Identify the regulatory and practice issues emerging in this case study. How will you manage this situation? Provide reasons for your response

Question

What will be an ideal response?

Answer 1

Answer:
Appropriate responses include:

Issues include:
The scope of practice for perioperative nursing—this task is not within the current scope of practice for perioperative nurses.
Advanced practice roles—there are tertiary education programs to prepare perioperative nurses for the surgical assistant role. Does your colleague have this qualification and is this advanced practice role approved in your facility?
Individual competence and skill—nurses can be taught new skills and may continue to develop competence in their role; however, the skills must be within the current scope of practice, and an experienced clinician should supervise and assess competence.
Patient consent—was the patient informed and did she consent to the possibility that the nurse might be assisting and suturing the facial incisions?
Remind the surgeon that assisting surgery is an advanced practice role and outside your scope of practice so it is not an appropriate activity for you to perform.
Discuss this conversation and the issues you have identified with your manager as soon as practical. If your manager is not available, then talk with your educator or a senior nurse in your department.

RN Rosie has been working as an anaesthetic nurse for several months and she is in the anaesthetic room with Mrs A, who is to undergo a total knee replacement. Mrs A has had a premedication, which has made her drowsy, but she is clearly still very anxious and holding firmly onto Rosie's hand. Rosie notices that Mrs A's healthcare record and her consent form both state that the procedure that she is about to undergo is a right total knee replacement. The operating list in the operating suite has Mrs A listed for a left total knee replacement. Rosie asks Mrs A to clarify which knee she is having replaced and Mrs A points to her right knee, but tells Rosie that ‘both knees are bad'. Rosie checks Mrs A's legs to see whether the surgeon has marked the operative site for today's procedure and notes that this has not occurred.