LOCAL ANESTHESIA

Local Anesthesia

The roles of all healthcare professionals have changed considerably over the years and the nurse in particular has been affected. These changes have been influenced by the following guidance, Code of Professional Conduct (UKCC 1992) and Code of Professional Conduct (NMC 2004). Such changes involve the whole area of advancing roles in perioperative nursing, such as the nurse working as advanced scrub practitioner (ASP) (formally known as first assistant). Boss (2002) mentions that these new role developments are concerned with principles such as serving the interests of patients, providing holistic care, developing professional skills and knowledge and being accountable and responsible for your individual actions. Nurses acting as an ASP have many matters to contend with, such as autonomy, duty of care and other legal issues, and professional accountability. This paper explores these issues in more detail.

The roles of all healthcare professionals have changed considerably over the years and the nurse in particular has been affected. These changes have been influenced by the following guidance, Code of Professional Conduct (UKCC 1992) and Code of Professional Conduct (NMC 2004). Such changes involve the whole area of advancing roles in perioperative nursing, such as the nurse working as advanced scrub practitioner (ASP) (formally known as first assistant). Boss (2002) mentions that these new role developments are concerned with principles such as serving the interests of patients, providing holistic care, developing professional skills and knowledge and being accountable and responsible for your individual actions. Nurses acting as an ASP have many matters to contend with, such as autonomy, duty of care and other legal issues, and professional accountability. This paper explores these issues in more detail.

According to Morrison (2000) the practice of nursing is one that is driven by, and constantly changing as a result of, the needs of patients and their families, the needs of the healthcare system and of wider society. Salussolia (1997) shares this view and adds to it by arguing that nursing has also changed as a result of the 'professionalisation' of nursing. However, she does mention that when considering the changes taking place in nursing, for example the development of extended roles such as the ASP, there is a danger that nursing could end up in a state of confusion. Therefore nurses need to be aware that when accepting the ASP role, issues such as the development and underpinning education of practice, and the standards of care that patients deserve and require need to be considered in the context of the requirements of healthcare management and governing bodies.

In 2003 The Perioperative Care Collaborative (PCC) redefined the title and job description of the first assistant role to that of ASP. It defines the role as, 'providing competent and skilled assistance under the direct supervision of the operating surgeon while not performing any form of surgical intervention' (PCC 2003, p2).

Sutton (2003) and Tanner (2001) mention that the ASP role does not involve extended practice. Instead they argue that this role is already established into the theatre nurse role ...