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Using robotics in the OR

Nurse Leader Weekly, May 20, 2005

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Make sure your nurses are trained and ready
Although training is time-intensive and complex, OR nurses today must be tech-savvy-especially if the facility's surgeons use robotic technology.

"I feel that the investment in training comes back to you 10-fold," says Annette Wasielewski, RN, BSN, CNOR, administrative director of minimally invasive surgery at Hackensack (NJ) University Medical Center. "You get somebody who's well-trained, and there's less stress in the room."

The robotic surgical systems that Hackensack uses to perform minimally invasive surgery (MIS) are highly technical, says Wasielewski. The robots are equipped with flexible instruments that mimic the movement of the surgeon's hands, she says.

Simply put, the surgeon sits at a remote console and, through a vision system, views a 3-D image of the surgical site. While still at the remote console, the surgeon then uses controls to manipulate the instruments.

Nurses must know how to perform the tasks necessary to assist during this type of surgery, as well as those tasks related to caring for and maintaining the equipment, says Wasielewski. For example, nurses must know how to set up and control the robot. According to Wasielewski nurses must also know how to

• troubleshoot when there is an error message.
• assemble and disassemble the robot.
• assist the surgeon in changing the instruments.
• drape the robot in a sterile manner. (The machine itself is not sterile, but the instruments are. The whole machine-much like a microscope-must be draped and prepared, says Wasielewski.)
  

Training
Training begins by slowly exposing nurses to the robot during procedures. Trainees observe surgeries that use the robot and are matched with preceptors who can answer any questions. After watching several surgeries performed with the robot, trainees are sent to a training class.

Following classroom training, trainees and preceptors reverse roles in the OR, and the new nurse acts as the robotics specialist and the trained nurse takes on a circulating role so trainees can focus on learning the robot, says Wasielewski. If trainees have questions, they can ask the circulating nurses who are there to serve as mentors.

Source: Adapted from Competency Management Advisor (April 2005), published by HCPro, Inc.

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