Have you ever wondered what and Anaesthetic/PACU ANUM does? The operating theatre is a secret word where everyone changes into pyjamas and then secret things happen. Theatre nurses are all part of a committed team to save lives and make live better for their patients every day. Well, this is just an idea of a single day in my working life. My days do vary depending on my allocations each day but this is just an outline of one of those more standard days. I am an operating room nurse and I provide patient care before, during and after surgery. It is a high-stress job that requires emotional and physical stamina, the ability to operate complicated equipment and knowledge of procedures, instruments and supplies. When I do anaesthetics, I might be the last person someone sees as they go off to sleep. Then when I work in PACU I am the first person they see when they wake up.
I saw this written once…. If you can hold 5kg at a strange angle for hours on end, then you are a theatre nurse. If you have short nails because of the chemicals you rub on them all day, then you are probably a theatre nurse. If you don’t have to do your hair because no one will know what it looks like because it is under a hat, then you are probably a theatre nurse.
Sometimes you may work an entire shift with little or no break. You need to be able to work with others in your team even if you are not friends. In an operating theatre, you can’t walk out on your team for a bit of space like you might be able to do in other areas of nursing. A black sense of humour is a necessity, for emotional survival – others outside of nursing often think it is inappropriate and may not get it. There are also area-specific jokes to your speciality area that may totally shock your family members if you were to tell them.
So, this is one of my days….
I wake up around 0530 and I struggle to get up for about 10 minutes. I have breakfast usually muesli. I look at my phone for social media updates and I watch the TODAY show for news updates. I get dressed and I drive 35-40 minutes to work.
I the car I will listen to the radio or podcasts. I like to listen to podcasts as I think of it as improving my brain while I can still concentrate on the road.
When I arrive. I thumb in and change into my scrubs, tie my hair up and put on a scrub hat. I might chat a little to others in the change room. I check the board for my allocations. Today I am running the floor. I sort out the board, the staff have already been allocated to their theatres according to surgeons and surgeries that day. Each theatre has an anaesthetic nurse, scrub and scout nurse and theatre technician. There are also day nurses, holding bay nurses, orderlies and CSSD nurses. I check for sick leave overnight and move things around to make it all workout.
I check in with the staff in each area to see that they have all the things that they need – instruments and consumable. Staff arrive between 0700 and 0730 for their lists that commence often at 0800. I check in with CSSD to make sure that everything is working in their area. I don’t know a lot about sterilising but I know how important it is to keep the department flow going. I touch base with the holding bay to see if we already have issues with beds.
Once the lists start I begin inputting the man hours for the previous day. This where you add data to a spreadsheet about the working hours of the previous day. I try to get this done by 1000.
By 0930 it is the bed meeting and myself of the day surgery ANUM go. This is where all the floor managers from each of the wards meet with the hospital coordinator to go over all the expected patients and where they are all going to be for the day. Their admissions/discharges. Special care requirements that they may need. This data is added to a spreadsheet called the bed board. So, that all staff can view it. It also has staff projections included in it.
When I am checking over the theatre lists for the next day I check that we haven’t missed ordering anything special. Since out lists finish around 1200 that sorts out lunch breaks. If they finish earlier, we can start setting up for the next day. The PM lists start at 1300 so we must be ready to go again. Sometimes you must juggle things around to make sure that everyone has lunches etc. Recharging is very important.
Between a theatre case we “turn over the theatre”. This involves cleaning and resetting the theatre getting it ready for the next patient. The faster and more economically you can do this the better your list will run. It also makes the surgeons and often the anaesthetists very happy.
After lunch is a good time to check the coming week’s allocations. Where lists have changed, the staffing should be changed and this is a time-consuming job.
Around 1630 the theatre list is checked with the theatre clerk for the next day. This is super important as we check patient details on admission against these lists.
My shift officially finishes around 1800. If I am lucky I get to go home then, sometimes I am on call. Sometimes the theatre run over. When I run the floor, I need to check that everyone can get home so I might stay to finish a list. Then I head home once it is all done. If I am on call. I will get home and will be called in at any time over the night till 0700 the next day.
“You never know what’s going to happen, what’s going to unfold for the day. The staff all have the training and skills to deal with it if all hell breaks loose, but they still provide the utmost care to the routine cases. It’s about that consistency of care.”
When I am having a clinical day, I will work in Anaesthetics or PACU (recovery). As part of my setting up, I have run checks on all my equipment as a standard daily check. We also check other things like airway trolleys and defib machines. The Anaesthetic nurse meets the patient and prepares them for their surgery. We provide education and reassure. I prime lines that are required. My colleagues are setting up equipment that they might need in the theatre. Everything g must remain sterile so there are lots of drapes creating that sterile field.
Once the patient is in the theatre, as the anaesthetic nurse I support the anaesthetist and the scout/scrub nurses support the surgeon. They check all the instruments and consumables and make sure that the surgeon has everything they need. As I make sure the anaesthetist has everything they need. We follow procedures and check off checklists. Everything is counted or accounted for in the theatre before, during and after the surgery. We have the correct patient, the correct procedure and the correct equipment.
Alongside the anaesthetist, I keep an eye on the patient monitoring their status and responses in the theatre. I also start to plan for the next cases. We are always ready to act if the patient deteriorates. We can respond to an airway emergency, bleeding, anaphylaxis or resuscitation for example. Everyone has their own role. If we need more help others can be called on and will bring equipment to the theatre to assist. We can all communication almost without talking sometimes we are so well in tune – some days!
Once the surgery is over the patient moves into PACU/recovery. Where another nurse cares for them, giving them pain relief and monitoring them until they are stable enough to return to the ward.