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A Reflection on Preoperative Experience

The Importance of Seeing the Surgery through the Patient’s Eyes

The nursing field has given me a dozen experiences that I have embraced and taken lessons from. Perioperative care is an enthralling branch of nursing that encompasses providing care to the patient from admission to the ward, anesthesia, operation, and recuperation (Borenstein et al., 2018). In this profession, I had the opportunity to observe a client in the surgery room who was undergoing a procedure of total ankle replacement as a result of a bad fall. Throughout the surgical operation, I witnessed the anxiety between both the surgeon and the patient as each of them was probably anticipating the dangers that accompany even the slightest mistake in an operation room. The patient was most anxious, and this made me realize that when caring for patients who suffer from anxiety, surgery is a stressful event for both the patient and the healthcare practitioner.

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Roles of Health Care Team Members During the Perioperative Phases

During an operation, the different health care team members work harmoniously to ensure a successful process. There exist three stages of perioperative care, which are preoperative, intraoperative, and postoperative (Baptista et al., 2019). The preoperative stage involves preparing the patient psychologically for the operation and giving them necessary information concerning the procedure. Perioperative nurses are concerned with the mental preparation of patients, and they offer them the necessary support while teaching them about what the procedure will entail. The intraoperative stage is more detailed as it involves four specialists. The anesthetist ensures successful induction of anesthesia for the patient and monitors a patient’s physiologic status throughout the operation. The circulating nurse readies the operating room for surgery, preserves surgical sterility while draping and handling equipment, and aids the surgeon by passing necessary items. The assistant nurse, on the other hand, gathers and captures every operation that the surgeon conducts during surgery. The surgeon is the overall team leader who operates on the patient and ensures the four team members are functional.

Roles and Responsibilities of the Registered Nurses in Preoperative Process

The surgery room consists of two registered nurses: the assistant nurse and the circulating nurse. The assistant nurse helps the surgeon during surgery by aiding with bleeding control, monitoring for indicators of problems, administering sutures, and providing dressings. They also gather and capture every operation that the surgeon conducts during surgery. The scrub nurse on their part ready the operating room for surgery, preserves surgical sterility while draping and handling equipment, and aids the surgeon by passing the necessary items.

Organization of the Surgical Unit

Each section includes a charge nurse and there is a good flow of services. Patient safety is the most critical concern for every team member. There is restricted movement of the patient in the operational area to further guarantee safety. In terms of communication, nurses are assigned helping duties to both the surgeon and the anesthetist. A surgeon, for instance, can assign a scrub nurse the role of supplying the surgical tools. Conversely, an anesthetist may authorize a Registered Nurse to aid with IV medicine.

Types of Clients, Operations (Including Medications), and Apparatus Used

The client in this case was a victim of a bad fall who had badly injured his ankle and was in the surgical room for a total ankle replacement. In the preoperative stage, the patient was sent for a CT scan to give a visual image of how badly the ankle had been damaged. Afterward, a preoperative nurse offered to counsel the patient and detailed the procedure that would be involved in ankle replacement. In the surgery room, the patient was prepped for the operation by use of a general anesthetic procedure. The patient was then placed in a supine position on the operating table and a piece of arthroscopic equipment was used. A large syringe and lactated Ringer’s solution were used to dilate the joint. Hemostats were used to dissect the ankle and a viewing screen was constantly used to reflect the progress of the procedure. Other equipment included were forceps, probes, and knives. At the end of the procedure, a plaster was wrapped around the leg from the foot to the calf.

Standards of Care and Protocols Followed by the Registered Nurse

Some of the standards followed by registered nurses include medical care coordination throughout the patient’s perioperative journey. Another standard dictates consultation on the specialist discussion that is relevant for the patient. Health promotion of the patients and prescriptions is another set of standards of care followed by the RNs. Ethical standards, as well as efficient resource utilization, were also key protocols followed throughout the perioperative care of the patient. All this was done with the patient’s safety in mind as the top priority.

Stressors Experienced by Nurses in the Perioperative Setting

In my experience, the main stressors of a nurse in a perioperative environment are associated with burnout from high volumes of work, time constraints, concern for patient safety. Additionally, elements of insufficient communication among team members and verbal abuse contribute to a nurse’s workplace stress. Intrinsically, emotions of unpreparedness for operations, and demands for continual learning contribute to high levels of workplace stress.

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An Example of Best Nursing Practice to Poor Nursing Practice Observed

Best nursing practices are critical in ensuring successful health care endeavours. The best nursing practices observed include professionalism, quality patient care, good relations amongst nursing team members as well as patients’ relations. Elements of confidentiality, as well as openness, were prominent throughout the procedure. From the onset of preoperative services until discharge of the patient, nurses demonstrated collaboration, discipline, and executive services in caring for the patients. The only poor practice witnessed that day was breakages in information flow amongst team members in the perioperative procedure.


Baptista, M., Vasconcelos, J. B., Rocha, Á., Silva, R., Carvalho, J. V., Jardim, H. G., & Quintal, A. (2019). The impact of perioperative data science in hospital knowledge management. Journal of Medical Systems, 43(2), 41. Web.

Borenstein, T. R., Anand, K., Li, Q., Charlton, T. P., & Thordarson, D. B. (2018). A review of perioperative complications of outpatient total ankle arthroplasty. Foot & Ankle International, 39(2), 143-148. Web.

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