Duties of A Circulating RN

Before meeting patient:

-ensure room has proper and functioning equipment

-case cart is complete

-all necessary positioning aids available

-OR lights work (you'd be amazed by how frequently those bulbs can burn out!)

-get necessary meds for case (local anesthesia, thrombin, heparin, etc)

In preop:

-interview patient (correct name/DOB/allergies/medical & surgical history/etc)

-verify consents (match what patient states they are having/anesthesia type and that anesthesia has seen patient)

-check labs

-check blood availability if applicable

-check antibiotics (given by preop nurse, need given by OR nurse, hold until after cultures, etc)

-transport patient to OR

In OR:

-assist with anesthesia induction

-insert foley if necessary

-position

-apply grounding pad for electrocautery and forced air warming blanket if using

-prep

-count instruments, sponges, and sharps

-give any meds to sterile field

-page surgeon to come back if not already in OR

-TIME OUT (verify that you have correct patient, correct surgeon, correct procedure, anything else set forth in facility policy- we also include DOB, allergies, antibiotics, any meds on field)

-hook up equipment as needed (suction, electrocautery, laparoscopic equipment)

-document in patient record

-assist with anesthesia emergence

-transport patient to PACU and give report

-return to OR, turnover, and get ready to repeat!

This is just a basic overview, probably overly simplified and incomplete since almost every different type of surgery will be different, as well as how each facility handles things. Some hospitals have the circulator transport patient to OR, some have anesthesia transport. Some facilities allow for circulator/scrub to switch every other case if both are RNs. Others may have additional people in the room that can do some of those duties (we assign 2 STs to each room, so often they will prep while circulator counts/pages surgeon).

Edit to add: Most of the "work" happens before and after the surgery itself. During the surgery, most of it is documenting, or running for extra supplies because the surgeon changes his/her mind on what they want to use.