A Day in the Life of a Cardiothoracic Theatre Team
Written by Kristine V. Lapid, Clinical Nurse Manager II of Cardiothoracic Theatre Department, University Hospital Galway
At the Cardiothoracic Department, Theatre 11 in Galway University Hospital there is a dedicated Cardiothoracic Theatre Team consisting of 13 staff members led by Kristine Lapid, the acting Clinical Nurse Manager II, working alongside her 12 highly specialised theatre staff nurses.
Covering a wide variety of Cardiothoracic surgeries the likes of which include Coronary Artery Bypass Grafting, Mitral and Aortic Valve Replacement, Aortic Root Replacement, Minimally Invasive Valve Repair and Replacement, Septal Myectomy, Pericardiectomy, Video Assisted Thoracic Surgery and Open Thoracotomy , all but to name a few ensures that for the staff operating within the Cardiothoracic Department, no two days are the same with each day presenting its own unique challenge for all of those involved. With patient safety and surgical success at the heart of what they do ‘Literally’.
Elective cases start off with the routine morning briefing with the Perioperative Surgical Team, Anaesthetic Team, Perfusionists and Cardiothoracic Staff Nurses all in attendance. It is of vital importance as it enables the sharing and clear communication of the Operative Plan, promoting the need for Teamwork, mitigating any potential hazards for the patient, reducing preventable harm and ensuring that all equipment required will be available and at hand.
Lending itself to a broader knowledge base for the upcoming planned procedure with a clear pathway and clear communication ensures that each Team Member has a clear understanding of the tasks at hand and can anticipate future events pre planning accordingly.
Once the patient has been sent for and has been brought into the Theatre, prior to the induction of anaesthesia WHO sign in is carried out the confirm that the patients identify and align with the correct site and the procedure type written in the consent form, any anticipated blood loss, allergies and any other possible future complications.
The surgical equipment and instruments are prepared and Cardiothoracic Nurses anticipate the needs of the Perioperative Team from the very start. Always ensuring the highest integrity and sterility of any possible implant for each Cardiothoracic Case, remaining calm, alert and focused, at all times has become the dayto-day routine for this Team of Nurses. Advocates for the patient from the moment he or she enters the Theatre until they are ready to be transferred safely to another department, safety, privacy and dignity is at the forefront of this Teams culture during their stay in the Cardiac Theatre.
The majority of patients will be anaesthetised for Cardiothoracic Cases so providing them with the best care when it comes to sterility ensuring that there will be no postoperative infection from the initial thorough skin and site preparation to the application of the dressings on the wound site.
An utmost standard of care is maintained at all times from making sure that the surgical count is correct, maintaining infection control, ensuring patient skin integrity all throughout the surgery, safe placement and positioning of the patient right down to maintaining the Cardiothoracic theatre Temperature based on the needs and requirements of the patient.
Double checking patient input and output, making sure regularly that all blood and blood products are available should they be required, with clear and concise communication and engagement with the Perioperative Team, multidisciplinary Team members such as the Blood Bank, Wards, Porters, Purchasing Department and the Intensive Care Unit this Cardiothoracic Team of Nurses ensures that no stone is left unturned.
Covering elective day to day cases forms the vast majority of the Cardiothoracic Teams duties and responsibilities but it doesn’t just stop there. Emergency situations occur regularly where quick thinking and action is required at a moment’s notice. Forming part of the equipment required for such an event is the Cardiac Tamponade Trolley.
Cardiothoracic Staff Nurses are on call at all times to respond instantly if and when required. Through ongoing training and development the Cardiothoracic Theatre Nurses called in to respond immediately delegate and take on the role of a scrub nurse whilst also requiring the need to circulate at all times attending to the needs of the patient in a high pressure high stress emergency environment.
With the scrub role comprising of surgical assistance alongside the surgical team, setting up the sterile instruments and equipment required at a moment’s notice. With the patient on the verge of Cardiac Tamponade defined by a fluid accumulation in the pericardial sac requires early diagnosis and immediate intervention. This condition is known to have multiple causes including but not limited to postoperative bleeding after Cardiac Surgery.
Cardiac Tamponade an increase of the intrapericardial pressure, a compression of the heart with Cardiac inflow restriction, eventually leading to organ failure, shock and Cardiac Arrest in extreme cases. For this unique Team of Nurses and their broad range of specialities they have learned to take each day in their stride irrespective of what may present itself to them, ready to jump into action when called to do so.
Welcome to the Cardiothoracic Team, welcome to Theatre 11.
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