Who Is Providing Your Care Before, During, and After Surgery?

The Medical Professionals Who Provide Your Surgical Care

Surgery Staff
It Can Be Difficult to Determine Staff Roles When Everyone Wears Scrubs.

If you are having surgery, it is likely that dozens of people will provide care for you before, during and after your procedure.  Keeping all of those people straight and understanding how they contribute to your care can be very confusing.  Here is a basic introduction to the individuals who you are likely to meet when having surgery. Keep in mind every facility is different, and you may notice small differences in the staff or the titles given to the staff at your facility.

Before Surgery (Planned Surgery)

Pre-op Registration: This person takes care of the paperwork portion of your hospital visit and is not a healthcare provider.  The people at registration will take care of insurance issues, financial issues, and often issue your hospital band with your name and additional important information.  If you have questions about insurance, costs associated with your procedure, payment or general questions of a non-medical nature, registration is a great place to get answers.

Pre-op Nurse: This is the nurse who will help prepare you for surgery. That means changing into a gown, having an IV or two placed, and administering medications that you may need for your procedure.  This is where your vital signs are checked and any last-minute labs may be drawn.

Before Surgery In the Emergency Room (Unplanned Surgery)

Physician: Most individuals who have surgery unexpectedly start the process as a patient in the Emergency Room.

  Whether the problem is an injury or a sudden illness, the ER staff will determine the nature of the problem and if it is severe enough to warrant an admission to the hospital. Typically, a physician is the individual directing the care provided, but may rely on additional practitioners to handle the patient load.

  This physician is trained to provide care to a wide range of patients, caring for the very sickest and most critical patients accident victims as well as more common ailments such as broken bones.

Nurse Practitioner: A nurse practitioner is typically a master's degree prepared nurse who is able to independently diagnose and treat patients.  These individuals can write prescriptions, order tests and admit patients to the hospital.  They often work closely with a physician.

Physician Assistant: A Physician Assistant is very similar to a nurse practitioner, and is a master's degree prepared clinician who is able to diagnose and treat patients, write prescriptions, order testing and determine if a patient needs to be admitted.  They work closely with a physician. 

ER Bedside Nurse: Often a registered nurse, the ER nurse provides care to patients who are ill or injured, administering medications and monitoring the patient for any changes in condition.  The ER nurse is able to provide care for the widest range of patients, caring for those with serious injuries as well as those with common and less urgent ailments. 

In Your Hospital Room (Before and After Surgery)

Bedside Nurse: This individual is often an RN but may be an LPN depending on the state where they practice.

  This person provides care while the patient is in their room within the hospital, and provides medication, monitors the patient’s condition and sees that the patient’s needs are met.  This nurse may be practicing in a critical care area, or in a medical surgical area.  

Attending Physician: This physician will typically be in charge of your care.  For example, if you are admitted to your regular family practice doctor and is it determined that you may need surgery, a surgeon will give a consultation about whether or not surgery is necessary.  In some cases, the attending physician may be your surgeon.

  The attending is typically involved in consulting specialists for your case, so if it is determined that your situation requires a nephrologist (kidney specialist), a surgeon and a cardiologist (heart specialist) the attending physician would be the one requesting consults from these specialists.

Nurse Practitioner/Physician Assistant: You may receive care from several of these providers as they often work as hospitalists providing care to patients who have been admitted to the facility as well as those who work as specialists in fields like nephrology and cardiology.

Patient Care Technician: These individuals will likely be responsible for taking your vital signs, helping you with basic needs such as bathing and helping with meals.  They may also do simple medical tasks like checking your blood glucose.

Phlebotomist: In some facilities the nurses are responsible for drawing blood, in others a phlebotomist will be drawing blood when it is needed for laboratory testing.

Respiratory Therapy: If you need breathing treatments, oxygen or even a ventilator, respiratory therapy will be responsible for administering and maintaining this aspect of your care.

Radiology Technologist: If you need an X-ray, CT Scan or MRI, these individuals will be the ones responsible for getting the best images.  They may help you position yourself for an imaging test, or they may come to your room with a portable machine and take a quick X-ray.

During Surgery

Anesthesiologist/CRNA: Anesthesia is typically provided by a physician who may be an MD or DO, a master's degree prepared Certified Registered Nurse Anesthetist, or both.  A few states have Anesthesia Assistants, who are able to provide anesthesia under the supervising physician.  

Surgeon: This individual is a physician who may be a general surgeon who is trained to do many kinds of common surgeries, such as appendectomy procedures or gallbladder surgery.  You may also have a specialist, such as a cardiothoracic surgeon, a surgeon who specialized in the heart and lung procedures.

Circulating Nurse: This is an RN who assists by documenting what is happening in the operating room and often assists with the procedure by providing supplies to the surgical technologist and counting any supplies that are used.

Surgical Technologist/Scrub Nurse/First Assist: These are the individuals who are, like the surgeon, scrubbed in and sterile.  The surgical technologist/scrub nurse provides the surgeon with sterile supplies, such as scalpels and suture materials. The first assist plays a more active role in the procedure itself, directly involved with the surgery, along with the surgeon. 

After Surgery

PACU Nurse: The Post Anesthesia Care Unit (PACU) nurse is responsible for the care of the patient in the first hour or more after surgery.  They closely monitor the patient, treat the patient for pain and make sure that the patient is clearing the anesthesia (waking up) as expected.  If the procedure is an outpatient surgery, the patient will often receive paperwork and go home from the PACU.  If a patient is staying in the facility overnight, the patient is transported to their hospital room where the bedside nurse assumes care of the patient.

ICU Nurse: For critically ill patients, the recovery process happens in the ICU rather than the PACU.  The patient is typically transported directly from the OR to the ICU where the recovery process can be monitored closely.

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