Meet Your Surgical Team: Who’s Who And Their Responsibilities

Surgery is a multi-faceted, complex aspect of medicine that heavily relies on effective collaboration. Surgery requires a multidisciplinary team that works together in perfect harmony. 

Surgical teams are the unsung heroes who work tirelessly to save lives, restore health, and bring hope to patients and their families. They bring together diverse skills, expertise, and experience to execute complex surgical procedures with utmost care and precision.

In this article, you’ll meet the people behind every surgery, their roles, and the collaborative excellence they exemplify in delivering optimal patient outcomes. Read on to learn more. 

The Surgeon 

The role of the surgeon within a surgical team is pivotal and multi-faceted. As the leader and primary decision-maker, they assume several responsibilities that contribute to the successful outcome of the operation.

Here are the following roles and responsibilities of a surgeon in a surgical team:

• Leadership and Decision-Making: Surgeons are responsible for making critical decisions such as the surgical approach and necessary adaptations based on the patient’s condition during the procedure.
• Surgical Expertise: Surgeons undergo years of training and education to develop their surgical expertise and technical skills. They possess an in-depth understanding of human anatomy and the latest advancements in surgical techniques.
• Interoperative Performance: During the surgical procedure, the surgeon is at the forefront, leading the entire team. They perform surgical intervention, executing precise maneuvers with utmost care and attention to detail.
• Decision-Making in Unforeseen Circumstances: Surgeons must think quickly and exercise sound judgment during unforeseen circumstances. They may need to modify the surgical plan or consult with other specialists to ensure the operation’s success.

Surgeons play a central role in a surgical team, providing leadership, expertise, and decision-making capabilities. Their ability to collaborate effectively with other members contributes significantly to the success of the operation and the patient’s overall well-being.

The Anesthesiologist

The anesthesiologist is the second attending physician in the operating room and can be considered second in command next to the surgeon. 

Before the surgery, the anesthesiologist will see the patient and explain how they can be comfortable during the procedure. Here are other roles and responsibilities they assume in the operating room:

• Anesthesia administration, including general and regional anesthesia
• Monitoring patient’s vital signs, including heart rate, blood pressure, oxygen saturation, and end-tidal carbon dioxide levels
• Post-operative pain management
• Handling surgical crises and emergencies (e.g., responding to cardiac events, allergic reactions, etc.)
• Post-operative care (e.g., monitoring patient’s recovery from anesthesia)

Moreover, keep in mind that they’re not the same as certified registered nurse anesthetists (CRNAs). The former is a medical doctor, while the latter is a registered nurse specializing in pain management. Understanding anesthesiologists vs CRNAs can help aspiring healthcare professionals decide which path to take.

The Nurse Anesthetist (CRNA)

A nurse anesthetist is an advanced practice registered nurse (APRN) who provides anesthesia care to patients. They administer anesthesia, monitor patients during surgical procedures, and ensure patient safety and comfort.

CRNAs may work under anesthesiologists, depending on where they practice. They play a crucial role in the diagnosis as well as the surgical and therapeutic aspects of surgery. They’re involved in the evaluation, pre-anesthetic assessment, and post-anesthesia care.

In addition, CRNAs are licensed to work in several medical fields, including obstetrics, trauma, and surgery. To become a certified registered nurse anesthetist, one should complete a four-year degree in nursing and gather sufficient experience as a nurse. Then, you may enroll in a two-year doctorate program to complete the CRNA degree.

The Surgical First Assistant

The surgical first assistant helps the surgeon perform the operation. They can be a resident doctor, a physician assistant (PA), a certified surgical assistant (CSA), a medical student, or a nurse practitioner (NP). Their responsibilities include suctioning, retracting, and other support a head surgeon may require.  

An excellent surgical first assistant is knowledgeable in physiology, anatomy, surgical instrumentation and procedure. They should also be skilled in positioning, prepping, draping, sterile technique, using casts and splints, and suturing. 

Aside from those, an effective surgical first assistant should be intuitive, perceptive, and attentive to the surgeon’s needs, ensuring a smooth operation flow.

The Scrub Nurse

Also known as a perioperative nurse, a scrub nurse prepares, organizes, and provides every surgical tool and instrument the surgeon and first assistant need. Although it sounds plain and simple, it’s fast-moving and requires a deeper understanding of how to keep the operation flowing smoothly. 

Here’s a list of roles and responsibilities assumed by a scrub nurse:

• Operating Room Preparation: The scrub nurse sets up the operating room before the surgical procedure. This includes ensuring all necessary instruments, equipment, and supplies are sterilized and available.
• Sterile Technique: During the surgery, the scrub nurse works directly alongside the surgeon, providing sterile instruments, sutures, and other necessary items. They anticipate the surgeon’s needs, passing tools and supplies efficiently.
• Patient Positioning: The scrub nurse assists in positioning the patient on the operating table, ensuring the patient’s comfort and safety. They also assist in applying safety devices (e.g., straps and padding) to maintain the patient’s position during the surgery.

The scrub nurse plays a critical role in maintaining a sterile environment, assisting the surgical team, and ensuring patient safety during the operation. Their expertise in sterile technique, instrument handling, and surgical procedures contributes to the overall efficiency and success of the surgical team.

The Circulating Nurse

Unlike the scrub nurse, who works directly in the sterile field, the circulating nurse remains outside the sterile area and focuses on coordinating and managing various aspects of the surgical procedure. Their key responsibilities include the following:

• Pre-Operative Preparation: The circulating nurse checks and restocks supplies, verifies equipment functionality, and prepares the patient’s chart and other necessary documentation.
• Patient Advocacy: Patient advocacy and safety are paramount responsibilities of the circulating nurse. They act as patient advocates throughout the surgical process, ensuring the patient’s rights, privacy, and dignity are respected.
• Intraoperative Support: During the surgery, the circulating nurse actively monitors the environment and addresses any issues that may arise. They may anticipate the needs of the surgical team and retrieve additional supplies or equipment as necessary.

The circulating nurse serves as a communication hub within the surgical team, coordinating activities and information flow. They communicate with the surgical team members, including the surgeon, anesthesiologist, scrub nurse, and other healthcare professionals, ensuring effective collaboration and synchronization.

Final Thoughts

Surgical teams rely on effective teamwork to address challenges that may arise during a procedure. They collaborate by anticipating the needs of team members, providing timely assistance, and adapting to unexpected situations. The ability to work together under high pressure is a testament to their dedication, regardless of their specific roles and responsibilities.