Shands Operating Room
The Shands Operating Room consists of 23 operating rooms, two cystoscopy suites and four block spaces.
Twenty-one to 23 operating rooms are used each day. The Shands OR is staffed 24 hours a day, seven days a week with an in-house surgical team. The Shands OR also staffs Labor and Delivery (L&D) and the Burn Intensive Care Unit (BICU) three times per week. The OR keeps a room open every day for trauma.
Perioperative nurses working in the Shands OR strive to achieve a new standard of excellence in care for every patient requiring surgical intervention.
Patient Population
The surgical specialties include orthopaedics, neurosurgery, general surgery, gynecology, plastic surgery, urology, pediatrics, peripheral-vascular, oral, cardiovascular/thoracic, otolaryngology (ENT), ophthalmology and burn. These specialties use the latest in operating room techniques and equipment. Both inpatient and outpatient services are provided. Some of the complex medical surgical procedures include:
- Aortic-femoral bypass
- Cholecystectomies
- Coronary artery bypass
- Craniofacials
- Craniotomies for tumors and aneurysms
- General and urological procedures
- Hernia repairs
- Kidney, liver, lung and heart transplants
- Laparoscopic gynecology
- Obesity surgery
- Total joint replacement
Surgical procedures take from 30 minutes to 8 to 12 hours with minimum and maximum range on both ends.
The nursing staff is committed to innovative patient care through the assessment, diagnosis, treatment and evaluation of hemodynamic instability; respiratory compromise; fluid and electrolyte abnormalities; the impairment of skin integrity; perioperative educational needs; psychosocial assessments in preparation for the surgical experience; and family and patient anxiety related to the surgical experience.
Health Care Team
The Shands OR leadership fosters autonomous, accountable nursing practice by providing opportunities to staff members for involvement with quality improvement, peer reviews and professional practice activities. Collaboration on the unit among registered nurses, surgical technologists, sterile supply technicians, equipment specialists, patient support technicians and control desk clerks is fostered by participation in unit committees.
The medical director of the OR is an appointed board-certified anesthesiologist. The anesthesiologists provide in-house coverage 24 hours a day, seven days a week. Surgeons, anesthesiologists and nurses work collaboratively to provide quality care.
The nurse management for the unit includes registered nurses in positions of director of surgical services, application analyst III and clinical managers over teams. In the absence of a clinical manager, an R.N. designated as charge nurse will facilitate clinical care delivery.
The perioperative nursing staff consists of registered nurses licensed by the Florida Board of Nursing. New staff are oriented to the unit during a planned orientation ranging from three to six months depending on previous perioperative nursing experience. Professional certification in Certified Nurse Operating Room (CNOR) for perioperative nursing is available from the Association of Operating Room Nurses (AORN) and American Society of Post Anesthesia Nurses (ASPAN). Certification in Surgical Technology (CST) is available from the Association of Surgical Technologists (AST). All staff who are responsible for direct patient care pass Basic Life Support (BLS) skills. Operating room staff are provided training experiences to attain and maintain competence in their role as defined by the job description for the specific role as described in the hospital plan for nursing care.
The perioperative nursing staff are expected to demonstrate a positive attitude toward patients and families and the ability, willingness and interest to work with age-appropriate and developmental needs of the patient.
Staffing Plan
The nursing care provided to patients is by team patient care approach, with an R.N. assuming care for the patient. Surgical technologists provide scrub assistance to the surgical field, but an R.N. may do this as well. The unit is staffed by a charge nurse at all times. The charge nurse is an R.N. who is in charge of staff assignments, staffing needs, crisis intervention and general workflow on the unit. Each surgical specialty is led by a staff R.N. team leader. There is also an equipment specialist assigned to each service team. A block nurse and pre-op teaching nurses are assigned daily to facilitate and perform nursing assessments and a plan of care in the block area and anesthesia pre-op clinics.
Staffing of caregivers is based on the actual number of planned cases and anticipated acuity on a daily basis. Scheduled working hours may be flexible based upon the distribution of caseload.
An R.N. is assigned to the perioperative role for each procedure and is responsible for directing the nursing care of the surgical patient. The OR is equipped and staffed to accommodate every level of acuity for surgical patients of all ages.