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My Experience of…Theatre Nursing

Mo Mossman - Theatre Nurse Extraordinaire

In the first of this series of articles Mo Mossman tells us about why she made a 35 year long career out of Theatre Nursing.

I did a three-month placement in Theatre during my final year of training and knew almost immediately that this was where I wanted to develop my career.

There is no “grey” area in Theatre Nursing, you either love it or hate it, and I loved every one of the 35 years I spent working within the Theatre environment.

My first “proper” job in theatre was General Surgery in a busy, city centre teaching hospital. We provided 24-hour cover for General Surgery and “out of hours” Orthopaedic Surgery. I worked in this theatre for five years, then spent six years being “a full-time mum”, before returning to work in Gynae and ENT theatres. I found working in Gynae and ENT interesting, it gave me the opportunity to learn more about these surgical specialities and to work with a different set of surgeons. I particularly enjoyed ENT, especially the major Head and Neck Surgery.

After three years in these two specialties I worked for a year in Paediatric theatre before returning to General Surgery. Working in Paediatric Surgery was, mostly, very rewarding, it can also be heart rending, children are often so stoic, they put up with things which would have most of us adults weeping and wailing.

Children are not just “little adults” they present with a varity of problems only seen in childhood. I got the opportunity to participate in cardiac surgery, I had done adult cardiac surgery in my first post but Paediatric cardiac surgery is much more intricate and precise, especially when operating on Neonates.

We, also, did “life saving” procedures on Neonates born with such defects as Diaphragmatic Hernia. These babies were brought to Bristol from the whole Southwest region, and this usually meant being “called-in” to work in the middle of the night.

I returned to General Surgery because this was “where my heart was” and continued to work in this area until I retired. My main area was in Minimal Access Surgery, where I witnessed considerable advances over the years.

Gynaecologists have been doing Laparscopic Sterilisations for many years, but when I returned to General surgery the only Laparoscopic procedure which we carried out was Cholecystectomy (removal of Gall Bladder).

In the following 20 years we progressed to carrying out major Gastro-Intestinal surgery such as Colonic and small bowel resections.The Upper Gastro-Intestinal surgeons now use Minimal access surgery to repair Hiatus Hernia (Laparoscopic Nissen Fundoplication).

Laparoscopic Cholecystectomy is now often carried out as day surgery, another major advance. Minimal access surgery causes much less surgical trauma, which means that recovery is quicker requiring shorter hospital stays post-op. The “down side” of shorter stays is that bed occupancy is increased, thus adding to the already hectic workload.

A major “leap forward” which I witnessed in my last five years at work, was the increase in Diagnostic Laparoscopies carried out on emergency patients. This enables the surgeon to make a definitive diagnosis without having to perform a Laparotomy. Most emergency Appendicectomies and “Oversewing” of perforated Gastric and Duodenal ulcers are now carried out Laparoscopically, this again means quicker recovery and much shorter post-op stays.

Whilst I was specialising in Minimal Access Surgery I was lucky enough to be given the opportunity to visit the European Institute of Surgery in Hamburg. This institute is run by one of the major companies who manufacture the instruments used in Laparoscopic surgery and provides courses for both medical and nursing personnel. I was lucky enough to attend both the “Theatre Sisters” course and the Surgeons course. On the surgeons course, which I attended with one of our SPRs, we operated on live pigs and I was allowed to do some intra-abdominal suturing with my colleague acting as “cameraman”. Great stuff but I was petrified!

If you decide to make Theatre Nursing your speciality, once you have a good grasp of the basics it is advisable to undertake a “Theatre Course”. These courses are usually run “in house” and are of 6-12 months duration. During the course you get the opportunity to gain an insight into other surgical specialities, and to work in Anaesthetics and Recovery.

In these times of reduced working hours for junior doctors it is now possible to train as an assistant to the surgeon. I did an “in-house” course to become a “first assistant” and also to act in a “dual-role”. Acting in a “dual-role” means to be the “scrub-nurse” and a surgical assistant, simultaneously. This means that not only is the scrub nurse responsible for checking instruments and swabs and handing them, in the right order, to the surgeon, they also act as surgical assistant. Surgical assistants carry out such tasks as, holding retractors, applying suction cutting ligatures and sutures, and, in the case of Minimal access surgery being the “cameraman”.

As a Theatre Nurse it is a good idea to join the National Association of Theatre Nurses (NATN), this organisation provides help and advise covering all aspects of Theatre Nursing.

Mo Mossman. November 2008.

Mo has since answered questions about <a href = “/careers/articles/584-my-experience-oftheatre-nursing-part-2-some-questions-answered”>developing a career as a theatre nurse and further training.