Assisting in Major and Minor Surgeries

Introduction

Major and Minor Surgeries: Surgical procedures are used to treat physical problems affecting the individual’s health and quality of life. The OT nurse is a significant member of the surgical team which facilitates this process.

Definition

Assisting in major and minor operations refers to the varying degrees of support provided by the scrub nurse and circulating nurse in the conduction of the surgical procedure in the OR.

Common Major and Minor Surgeries

Common Differences Between Major and Minor Surgeries

Prerequisites for Assisting for Surgery

The nurse should be knowledgeable, skillful, and well trained regarding;

• Relevant medical terminology.
• Application of the principles of aseptic technique.
• How to maintain a sterile field during major and minor surgical procedures.
• How to assist the physician during a surgical procedure.
• How to apply a dressing after a surgical procedure.
• How to practice and perfect one’s skills in assisting the physician during a surgical procedure, including the tray setup, draping the area, assisting throughout surgery,
  applying the dressing, and completing the procedure.
• How to correctly record and report procedures.

Assisting in Minor Surgeries

These are typically outpatient procedures with minimal risk and short recovery times.

Preoperative Duties:

• Prepare and sterilize instruments and the surgical field
• Take vital signs and obtain informed consent
• Educate the patient and provide emotional support

Intraoperative Duties:

• Maintain a sterile field
• Hand instruments to the surgeon
• Use suction or retractors as needed
• Monitor patient comfort and vitals

Postoperative Duties:

• Apply dressings and provide wound care instructions
• Document the procedure and patient response
• Clean and disinfect the surgical area

Common procedures: skin biopsies, cyst removal, wound suturing, ingrown toenail repair.

Assisting in Major Surgeries

These are more invasive, often requiring general anesthesia and longer recovery.

Preoperative Duties:

• Confirm surgical checklist and patient identity
• Assist with positioning and anesthesia preparation
• Ensure all surgical instruments and equipment are ready

Intraoperative Duties:

• Maintain strict aseptic technique
• Monitor sterile field and surgical counts (sponges, instruments)
• Support the surgical team with retraction, suction, or cautery
• Communicate with anesthesia team regarding patient status

Postoperative Duties:

• Assist with patient transfer to recovery
• Monitor for complications (bleeding, airway issues)
• Document intraoperative events and handoff reports

Roles of the OT Nurse

Scrub Nurse or Assistant
The scrub nurse assists the surgeon during the whole procedure by,

• Anticipating the required instruments and setting up the sterile table.
• Maintaining surgical asepsis while draping and handling instruments.
• Passing instruments, sutures, and supplies.

Circulating Nurse

The circulating nurse plays the role of,

• Managing the OR.
• Protecting the safety and health needs of the patient by regular monitoring of the activities of members of the surgical team and checking the conditions in the OR.
• Responding to request from the surgeon, anesthesiologist, or anesthetist.
• Obtaining supplies and delivers supplies to the sterile field.
• Carrying out the nursing care plan.

Responsibilities of the OT-Nurse

Scrub Nurse

• Scrubbing for surgery.
• Setting up sterile tables.
• Preparing sutures and special equipment.
• Assisting the surgeon and assistant during the surgical procedure by anticipating the required instruments, sponges, drains, and other equipment.
• Keeping track of the time the patient is under anesthesia and the time the wound is open.
• Checking equipment and materials such as needles, sponges, and instruments as the surgical incision is closed.

Circulating Nurse

• Assures cleanliness in the OR.
• Ensures maintenance of proper room temperature, humidity, and lighting in OR.
• Makes sure that equipment are functioning safely.
• Ensures that supplies and materials are available for use during surgical procedures.
• Monitors aseptic technique while coordinating the movement of related personnel.
• Monitors the patient throughout the operative procedure to ensure the person’s safety and well-being.

REFERENCES

1. Annamma Jacob, Rekha, Jhadav Sonali Tarachand: Clinical Nursing Procedures: The Art of Nursing Practice, 5th Edition, March 2023, Jaypee Publishers, ISBN-13: 978-9356961845 ISBN-10: 9356961840
2. Omayalachi CON, Manual of Nursing Procedures and Practice, Vol 1, 3 Edition 2023, Published by Wolters Kluwer’s, ISBN: 978-9393553294
3. Sandra Nettina, Lippincott Manual of Nursing Practice, 11th Edition, January 2019, Published by Wolters Kluwers, ISBN-13:978-9388313285
4. Adrianne Dill Linton, Medical-Surgical Nursing, 8th Edition, 2023, Elsevier Publications, ISBN: 978-0323826716
5. Donna Ignatavicius, Medical-Surgical Nursing: Concepts for Clinical Judgment and Collaborative Care, 11th Edition ,2024, Elsevier Publications, ISBN: 978-0323878265
6. Lewis’s Medical-Surgical Nursing, 12th Edition,2024, Elsevier Publications, ISBN: 978-0323789615
7. AACN Essentials of Critical Care Nursing, 5th Ed. Sarah. Delgado, 2023, Published by American Association of Critical-Care Nurses ISBN: 978-1264269884.
8. Ernstmeyer K, Christman E, editors. Nursing Fundamentals [Internet]. 2nd edition. Eau Claire (WI): Chippewa Valley Technical College; 2024. PART IV, NURSING PROCESS. Available from: https://www.ncbi.nlm.nih.gov/books/NBK610818/

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