Operating Room Circulating Nurse

POSITION TITLE

Operating Room Registered Nurse: Orthopedic, Spine, Total Joints, & Pain Management

POSITION SUMMARY

The Operating Room Registered Nurse (OR RN) is responsible for providing safe, effective, and patient-centered nursing care throughout the intraoperative phase of the perioperative experience. The OR RN assesses patient need and develops and implements the perioperative plan of care. The OR RN coordinates activities within the operating room, advocates for the patient, and promotes a safe surgical environment. The position supports achievement of expected patient outcomes through adherence to facility policies and procedures, established standards of nursing and perioperative practice, infection prevention principles, and applicable regulatory and accreditation requirements.

REPORTING RELATIONSHIPS

Reports to: Director of Nursing or designee

Works closely with: Surgeons, anesthesia providers, surgical technologists, registered nurses, sterile processing personnel, clinical leadership, materials management, and other members of the perioperative team.

MINIMUM QUALIFICATIONS

· Graduate of an accredited school of professional nursing required.

· Current, unrestricted Registered Nurse license to practice in the State of Arizona or multistate privilege recognized by Arizona, as applicable.

· Basic Life Support (BLS) certification required within 30 days of employment or within the timeframe established by facility policy.

· Advanced Cardiovascular Life Support (ACLS) and Pediatric Advanced Life Support (PALS) certification required within 90 days of employment or within the timeframe established by facility policy, based on the patient population served.

· Minimum of two years of operating room nursing experience preferred or required based on facility needs.

· Current perioperative nursing experience in an ambulatory surgery center or hospital operating room preferred.

KNOWLEDGE, SKILLS, AND ABILITIES

· Knowledge of perioperative nursing practice, surgical procedures, aseptic technique, infection prevention, patient positioning, surgical safety, and emergency response.

· Ability to perform comprehensive perioperative nursing assessments and correlate clinical findings with the patient's medical condition, planned procedure, and anesthetic plan.

· Ability to prioritize care, anticipate procedural needs, and respond effectively to changes in patient condition or surgical workflow.

· Ability to function competently as the circulating nurse and coordinate activities of the perioperative team.

· Knowledge of surgical counts, specimen handling, medications on the sterile field, implants, equipment, electrosurgical safety, positioning devices, and other intraoperative safety practices.

· Ability to communicate clearly and professionally with patients, families, physicians, anesthesia providers, and members of the healthcare team.

· Ability to provide direction and delegation consistent with professional standards, facility policy, and individual scope of practice.

· Ability to document patient care accurately, completely, and contemporaneously in the medical record.

· Ability to work independently within assigned responsibilities while functioning effectively as part of a fast-paced perioperative team.

ESSENTIAL DUTIES AND RESPONSIBILITIESPatient Assessment and Perioperative Nursing Care

· Performs and documents a focused perioperative nursing assessment and verifies relevant patient information prior to the procedure.

· Reviews the planned procedure, consent, patient identity, allergies, pertinent diagnostic information, preoperative preparation, and other required elements before transfer to the operating room.

· Develops, implements, evaluates, and revises the perioperative plan of care based on patient assessment, age-specific needs, procedure, anesthesia, identified risks, and expected outcomes.

· Provides individualized nursing interventions to promote patient safety, dignity, comfort, privacy, and achievement of expected outcomes.

· Identifies changes in patient condition and promptly communicates findings to the surgeon, anesthesia provider, and other appropriate team members.

· Provides nursing care in emergency situations and participates in emergency response according to facility policy and demonstrated competency.

· Ensures continuity of care through accurate handoff communication and transfer of pertinent patient information to the receiving nurse or clinical area.

Intraoperative Circulating Responsibilities

· Functions as the circulating Registered Nurse and coordinates nursing activities within the operating room throughout the surgical procedure.

· Verifies completion of required pre-procedure activities and actively participates in the facility surgical safety process, including pre-procedure verification, site verification as applicable, time-out, and sign-out.

· Maintains ongoing awareness of the sterile field and identifies and responds to breaks in aseptic technique or other patient safety concerns.

· Coordinates room preparation and confirms availability and safe functioning of supplies, implants, medications, positioning equipment, and surgical equipment required for the procedure.

· Assists with safe patient transfer, positioning, skin preparation, application of safety devices, and other intraoperative nursing interventions within demonstrated competency.

· Implements measures to reduce risks associated with positioning, pressure injury, falls, retained surgical items, surgical fire, electrical hazards, medication errors, infection, and other perioperative complications.

· Performs and documents surgical counts with the appropriate team member in accordance with facility policy and initiates required actions for count discrepancies.

· Manages medications and solutions used during the procedure in accordance with facility policy, including verification, labeling, communication, and documentation requirements.

· Coordinates handling, labeling, documentation, and disposition of specimens in accordance with facility policy.

· Coordinates implant documentation and traceability, including required device and lot information, as applicable.

· Maintains situational awareness and communicates changes in procedure, equipment needs, patient condition, or workflow to the perioperative team.

Patient Advocacy, Communication, and Documentation

· Serves as the patient advocate while the patient is sedated, anesthetized, or otherwise unable to advocate for themselves.

· Protects patient rights, privacy, dignity, and confidentiality throughout the perioperative experience.

· Documents assessments, interventions, medications, positioning, counts, specimens, implants, equipment, patient responses, and other required intraoperative information accurately and in a timely manner.

· Provides concise and pertinent communication to physicians, anesthesia providers, and other members of the healthcare team to support continuity and safety of care.

· Communicates with patients and families in a manner appropriate to their age, developmental level, language, understanding, and readiness to learn, within the scope of the role.

Safety, Infection Prevention, and Emergency Preparedness

· Practices aseptic technique, standard precautions, transmission-based precautions when indicated, and other infection prevention measures in accordance with facility policy.

· Uses equipment safely and according to facility policy and manufacturer instructions for use; reports malfunctioning or unsafe equipment and removes it from service when appropriate.

· Follows safe practices for sharps, medications, specimens, hazardous materials, surgical smoke, electrosurgery, lasers, radiation, and other procedural hazards applicable to assigned duties.

· Identifies unsafe conditions and takes appropriate action to protect patients, staff, and others.

· Participates in emergency preparedness activities and maintains competency in emergency procedures applicable to the operating room, including cardiopulmonary arrest, malignant hyperthermia, local anesthetic systemic toxicity, anaphylaxis, fire, and other facility-defined emergencies.

· Completes required incident or occurrence documentation accurately and promptly in accordance with facility policy.

PROFESSIONAL AND TEAMWORK EXPECTATIONS

· Demonstrates professionalism, reliability, accountability, sound clinical judgment, and respectful communication.

· Collaborates with surgeons, anesthesia providers, surgical technologists, nurses, and other team members to support safe and efficient patient care.

· Uses time effectively and supports efficient room preparation, case progression, turnover, and readiness for subsequent procedures without compromising patient safety.

· Provides appropriate direction and delegation to team members consistent with role, competency, and scope of practice.

· Participates in orientation and education of staff as requested and within demonstrated competency.

· Maintains professional competence through required education, annual competency validation, staff meetings, and continuing professional development.

· Participates in quality assessment and performance improvement, infection prevention, patient safety, and other facility initiatives as assigned.

· Accepts feedback constructively and contributes to a positive, collaborative, and professional Surgery Center environment.

· Demonstrates responsible stewardship of supplies and equipment and supports appropriate cost-containment practices.

· Performs other duties within the scope of Registered Nurse practice and demonstrated competency as assigned by the supervisor.

EQUIPMENT USED

Equipment may include, but is not limited to: operating room tables and positioning devices, electrosurgical units, suction equipment, tourniquet systems, sequential compression devices, warming equipment, surgical lights, video and endoscopic systems, powered surgical equipment, medication and fluid delivery equipment, emergency equipment, patient transport equipment, computers and electronic medical record systems, radiation protection equipment, and other clinical equipment utilized by the facility. Use of equipment is limited to devices for which the nurse has received appropriate training and demonstrated competency.

WORK ENVIRONMENT

Work is primarily performed in operating rooms and perioperative patient-care areas within a climate-controlled healthcare environment. The position involves frequent interaction with patients, physicians, anesthesia providers, and clinical staff and may be fast-paced and subject to interruptions and changing priorities. Potential exposures include blood and body fluids, infectious materials, sharps, medications, cleaning and disinfecting agents, surgical smoke, radiation, chemicals, unpleasant odors, and mechanical or electrical hazards. Required personal protective equipment and safety precautions must be used based on assigned duties and identified hazards.

PHYSICAL REQUIREMENTS

The position requires prolonged standing and walking; frequent bending, reaching, grasping, pushing, pulling, and fine motor activity; and sufficient visual acuity, color discrimination, hearing, and communication ability to safely perform perioperative nursing responsibilities. Must be able to assist with patient transfers and positioning; push or maneuver patients on stretchers and heavy equipment; lift and carry instrument trays and supplies up to 25 pounds; and wear required protective equipment, including lead apparel when applicable. Safe patient-handling techniques, team assistance, and mechanical aids should be used when appropriate. Reasonable accommodations may be made to enable qualified individuals with disabilities to perform the essential functions of the position.

EXPOSURE CLASSIFICATION

This position has occupational exposure to bloodborne pathogens and other potentially infectious materials. Exposure may occur during direct patient care; vascular access; medication administration; handling of sharps, specimens, contaminated instruments, dressings, supplies, and patient waste; and assistance with anesthesia or other invasive procedures. The employee is required to follow the facility Exposure Control Plan, standard precautions, sharps safety practices, and personal protective equipment requirements.

SUPERVISION

Works under the general supervision of the Director of Nursing or designee. The Operating Room Registered Nurse is expected to independently perform assigned nursing responsibilities within the nurse's scope of practice, facility privileges or competencies, policies and procedures, and demonstrated competency; exercise appropriate clinical judgment; and promptly escalate changes in patient condition, safety concerns, or situations requiring additional clinical or administrative support.

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Employee assistance program
• Flexible schedule
• Flexible spending account
• Health insurance
• Health savings account
• Life insurance
• Paid time off
• Retirement plan
• Vision insurance

Work Location: In person