Eileen O’Keeffe, shares an insight into her role as a Theatre Assistant at the Royal Orthopaedic Hospital
Theatre Assistants work as part of a team contributing to the delivery of patient’s individual care needs in the Theatre environment. Theatre Assistants like Eileen work with different consultants, surgeons and specialists on a range of patient cases. At the Royal Orthopaedic Hospital (ROH), this could be anything from joint replacements like hip and knee replacements to spinal fusions and oncology cases. We work in our clusters but are expected to work in any theatre case, building up a good knowledge base across different orthopaedic surgeries.
Setting up theatre
As soon as I get to work, I change into blues and clogs, and check our Theatre board to see who we are expecting today.
In Theatre I work with ODPs (Operational Department Practitioner), scrub nurses, other Theatre Assistants and an Anaesthetist as well as the consultant/ surgeon.
To set up the theatre, all surfaces and equipment are cleaned, essential equipment put in its place, and the paperwork is all made ready.
Then the surgeons and anaesthetist arrive, and we discuss the needs of patients on the surgical list – things like the type of anaesthesia, medical history, and if any specimens being taken for research in our Dubrowsky Lab.
Sending for the patient
Once the theatre is all set, and we’ve discussed the surgery with the surgeons and anaesthetist, the patient is sent for.
Final checks are made by the Theatre team before the patient arrives.
The patient then arrives in the anaesthetic room. The ODP runs through some checks with the patient and we attach ECG dots to the patient to monitor their vital signs - heart rhythm, blood pressure and blood oxygen. We also fit a Flowtron garment which is attached to the lower leg to reduce the risk of Deep Vein Thrombosis (DVT).
Our most important job during surgery is being an advocate for the patient while they are at their most vulnerable. We observe, highlighting any concerns, making sure the patient care is of the highest standard, and always maintaining the patient’s safety, dignity and privacy. We will talk to the patient to make sure they are comfortable and relaxed.
We assist in holding and positioning of the patient during spinal blocks, tourniquets, diathermy plates, body warmers and catheters. Before any blocks are done we have a ‘stop before you block’ in place. Building in this pause means we can again confirm the patient details, as well as the correct site and side for the surgery.
Scrubbing in
Meanwhile, in theatre the scrub nurses prepare by scrubbing in (this means making sure they are clean and sanitary for surgery) and we start to open the surgical trays, checking as we go that everything is as it should be. After the scrub nurses get in their sterile gowns, the trays are passed on to them, for their specialist checks.
The theatre assistant then opens any extra items and assist the surgeons with sterile gowns. Implants (like those used in joint replacements) are logged and scanned against the patient’s details.
We also confirm with the scrub nurse our first count of items to be used in the surgery. We will do the same at the end of the surgery to ensure everything is accounted for.
Patient is brought into theatre for the surgery
The patient is then brought into the theatre ready for their procedure. Once the patient is settled onto the anaesthetic machine, the surgeon starts their work and we assist.
During the case we start the perioperative care plans, record any medication used, surgery details, and pass on to the scrub nurse for verification.
All other paperwork which includes reporting any issues with trays, or filling out details in the surgeon’s books and national joint registry forms, surveillance forms.
During the case we listen for any other items needed, and prepare the implant. A second count is done to confirm we have everything in place.
Towards the end of the operation we do a Sign Out where the operation is recorded, we confirm counts, ensure that implants are correct and any anaesthetic updates. The final count is done and contents of trays checked.
After the procedure, we clean and reset the theatre space, complete any paperwork and process any samples or specimens.
Setting up for the next surgery
During the daytime, we then get everything ready for the next day (surgical trays, items needed, getting paperwork in order) using the surgeons’ books as reference and speaking with the scrub nurse in our cluster. The scrub nurse in theatre then checks all laying up to make sure it is correct for the next day.
At the end of the day we remove all paperwork, clean all equipment including lights/canopy, push everything out of theatre for cleaners to access, restock, complete cleaning logs, remove all trays, put away unused unopened items, prep, saline and put these away.
We are also part of a 24hour emergency team who can be called out at any time during being on call.
