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Theatre nursing

Theatre nursing

Theatre nurses work with patients of all ages and primarily within hospital operating theatres and anaesthetic/recovery areas. They may also be involved with certain procedures on wards, clinics or in other specialist areas such as cardiac catheterisation units.

They work as a part of a perioperative team that includes: 

Some procedures may involve other staff such as audiologists when fitting cochlear implants or cardiac physiologists when fitting a pacemaker or undertaking cardiac bypass.

Theatre nurses and ODPs can sometimes undertake similar tasks dependent on their skills, training and job description and can develop their careers in similar ways after qualifying. However. the entry routes are different as is registration (a legal requirement to practice in the UK as a theatre nurse or ODP).

More information on becoming an ODP.

The role of the theatre nurse

Theatre nurses provide high standards of skilled care and support during the 'perioperative' journey. Perioperative care can be divided into interconnected phases:

Preoperative phase

Preoperative assessment is fundamental to the patient's surgery. It ensures that the patient is fully informed about the risks and benefits, and that they are in optimal health for the surgery.

A preoperative assessment visit creates trust and confidence by providing information about the operation and gives patients the opportunity to ask questions. It reduces the risk of late cancellation by ensuring that all essential resources are available.

Anaesthetic phase

During this phase, the theatre nurse will:

  • assist the patient prior to surgery and provide holistic care
  • need to communicate and work effectively within a team
  • use many clinical skills such as the preparation of a wide range of specialist equipment and drugs. This includes anaesthetic machines, intravenous equipment and devices to safely secure the patients airway during anaesthesia
  • act as an assistant to the anaesthetist.

Surgical phase

Theatre nurses will participate, as part of the operating team, in a number of roles including the 'scrubbed' role, application of aseptic technique (work carried out under sterile conditions), wound management and infection control.

During this phase theatre nurses will:

  • wear a sterile gown, mask and gloves, and prepare all the necessary instruments and equipment for the procedure. This may involve complex machinery including microscopes, lasers and endoscopes
  • work alongside the surgeon, providing instruments, needles, swabs and other materials as required, and be able to anticipate their requirements
  • have a role in the promotion of health and safety and be responsible for ensuring that surgical instruments, equipment and swabs are all accounted for throughout the surgical procedure
  • sometimes undertake the 'circulating practitioner' role, using communication and management skills, preparing the environment and equipment needed for the particular operating theatre list, assisting the scrub nurse and acting as the link between the surgical team and other parts of the theatre and hospital.

Recovery phase

During this phase, theatre nurses will:

  • receive, assess and deliver  care on the patient's arrival into the post anaesthetic care unit
  • monitor the patient's health and support them, providing appropriate care and treatment until the patient has recovered from the effects of the anaesthesia and/or surgery and is stable
  • assess the patient in order to ensure they can be discharged back to a surgical ward area
  • evaluate the care given during the perioperative phases (anaesthetics, surgery, recovery).

Generally speaking theatre nurses can specialise in a specific area such as anaesthetics, scrub and post-anaesthetic care or rotate through the areas. Rotation is common practice in a day surgery environment.

Other roles and opportunities

In addition to the work done during these phases, theatre nurses may be involved in:

  • liaising with wards where patients are awaiting their operation/procedure
  • inputting information about each surgical procedure/operation on to a computer system
  • taking phone messages 
  • completing paperwork
  • ordering supplies of equipment 
  • liaising with the hospital's Sterile Services Department to ensure that equipment has been returned once re-sterilised and re-packaged.

More senior operating theatre nurses may work as team leaders. This might involve:

  • organising the workload between the various team members
  • clinical risk assessment and patient safety initiatives
  • planning duty and on call rotas
  • undertaking staff appraisals.
  • responsibility for budgets
  • contributing to the development of the theatre/suite of theatres.

Entry requirements

You will need to be a registered nurse to work as a theatre nurse.

Normally after a period of induction you would participate in specialist training relevant to the role and embark on continuing professional development as part of your professional registration requirements. After general qualification there are post basic educational courses to consolidate the specialist skills required in the perioperative environment.

Skills

As well as the general skills needed for nursing, theatre nurses require:

  • the competence to work in a highly technical area
  • an ability to pay great attention to detail and to concentrate for lengthy periods of time
  • the ability to work effectively within a multidisciplinary team
  • very good interpersonal skills
  • physically able to adapt to the environment including the potential to stand for long periods as well as react in an emergency within a confined area.

Training

A number of courses in operating theatre/perioperative care are available across England and beyond. These are open to nurses already in employment and are at Diploma of Higher Education (DipHE), degree and Masters levels and are often on a part-time basis.

Details of these courses are available on the Association for Perioperative Practice website. 

Funding for training

Financial support may be available through your NHS employer.

Career prospects

There is currently a shortage of staff working as theatre nurses so they are in high-demand.

There are several options for theatre nurses to further their careers. These include opportunities in management, education, research and advanced practice. There are also opportunities to work as consultant nurses.

Experienced theatre nurses can also take further training approved by the Royal College of surgeons to work as surgical care practitioners. This training typically takes 2 years, and enables them to undertake certain surgical procedures within clearly specified boudaries, under the supervision of a consultant surgeon.

Job vacancies

Job vacancies appear in a range of sources including NHS Jobs and the Association for Perioperative Practice.

Further information

The Association for Perioperative Practice
Daisy Ayris House
42 Freemans Way
Harrogate
England
HG3 1DH

Tel: 01423 881300
Website: www.afpp.org.uk/home

The Royal College of Nursing
20 Cavendish Square
London
W1G 0RN

Tel: 020 7409 3333
Website: www.rcn.org.uk