The nurse as first assistant: a review of the literature.
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This article discusses two different types of nursing role currently being developed and highlights their impact on professional practice. One role type is concerned with meeting trusts' needs to reduce junior doctors' hours and costs, and includes specific aspects of medical practice. The second seeks to advance nursing practice and patient care. Both however, lack organization and clarity of definition. Developing the first type will not achieve the objectives of the second, even if the title of nurse practitioner is attached to the role. The nurse surgical assistant provides a lucid example of a role that is being medically defined, driven and supervised. Although individual nurses are clearly enjoying their new roles, the unique and valued characteristics of nursing are being threatened. This retrograde step should be viewed as unacceptable to the profession.
The incidence of pressure sores is seen as a key quality indicator by the Department of Health (1993). The effects of pressure are dependent on its intensity and duration and are widely acknowledged as contributing to pressure sore formation. Therefore, all patients undergoing surgery should be regarded as being at risk. The first article in this two-part series, outlined the pathophysiology of pressure sores and the contributory factors present within the operating theatre (Vol 8(4): 211-17). This article suggests nursing interventions to reduce the incidence of pressure sore formation during the perioperative period.
With the introduction of National Vocational Qualifications (NVQs), the boundaries of responsibility between theatre nurse and operating department practitioner have become indistinct. The author calls for a clearer definition of roles and for nurses to show the true value of their contribution to perioperative patient care.
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This article aims to answer frequently asked questions regarding accurate reporting of assistant surgeons versus assistant at surgery modifiers.
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