Role of Nurse Practitioner in Surgical Ward: A Critical Analysis Paper

This critical analysis paper discusses the role of nurse practitioners in surgical wards, including their responsibilities during preoperative, intraoperative, and postoperative stages. It also covers the registration and practice standards in the country.

Critical analysis paper

TABLE OF CONTENT
INTRODUCTION...........................................................................................................................3
MAIN BODY...................................................................................................................................3
Role of nurse practitioner in Surgical Ward-...............................................................................3
CONCLUSION................................................................................................................................9
REFERENCES................................................................................................................................1

INTRODUCTION
Critical analysis paper can be defined as the systematic evaluation of the effectiveness of
work which involves what things are done well as what things are done properly. This critical
analysis paper will discuss on the surgical ward in the hospitals. Surgical wards are the wards
which involves taking care of the patients using the surgical conditions such as laminectomy,
craniotomy, septoplasty, appendectomy, hysterectomy, maxillofacial and many other surgeries.
These wards are located in the hospital and requires the license as this provides the treatment to
the patients who are in very critical conditions and cannot be treated by medicines (Abbott and
et.al., 2018). Focusing on role of nurse practitioner in surgical ward, there are certain role and
responsibility of nurse practitioner to perform during surgery, nurse practitioner are one of the
most important character in surgical ward.
The surgical wards has the team which is involves at least one surgeon as well as one
surgical ward nurse practitioner. These wards takes only those patients who are suffering from
very critical conditions and requires the immediate treatment as without this, they may die within
the 24 hours. This is the department of the hospital which provides the special treatments to the
patients or supports the emergency physicians in the highly emergency cases. This critical
analysis paper will discuss the role of the nurse practitioners in the surgical ward as well as the
registration and practice standards in the country.
MAIN BODY
Role of nurse practitioner in Surgical Ward-
The nurse practitioner (NP) is nurse practitioner with advance degree in practising and
managing nursing, these nurse practitioner work under health care unit to provide plans and
procedures during surgery. Mainly found in surgical ward, nurse practitioner are more like nurse
practitioner who perform certain other task. The nurse practitioners practitioner can be referred
to as the scrub nurse practitioner or the theatre nurse practitioner which is highly skilled and
specialized in the perioperative care as well as providing the quality cares to the patients which is
before and after the surgery of the patients. Before becoming the theatre nurse practitioners, they
have to complete proper training so that they become experienced and skilled. There are various
stages during the surgery in which the theatre nurse practitioners are required for supporting as
well as assisting the patients, surgeons, surgical technicians , nurse practitioner practitioners as
well as the nurse practitioner anaesthetists (Hall-Lord and Ballangrud, 2022). These surgical

nurse practitioners have the responsibility of almost six patients which depends nature of the
surgical wards.
The theatre nurse practitioners are considered as the part of perioperative surgical team in
which they have to work with the surgeons, surgical technician and many more. The three main
phases of the surgery are such as preoperative, intraoperative as well as postoperative stages.
Preoperative Stage-
The preoperative stage of the surgery is undertaken when the patients finally decided to
take the surgery. This stage involves discussing with the patients about all the advantages of
taking the surgery but with this, all the dangerous incidents which can happen during the surgery
are also discussed. At this stage of the surgery, it is very important for the patient to get prepare
mentally as well as physically for the operation. This stage is basically the time period for the
decision of the patients to have the surgery as well as the beginning of the overall surgical
procedures.
The roles of nurse practitioners during this stage of surgery are such as-
Taking care of patients: The first and the foremost role of the nurse practitioner during this stage
is to make sure that the condition of the patients is good which means he/she is eligible for the
surgery. The nurse practitioners must perform all the assessments such as blood pressure, sugar
level, breathing rate, pulses, Kidney and liver status, cardiovascular status, respiratory status,
physical assessment and many more such things (Aliaga and et.al., 2018). This will enable the
nurse practitioner to know whether the patient can be taken to the surgical ward or not. If any
one of the readings for such assessments is not suitable for the surgery then they must not be
considered for the surgery until these readings not gets normalise. The nurse practitioners are the
main part of the surgery team as they have to take care of the patients very carefully as by seeing
all these things only the patients surgery is done. The overall documentation of the readings is
prepared and ensured critically everything before taking them to the surgical wards.
Addressing patient and their needs: Before any surgery, NP focus on addressing patient and
their need. For example; preparing operation procedure including informing patient's family,
informing patient and preparing other documentation. The nurse practitioners after performing
all the assessments of the patients, then the patients now has to be shifted to the surgical wards.
They have to keep the eye on the motion of the patients basically around the shoulders. The
nurse practitioner have to understand the stability limits of the patients as this will help the

surgeons to evaluate their balance. Must have to arrange all the equipments for transferring the
patients such as the stretcher on which the patients will be shifted, patients record file as well as
all the identification labels. After deciding the transferring of the patient, the nurse practitioner
has to ensure for informing all its relatives and then assisting them to collect the other belongings
of the patients. The nurse practitioner is responsible for transferring the patients to the surgical
wards with all its files in which the assessments have been recorded and the diseases from which
the patient is suffering (Stromberg, 2020).
Carrying out surgery assessment: NP carry out surgery assessment and make procedures to
perform surgery, role is critical because doctor may perform surgery according to the assessment
prepared by the nurse practitioner in the process. The nurse practitioner has to now prepare the
patients which is not allowing them to drink and eat for the certain period of the time before
going for the surgery. The nurse practitioner has to make them aware about all those things
which should not be done by the patient before going for the surgery in the surgical wards. The
nurse practitioners are the main element for taking care of the patient before they go for the
surgery as making them less anxious, clearing all the doubts of the patients and their relatives.
Intraoperative Stage-
This stage of the surgery starts when the nurse practitioner who has assessed all the rates
of the patients and prepared the patients for the surgery brings the patient for the surgery and
provides all the recordings of the patients to the theatre nurse practitioner. After this, many
things are checked and evaluated by the nurse practitioner for providing the safe environment for
the surgery of patient as well as for the overall theatre staff (Daode and Aihong, 2018). The
nurse practitioner then performs all the activities for maintaining the sterile environment in the
surgical ward as well as make sure that all the surgical equipments are working properly.
Role of nurse practitioners during this stage are as follows-
Assessment of equipment: The primary role which is followed by the nurse practitioner in the
surgical war during the surgery is to select the instrument which is required by the surgeon and
then passing that instruments to them. This role is performed by the nurse practitioners so that
there are no disruptions in the surgery as well as so that the surgery can be finished as soon as
possible. They firstly puts all the instruments at one place and from that place all the instruments
are selected and passed to the surgeons for smooth running of the surgery. They must have the
deep knowledge as what all instruments are required by the surgeons and for what purposes. This

will help the nurse practitioners as well as surgeons to provide the correct instrument for the
specific roles (Nibbelink and Brewer, 2018).
Understanding the hand signals: The nurse practitioners has to understand all the hand signals
which states which instrument is required by the surgeon. This means that the nurse practitioner
must have to understand all the signs and signals of the doctors which will enable them to know
the things in better way. The roles of the surgical ward is very comprehensive that they have to
play significant roles for the overall surgery of the patient. As the nurse practitioners are very
important for the successful surgery, it is very necessary for them to quickly provide all the
equipments to them as this will enable the surgeons to effectively perform there overall surgery.
There are various roles involved in this such as cleaning the tool after the surgeon again
handover to the nurse practitioner and then again keeping the tool at its place on the table
(Mohamed and Fashafsheh, 2019). Basically the nurse practitioners has to work as the assistant
to the surgeons during the surgery of the patient. The nurse practitioners are trained for how to
clean the tools so that the surgery happens smoothly.
Monitoring the environment: The another most important role of the surgical nurse practitioners
in the surgical ward is to monitor the overall surgery procedures so that the everything during
this time period remains sterile. This helps the surgery to effectively happen by monitoring the
overall sterile status using the surgical conscience (Ponte, 2021). The overall safety of the patient
is been consistently checked by the nurse practitioner so that the surgery happens successfully
without any disruptions. It is very important for the nurse practitioners to monitor the
environment as this will keep the patient safe and healthy. As they are the important part of the
overall operation process, it is very important for them to monitor the overall environment of the
surgical ward and keep the eye on all those factors which will help the environment to be safe as
well as the surgeons will be able to effectively complete the overall surgery successfully. During
the operation, it is very necessary for the nurse practitioners to maintain the safe environment.
Postoperative phase:
Postoperative phase is last phase which fall after operation in surgical unit, it is very clear
that every operation demand immediate care of patient which means nurse practitioner have
certain role after completion of operation. However, providing care is completely different from
operating in surgical unit, practitioner who remain in ward after surgery have certain roles to
complete, mainly it is related to care of patient, subordinate and self (Halliday, Hunter and

McMillan, 2018). Postoperative phase is also critical because if patient died during operation
then role of nurse practitioner will be different whereas if patient's surgery was successful then
role of nurse practitioner will be different. There are certain roles of practitioner or nurse
practitioner after operation in surgical unit, these are:
Role to maintain procedure: Operation is one of the most critical process in which doctor uses
certain equipment to carefully operate patient, use medical equipment is common but important
thing. nurse practitioner have role to clean and dispose equipment which can be dangerous for
doctor, subordinate, patient and even cleaning staff who will be cleaning the unit. Practitioner
have role of cleaning does not mean they have to perform cleaning job. Here, cleaning simply
means they have clean equipment that can be dangerous (Jackson and Lopez, 2018). For
example; blood exposure on floor, dress, material inside unit and many other things. Practitioner
who perform cleaning do manage hazard, they follow protocol provided by national health
authority and basic guideline to clean a surgical unit.
Role as RNP assistant: Nurse practitioner coordinate with doctor and perform their role
accordingly, it is very clear that this is critical role in which nurse have to become effective
during surgery and need continuous coordination. Nurse practitioner have several role in surgical
unit, they not only work effectively but their coordination play vital role in making operation
successful. Role of nurse practitioner increase after operation, when doctor perform surgery,
nurse practitioner provide equipment. However, RNP assistant is role of nurse practitioner in
which practitioner try to complete remaining work of doctor. For example; stitching in which cut
area is been stitch by nurse practitioner who carry experience, without experience, nurse
practitioner can not perform remaining part of doctor. It is very clear that nurse practitioner as
RN assistant know that doctor need help during surgery, they themselves can not perform all task
alone. These nurse practitioner coordinate with doctor and bring success to operation.
Role of scrub nurse practitioner: This is one of the most important role of nurse practitioner
where they carefully listen to doctor and perform certain task, these nurse practitioner set
operation room after operation (Kleinpell and et.al., 2019). Keeping every machinery and
equipment at right place so that next surgery can be effective and done perfectly to manage
situation of patient. Role of scrub nurse practitioner are critical in which they need to arrange
equipment and ever other element. For example; after surgery, doctor may demand nurse
practitioner to rearrange room, it is very clear that every surgery is different from each other

which means requirement of each surgery will be different. Role of scrub nurse practitioner are
challenging because if they forgot to add equipment or any other important then it will be
dangerous for whole operation.
Circulating nurse practitioner: This is another important role of nurse practitioner in which
they need to meet certain requirement during operation, circulating nurse practitioner inform
family member before starting an operation, informing family member if patient died then
circulating nurse practitioner have to inform family member. Circulating remind doctor about
patient condition, they analyse sign, blood pressure, heart beat and other patient related things
and update doctor about the patient condition (Owens, 2019). nurse practitioner who remain
close to doctor work as right hand who perfectly perform certain task and stabilize situation of
the ward. These nurse practitioner have great role in influencing success of operation.
PACU nurse practitioner: This is post anaesthesia care unit where nurse practitioner have to
perform critical role after surgery, role of nurse practitioner start by taking care of patient mainly
those patient who are in critical situation. It is very clear that these nurse practitioner have ability
to perform emergency care including role of RN assistance of stitching patient wound if it open
during care, power impact on patient to wake them and injection to patient if their condition is
critical. These nurse practitioner work closely with patient family and focus on continuous care
until and unless patient felt good, there are many cases in which PACU nurse practitioner was
able to safe life of patient when there was no doctor available because they carry experience of
perform minor surgery to manage and save life of patient.
Role of nurse practitioner according to Australian standards: Every national health authority
provide legal and effective way to perform surgery, it is very clear that every nation follow
international standard to perform surgery, but they have their own methods and techniques to
perform surgery. Australian health authority have major role in managing surgery in the country,
they have provided certain practice and surgery protocol in the form of law, legislation and act
(Torrens and et.al., 2020). Australian national health authority have major role in increasing
surgical success rate of the country. For example; WHS is responsible for providing guideline
during surgery, this act help both practitioner and doctor. Operation theatre carry certain hazard
and risk which need to be managed, which means practitioner and doctor need to follow
guidelines of WHS. Every nurse practitioner have known that guidelines of health institution of
Australia.

CONCLUSION
This report has discussed critical analysis paper where role of nurse practitioner has been
discussed. Later this report has discussed critical role of nurse practitioner during preoperative
phase in which they have role of setting and designing surgery room with equipment, material
and other important element which is used during operation. These nurse practitioner have
special role in arranging every equipment before operation, apart from this preoperative phase is
important and demand no mistake. Later role of nurse practitioner in operating phase is been
discussed where critical role for example providing help to doctor, performing monitoring and
other role in which they have coordinate with doctor. At last this report has discussed role of
nurse practitioner in postoperative phase in which they perform certain role after operation for
example role of care patient and even stitch and coordinate with subordinate in the process.

REFERENCES
Books and journals
Abbott, T.E., and et.al., 2018. Pre-hospital National Early Warning Score (NEWS) is associated
with in-hospital mortality and critical care unit admission: A cohort study. Annals of
Medicine and Surgery, 27, pp.17-21.
Aliaga, B., and et.al., 2018. Risk of falls among patients admitted to a medical-surgical ward.
Analysis of 376 medical records. Revista Medica de Chile, 146(7), pp.862-868.
Daode, Z.H.A. and Aihong, Y.A.N.G., 2018. Application of theory-practice integration teaching
model in clinical teaching of surgical nursing science. Chinese Journal of Integrative
Nursing, 4(6), p.172.
Hall-Lord, M.L. and Ballangrud, R., 2022. Patients’ Perceptions of Quality of Care: A
Teamwork Intervention Study in a Surgical Ward. SAGE Open Nursing, 8,
p.23779608221076814.
Halliday, S., Hunter, D.J. and McMillan, L., 2018. Ward staff perceptions of the role of the
advanced nurse practitioner in a ‘hospital at day’setting. British Journal of
Nursing, 27(2), pp.92-97.
Jackson, H.J. and Lopez, C.M., 2018. Utilization of the nurse practitioner role to combat the
opioid crisis. The Journal for nurse practitioner Practitioners, 14(10), pp.e213-e216.
Kleinpell and et.al., 2019. nurse practitioner practitioners and physician assistants in acute and
critical care: A concise review of the literature and data 2008–2018. Critical care
medicine, 47(10), p.1442.
Mohamed, S.A. and Fashafsheh, I.H., 2019. The effect of simulation-based training on nursing
students’ communication skill, self-efficacy and clinical competence for nursing
practice. Open Journal of Nursing, 9(08), p.855.
Nibbelink, C.W. and Brewer, B.B., 2018. Decision‐making in nursing practice: An integrative
literature review. Journal of Clinical Nursing, 27(5-6), pp.917-928.
Owens, R.A., 2019. nurse practitioner role transition and identity development in rural health
care settings: a scoping review. Nursing Education Perspectives, 40(3), pp.157-161.
Ponte, P.R., 2021. Elevating the Contribution of the Clinical nurse practitioner: An Interview
With Jeffrey
Stromberg, H.K., 2020. deWit's Medical-Surgical Nursing E-Book: Concepts & Practice.
Elsevier Health Sciences.
Torrens and et.al., 2020. Barriers and facilitators to the implementation of the advanced nurse
practitioner role in primary care settings: a scoping review. International Journal of
Nursing Studies, 104, p.103443.
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