First, I think it would really benefit your research to understand the roles of the CRNA vs the OR circulator. The CRNA is in charge of managing the patient's meds, IV's, vitals, etc. The role of an OR nurse is very different than other specialties of nursing. Here's how it's done in the facilities I've worked as far as meds and their charting. If a patient has come to the OR with a PCA still attached for some reason, the CRNA or anesthesiologist are the ones who disconnect it and document it. Anesthesia keeps documentation of meds given during the procedure. The OR circulator documents, in the surgical chart, meds on the surgical field that are given, such as local, antibiotic irrigation, hemostatics, topicals, etc, etc. Also an IM injection if given by the circulator. I have never charted on a MAR, so that must vary at different facilities. I have also never programmed or set up a PCA, or a pump for that matter, as I've only ever been in the OR. I had not even started IV's on patients since nursing school, until I recently started doing peds OR. Of course this will vary by facility and policies, but I haven't seen a huge difference in this process between working in a Level 1 in one state, and a small hospital in another state.
Anyway, it sounds like you need to talk to your facility's anesthesia staff regarding documentation and process.
