- 02 April 2020
- 12 min read
How I became a Theatre Nurse, what I do and why I love this job
I’m a 24-year-old Theatre Nurse working at the Royal Cornwall Hospital NHS Trust. I specialise in general and emergency. Here’s my story - about how I became a Theatre Nurse, why I chose this practise and what I love about it.
Topics covered in this article
In late 2018 I moved to the UK from New Zealand. In New Zealand I worked as a RN at Skin Institute, a private skin cancer, cosmetic, and dermatology clinic.
In the future I would like to start my own clinic in cosmetic medicine.
How I became a theatre nurse
I completed my Bachelor of Nursing degree in 2017.
In all honesty, theatre nursing wasn't something I'd ever considered - or even thought of - when I chose to become a Nurse.
My first experience of theatre nursing was during my final 3-month placement at Skin Institute, a skin cancer and dermatology clinic in New Zealand.
I assisted in both simple and complex skin cancer surgery.
It was here in which I gained an interest in theatre nursing; being able to immediately alleviate symptoms and treat patients was very rewarding.
After moving to the UK, I wanted a challenging career where I learned new skills every day.
I wanted to become the best/most experienced nurse I could possibly be.
I was offered a position in theatres at Royal Cornwall Hospital in October last year.
At first it was intimidating - I wasn't sure if I was cut out to be a theatre nurse - the long hours and limited patient contact were not something I was used to.
The amount of procedures and instruments I had to learn were overwhelming.
I felt my confidence, knowledge, and skills improving every day.
I love theatre Nursing because nobody tells me what to do - I just do it.
I don't have anyone breathing over my shoulder at work, I’m simply expected to get on with the job and finish it to the best of my ability.
I work within a team and completely trust my colleagues.
We each have a role within theatre and my role is just as important as everyone else - from the theatre assistants, to the nurses and the consultants, we all feel respected and valued as part of the team.
This is what I love about my job as a theatre nurse
I love the autonomy of being a theatre nurse.
Whether I am scrubbing or circulating, I’m simply expected to get on with my job, and trusted to do so.
I love the fast paced environment of being theatre, there is always something to do, which means the days go fast and I am always learning.
It is an extremely rewarding career - I finish my shift knowing I have made a real difference to my patient, or even helped to save a life.
There are so many different areas of surgery, so you can choose to specialise in what interests you.
What qualities make a great theatre nurse?
I believe a great theatre nurse should:
Be organised and tidy
During surgery every swab, instrument, and sharp must be accounted for. All items on your tray must be counted before, during, and after surgery, to ensure nothing is retained inside the patient.
Stay calm under pressure
During surgery, things can go wrong very quickly, you must be prepared for this and be able to react in a timely manner. Until you have seen how fast a severed artery ejects blood, you won’t know what this really means!
Have stamina and concentration
You will be on your feet for hours at a time and expected to concentrate until the moment you take off your sterile gown.
Be able to tolerate blood, intestines, bones and everything in between
This puts a lot of nurses off from working in theatres. You will get used to seeing legs amputated, and seeing organs outside the body will be a daily occurrence. I’m not saying you have to like the gruesome stuff, but if you aren’t able to tolerate it, being in theatre probably isn’t for you.
Developing skills to be a great theatre nurse
The only way to be a skilled theatre nurse is through experience and scrubbing in for as many surgeries as possible.
Nursing degrees are usually very generalised, so you will learn most theatre nursing skills on the job.
Many of my skills were gained through simply observing how other nurses worked.
I spent a lot of time learning the instruments, memorising one tray of instruments at a time.
Repetition and exposure are the best ways to learn. I would set up each tray, write the names, and take photos.
What does a typical day for a theatre nurse look like?
Check the whiteboard to see which theatre I am working in that day. I go to that theatre and look at the list of surgeries scheduled so I can start to prepare. I then help set up the theatre, checking that the equipment and suction is working.
Morning huddle - all theatre staff meet at reception, the team leader for each theatre goes through any issues they may foresee for the shift, we are given patient beds, and any other general updates.
Equipment check - Myself and another Nurse check that all of the surgical instruments/sets/devices are set up and ready for the day. We then read through the surgeons preference book to ensure that they have everything they need.
Team briefing - our theatre team meets with the surgeon and we talk about each patient, any expected challenges, comorbidities, allergies, and any medications that may be required. The first patient is sent for from the ward.
The patient arrives for the first elective surgery of the day. The patient is anaesthetised in the anaesthetic room, which is connected to the operating theatre. At this point I will start my 5-minute hand wash, which includes scrubbing my hands with a brush, cleaning my fingernails, and washing my hands and forearms three times. I don my sterile gown, and enter the operating theatre where my sterile sets are set up on trays. I am now sterile, and cannot touch anything out of my sterile field. Once my sets are checked for holes, I can take other equipment such as swabs, needles, blades, and extras.
With all checks complete, the surgery begins. Typically I would be scrubbed in general theatres for a hernia repair, gastric bypass, gallbladder removal and/or bile duct exploration, or a nissen fundoplication (where the stomach is wrapped around the esophagus to treat reflux).
The first surgery is finished, and the next patient has been sent for from the ward. I am the circulating nurse now, and the other nurse is scrubbed. We alternate each surgery to give ourselves a rest. As a circulating nurse, I ensure that the scrub nurse and surgeon has everything they need and complete the required paperwork and documentation.
Our third patient of the day, and it’s my turn to scrub again.
Afternoon surgeries tend to take a bit longer. I take off my sterile gown at 5.30pm, clean up the theatre, and have a break for dinner. I will go to CEPOD (the 24/7 emergency theatre) at 6pm to relieve other staff going home. I stay in CEPOD until 9pm when night staff take over. In CEPOD I scrub in for anything and everything that comes through the door.
How much does a theatre nurse get paid?
In the NHS, you are paid according to your “band level”.
This essentially means that you are paid for how much experience you have as a nurse. (See our NHS nursing pay information page.)
As a new graduate nurse, you will be paid around £25,000 annually (all qualified nurses start at band 5 - the 2020 - 2021 band 5 pay rate starts at £24,907).
You can earn more working privately or in London - between £30-35,000 annually.
What are the differences between working for the NHS and the private sector as a theatre nurse?
The main difference is patient workload and shifts.
In the NHS, the never-ending stream of elective and emergency patients means that you are always busy.
The shifts are usually 10 or 13 hours long, but you only do 3 - 4 shifts per week.
This means you have plenty of free time outside of work.
Many theatres close on the weekends, so it depends on where you work.
A benefit to shift work is also earning more money through working unsocial hours.
Comparing the NHS to the private sector in New Zealand, the workload is steady and the salary is usually much higher.
I worked the usual Monday to Friday, 8am - 6pm.
This meant I had weekends and nights off, which is ideal if you are a person who loves sticking to a routine.
I always knew that I would be free on the weekend, so I could make plans months in advance.
What are the ideal soft skills for a theatre nurse?
Soft skills - aka interpersonal skills, are essential in being a nurse of any kind.
What qualifications do you need to become a theatre nurse?
What are the different types of roles for a theatre nurse?
Scrub nurses work directly with the surgeon within the sterile field by passing instruments, swabs, sharps, and other items needed during the surgical procedure.
The scrub nurse is expected to act quickly to help the surgeon in an emergency as he or she is within the sterile field and is able to touch the patient.
What kind of settings do theatre nurses work in?
What are the career prospects for a theatre nurse?
Working in operating theatre is a great foundation for any nursing career.
You learn valuable skills that are transferable to other environments.
What is the current state of theatre nursing in the UK?
Finally, what does the future of surgery and theatre nursing look like in the UK?
I believe there will always be a demand for skilled theatre nurses, operating department practitioners, and surgeons, even as technology develops.
As health professionals, we should embrace technology and the positive effects it can have on patient outcomes.
- Nurse practitioners, surgical care practitioners, and prescribers will be in high demand.
- Medical training may be readily accessible online - virtual lecturing and web-based postgraduate degrees will result in educated and highly skilled nurses.
- Hopefully genomic testing will help to prevent cancer, reducing the amount of oncology related surgeries.
- Robotic surgery is no longer a concept of the future, it is implemented in many hospitals worldwide. It allows surgeons to complete minimally invasive surgeries with precision and control.