the patient.

Challenging anti-social behaviour.

Having the flexibility and experience to adapt to each discipline where needed several times per shift.

The scrub/circulating nurse/ODP is responsible for giving a full surgical support service whilst the patient remains in the perioperative environment.
12. JOB DESCRIPTION AGREEMENT
The job description will need to be signed off using the attached sheet by each postholder to whom the job description applies.
November 2009 10

JOB DESCRIPTION AND ESSENTIAL ADDITIONAL INFORMATION FORM –
SIGNATURE OF AGREEMENT
Post Title
Reference Number
The attached job description and essential additional information will be used as part of the Agenda for
Change assimilation exercise and therefore the job matching panel may wish to seek further clarification on any issues contained within the documents. Should this be necessary please identify an appropriate Manager and Staff representative who can be contacted.
Responsible Manager
Contact No.
Staff Representative
Contact No.
I/we the undersigned agree the attached document is an accurate reflection of the requirements of the post. The essential additional information provides accurate information of additional job related factors.
Signed :- (Manager)
Staff Members:
NAME
(BLOCK CAPITALS PLEASE)
SIGNED POST NO.
(office use only)
November 2009 11

POST REF NO:
JOB TITLE/GRADE:
D/LR/156/13
REGISTERED NURSE/ODP, BAND 5 (SCRUB
LOCATION:
CIRCULATING PRACTITIONER)
OPERATING DEPARTMENT, STRACATHRO
HOSPITAL
Conditions of
Service
Remuneration
Hours of Duty
The terms and conditions of service for this post are those determined by the NHS Staff Council.
The current salary scale for the post is £21,388 to £27,901 per annum (pro rata for part-time staff). Placing on the scale on appointment is normally at the minimum but may be higher subject to verification of previous relevant service.
Salary is paid monthly by Bank Credit Transfer.
The hours of the post are 37.5 hours per week.
Start and finish times will be determined by the needs of the service.
Superannuation Membership of the NHS Superannuation Scheme is not compulsory but is open to all staff between the ages of 16 and
70 (65 in some instances).
The contributions paid are a percentage of superannuable pay, which is essentially basic pay excluding, for example, overtime or travelling expenses.
Contribution rates with effect from 01.04.13 are as follows:
Contribution Annual Pensionable Pay
(Full-time equivalent)
Up to £15,278
£15,279 to £21,175
£21,176 to £26,557
£26,558 to £48,982
£48,983 to £69,931
£69,932 to £110,273
£110,274 and over
5%
5.3%
6.8%
9.0%
11.3%
12.3%
13.3%
Annual Leave
Contributions are subject to tax relief and reduced National
Insurance contributions. NHS Tayside also makes a substantial contribution towards scheme benefits – currently around 14% of basic pay.
On appointment = 27 days (pro rata for part-time Staff) or 5.4 weeks per year.
After 5 years aggregated service = 29 days (pro rata for parttime staff) or 5.8 weeks per year
After 10 years aggregated service = 33 days (pro rata for parttime staff) or 6.6 weeks per year
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References
Public Holidays = 8 days (pro rata for part-time staff) or 1.6 weeks per year
All offers of appointment are subject to receipt of two satisfactory references.
Occupational
Health
Clearance
All offers of appointment to new entrants to the National
Health Service are subject to a medical examination.
Medical examinations are arranged and undertaken by the
Occupational Health and Safety Advisory Service (OHSAS).
Rehabilitation of
Offenders Act
1974
(Exclusions and
Exceptions)
(Scotland) Order
2003
All current or spent criminal convictions, cautions, warnings or any case pending must be disclosed prior to commencing in employment as detailed on the application form.
Please note that having a conviction will not automatically debar you from obtaining employment with NHS Tayside. Careful consideration will be given to the relevance of the offence to the particular post in question. However, if you are appointed, and it is found that you did not reveal a previous conviction your employment may be terminated.
Disclosure
Scotland
Immigration,
Asylum and
Nationality Act
2006
The successful applicant will be required to become a member of the Protecting Vulnerable Groups Scheme (PVG) in respect of regulated work with protected adults and regulated work with children.
It is a criminal offence for an employer to employ anyone who does not have permission to live or work in the UK.
Shortlisted applicants will be asked to produce specific original documentation at interview e.g. Passport, or full birth certificate together with an official document giving the applicants permanent National Insurance Number and name issued by a
Government Agency or a previous employer, as well as photocopies of these documents.
Professional you should have current and continuing professional registration
Registration/ with NMC/HPC and hold the appropriate qualification(s).
Induction Standards
&
Code of Conduct
Smoking Policy Smoking is prohibited within NHS premises and grounds.
Applications Completed forms should be returned to: recruitment.tayside@nhs.net subject line quoting the job reference in the or to Human Resources Directorate, NHS Tayside, Level 9,
Ninewells Hospital, Dundee DD1 9SY
By closing date of Friday 21 st March 2014
November 2009 13