Circulator nurse doesn't leave the room ? How would this work?

[mhy12784]

I was reading a journal article today that talked about circulating nurses not leaving the OR room leading to better care and a more effective surgical process. How would this even work ? Do hospitals actually do this ? (because according to the article they actually do and it works better)

Essentially from what I read anesthesia does their interview with the patient, then they bring the patient to the OR (along with an orderly or something if needed)

When would the circulating nurse do their interview, and verify site/consent etc ? In the room while the patients on the table ? Or does the preop nurse do this ? The whole process sounds fishy... and I honestly cant imagine anesthesia agreeing to it

However the part about PACU coming to the OR to pick up the patient sounds fantastic to me. And really makes sense all around

[Rose_Queen, BSN, MSN, RN]

I've heard there are some facilities where the patient is comsidered anesthesia's patient and they are the ones to transport to the OR but I've never heard of one where PACU comes to the OR to pick up the patient. How would that work because in most PACUs nurses have another patient. Do you have a link to the article?

[MereSanity]

Anesthesia picks up patients? Be still my heart! Sounds great but who is going to make sure all the paperwork is in order, etc? Half the time something isn't signed.

[momathoner09, BSN, MSN, APRN]

Ours have to be transported from our area (holding) to the OR by a CRNA & a RN that will be in that OR.

[mhy12784]

I'll check later for the article, though it was in a cinhal database though gradschool so you'd need access to that kinda thing.

I did read another article later on the topic which basically described the process like this.

Previous case ends. Pacu comes to the OR and picks up the patient. Nurse finishes charting for this case goes to the holding area for patients and they interview the patient check consent etc etc while the rooms being cleaned.

They then go back to the room (which hopefully is cleaned at this time) So they can open and count with the techs etc etc. While they're doing that anesthesia interviews the patient and brings them over to the OR.

Slightly different than what I read in the other article, but anesthesia still ultimately brings over and sets up the patient

[Foggy14]

I'll check later for the article, though it was in a cinhal database though gradschool so you'd need access to that kinda thing.

I did read another article later on the topic which basically described the process like this.

Previous case ends. Pacu comes to the OR and picks up the patient. Nurse finishes charting for this case goes to the holding area for patients and they interview the patient check consent etc etc while the rooms being cleaned.

They then go back to the room (which hopefully is cleaned at this time) So they can open and count with the techs etc etc. While they're doing that anesthesia interviews the patient and brings them over to the OR.

Slightly different than what I read in the other article, but anesthesia still ultimately brings over and sets up the patient

This is what we do in my facility and it works great. I like being able to see the patient and assess positioning needs, etc. before setting up the room. After the case the patient is usually transported to PACU by anesthesia and a resident (or the surgeon). If everyone has already disappeared, I go with and then go straight over to pre-op to see the next patient.

[ORoxyO]

I worked for a hospital that did something similar to this. They called it parallel processing. It was TERRIBLE. Patients would be brought to the OR while it was still dirty. Consents wouldn't be signed, and other incomplete issues that I would have to deal with in the room. I never got a chance to ask patients important positioning, allergy, procedure and other questions...and anesthesia never bothered to ask so I felt like it led to improper care, and me not knowing my patients. Anesthesia and a resident/PA take the patient to PACU. It might work in a place where there is better communication but I felt very unsafe and quite this job after nine months.

[northgirl86]

We do this in our OR we interview in front of the anesthesia they have no problem with it and the PACU nurse comes t the OR and picks up the patient and gets report in the room with everyone present

[NurseFrawg]

At the hospital I work at the circulator and anesthesiologist go to pick up the patient from the preop area. The scrub and an aide or a floating RN stay in the room to finish opening items and preparing for the surgery. The only issue is making sure the count is done. We always ask before just surprising staff in the OR. At the end of the sturgery PACU if able will come to the OR to get report and the patient. Granted I work in a small (3 OR peds facility), but it works for us. Very short turn over times. I wouldn't trust my anesthesiologist checking to make sure ALL of the paperwork was done. I love them, but seriously they are pretty clueless on the paperwork needed. Also if I spot that a procedure is changed or added or a supply is needed I can call in and let the room know.

[SandraFenway]

Sounds like a dream date for a contract effiency expert to add to his/her resume. The actuality of the process is a nightmare for the poor RN who is trying to give safe care. I mean, HONESTLY, how many phone calls will it take (from the hermetically sealed OR bubble) to ensure the safety checks are done correctly, the implants match the case, blah, blah..

PACU taking the pt with anesthesia is a nice taxi service though, we have done that with success.