Surgical Nurse

Surgical Nurse Expert Witness

Surgical Nurses are nurses who manage patients undergoing surgical or invasive procedures. Surgical Nurses are also known as Perioperative Nurses because they help plan and implement patient treatment during the “perioperative” period which includes all preoperative, intraoperative, and postoperative stages. Each area of Perioperative Nursing relies upon the others as well as the support of an interdisciplinary team including surgeons, surgical technologists, anesthesiologists and/or Certified Registered Nurse Anesthetists.

Surgical Nurses are Registered Nurses (RN) who have obtained a Bachelor of Science (BSN) or Associate Degree (ADN) in Nursing. Surgical Nurses also may earn credentials as a Certified Perioperative Nurse (CNOR). There are several types of Surgical Nurses and each focuses on a specific element of the perioperative encounter:

  • Preoperative Nurse: monitors and assesses vital signs, executes orders for lab tests and medications, provides education to the patient and their family, and assists in obtaining informed consent for the planned procedure(s). Preoperative Nurses provide care until the patient enters the operating room (OR).
  • Circulating Nurse: also called an Operative Nursedoes not scrub into the case and therefore performs duties that cannot be done by staff who must remain sterile. This includes managing nursing activities such as patient preparation, patient positioning, and documentation of critical events including instrument and sponge counts. The Circulating Nurse also acts as the patient’s advocate while the patient is under anesthesia by ensuring patient safety during the operation. Circulating Nurses often focus on a particular subspecialty such as neurosurgery, cardiothoracic surgery, trauma surgery, pediatric surgery, general surgery, or gynecologic surgery.
  • Scrub Nurse: works alongside the surgeon within the sterile field to assist the surgeon and other surgical staff to minimize complications and ensure a smooth procedure.
  • RN First Assistant: a Registered Nurse First Assistant (RNFA) is a perioperative RN who works in a collaborative role with the surgeon and the OR team to provide intraoperative care. This may include the use of surgical instruments, stapling devices, and sutures. To become an RNFA, a RN must have two years of OR nursing experience, obtain a Certified Nurse Operating Room (CNOR) credential, and complete a Competency & Credentialing Institute (CCI) accepted RNFA program.
  • Postoperative Nurse: also known as a Post-Anesthesia Care Unit or “PACU” Nurse, cares for patients when they leave the OR and recover from anesthesia. Their primary focus is intensive observation for complications of surgery and anesthesia. PACU Nurses provide care to patients until the moment they are discharged from the hospital or until they are transferred to an inpatient unit for additional monitoring.

The most common allegations in Perioperative litigation include:

  • Improper informed consent
  • Incorrect sponge and needle counts
  • Surgical “time out” and wrong-side surgical errors
  • Patient positioning errors
  • Intravenous access
  • Location of grounding pads
  • Failure to recognize postoperative complications
  • Respiratory complications of anesthetics and pain medications
  • Discharging patients before they are stable (Aldrete score)
  • Patient safety and advocacy
  • Operating room nurse administration
  • Operating room nurse training and credentialing

 A Surgical Nurse expert witness is required to evaluate perioperative standards of care. To secure a hand-selected Surgical Nurse expert expert witness for your case, please contact Elite Medical Experts and speak with a physician or nurse on our Case Strategy Team.

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