During the whole operation, the medical staff must work closely together to ensure the success of the operation. The cooperation of nurses in various operations can be divided into direct cooperation and indirect cooperation.

1. The cooperation of instrument nurses refers to directly participating in the operation and cooperating with doctors to complete the whole process of the operation. The work scope of the directly cooperating nurses is limited to sterile areas, such as delivery instruments, dressings and various uses. So the nurse who cooperates directly is called the instrument nurse. Because working in a sterile area requires cleaning hands and arms, wearing sterile surgical gowns and wearing sterile gloves, they are also called hand washing nurses, disinfection nurses or surgical nurses.

(1) Main tasks and requirements of instrument nurses: The main tasks of instrument nurses are to prepare surgical instruments, deliver the instruments directly to the operators and assistants according to the surgical procedures, and closely cooperate with the operators and assistants to complete the operation. Instrument nurses should be: ① Have a high sense of responsibility and a correct concept of aseptic technology. If it is found that it violates the requirements of aseptic operation, it shall be corrected in time; (2) Grasp the diagnosis and operation of the patient, fully estimate the possible problems during the operation, and closely cooperate with the operator to ensure the smooth completion of the operation; ③ Know the preferences and needs of the surgeon before operation, and prepare special instruments and supplies; (4) Be familiar with the usage, purpose and use of surgical instruments, so as to cooperate with the operation accurately.

(2) Operation cooperation of instrument nurses

1) Wash your hands 20 minutes before the operation, wear sterile surgical gown and sterile gloves 15 ~ 20 minutes, prepare for the arrangement of the instrument table, and check whether all kinds of instruments, dressings and other materials are complete. According to the operation steps and uses, all kinds of instruments, dressings and other items are sorted in order.

2) Before and during the operation, when sewing the wound, accurately and carefully count the instruments, gauze, gauze pad, sewing needle, etc. Check with the visiting nurse and register. Check it again after the operation to make sure it is correct, so as not to leave it in the body cavity or tissue.

3) After the operation, according to the routine operation and intraoperative conditions, deliver instruments and gauze pads. To the operator and assistant. Proactive, agile and accurate.

4) Keep the operation area, instrument tray and instrument table clean and dry. After the instrument is used up, retrieve it quickly and wipe the blood. Instruments and objects are arranged in order. Instruments used in unclean parts should be placed separately, soaked in liquid medicine or handed over to nurses under the stage for treatment. Prevent the spread of pollution.

5) Pay attention to the progress in the operation process at any time. In case of bleeding or cardiac arrest, contact the visiting nurse calmly and decisively, and prepare rescue equipment and articles as soon as possible.

6) Keep any cut tissues and fix the parts that need to be sent for inspection with 10% formalin. Record the patient's name, ward, date, etc. After the operation, fill in the specimen register.

7) After the operation, assist in wiping the blood around the wound and drainage tube, bandage the wound and fix various drainage objects.

8) Dispose of postoperative instruments and other items. Handle precision and sharp surgical instruments separately, and don't damage or lose parts. And clean up the operating room.

2. The cooperation of visiting nurses refers to the task that although they are not directly involved in the operation, they are assigned to a fixed operating room to cooperate with equipment nurses, surgeons, assistants and anesthesiologists to complete the operation. The work scope of indirect cooperation nurses is to patrol patients, surgeons, anesthesiologists and other personnel outside the sterile area, so they are called visiting nurses.

(1) Responsibilities of the visiting nurse: The main task of the visiting nurse is to prepare for the operation; Fully responsible for the safety of patients entering and leaving the operating room; Cooperate closely with the operation group and anesthesiologist to complete the operation task efficiently and safely. Visiting nurses are required to: ① create operating environment and conditions for patients, make good nursing plans and care for patients; (2) to ensure the comfort and safety of patients, so that patients can receive surgical treatment with a calm mind and prevent accidents; ③ Adhere to the aseptic concept, be the "guardian" of aseptic technology, beware of violating aseptic operation and correct it in time; (4) Master the condition, name and method of operation, and actively cooperate with the operation team and anesthesia work in a planned and step-by-step manner; ⑤ Be familiar with patients' preoperative preparation, intraoperative posture and the use of instruments.

(2) Business cooperation

1) Check whether all kinds of medicines in the operating room are available and indoor fixed equipment (power supply, shadowless lamp, aspirator, etc.). ) is perfect, safe and applicable. According to the needs of surgery, implement, supplement and perfect everything, and adjust the room temperature and light.

2) Patients undergoing surgery (usually 30 minutes before surgery, the patient is sent to the operating room) should be enthusiastic to eliminate the fear and nervousness of patients. Check the patient's name, age, sex, surgical site and anesthesia method according to the operation notice. Check items (medical records, X-rays, medicines, etc.) in detail. ) Everything sent by the ward is complete. Verify the patient's blood type and cross-examination results to prepare for blood transfusion.

3) Check the patient's preoperative preparation, such as whether the skin is clean and scraped, whether the dentures, ornaments, hairpins and valuables are removed, and supplement or keep them if necessary. Wrap the patient's hair or put on a hat and send it to the operating room.

4) According to the requirements of anesthesia, patients or children who are under general anesthesia or unconscious should be properly restrained or specially cared to prevent falling from the bed. According to the surgical requirements, the patient's posture should be fixed, and the purpose and importance of his posture should be explained when the patient is conscious, so as to obtain the patient's cooperation. Give patients comfortable and safe care to prevent crush injury and fall injury. When using the electrocautery, the lead plate should be placed in the muscle-rich part to prevent burns.

5) Help the operating personnel to wear surgical gowns, arrange all kinds of personnel to be in place, adjust the lighting at any time, supply all necessary items for the hand washing nurses, ensure the smooth blood transfusion, accurately implement the doctor's advice, and actively cooperate with the rescue work when the condition changes. Timely replenishment of various items lacking in the operating room.

6) Count the number of instruments and dressings registered on the operating table in detail, check with the hand-washing nurse and the surgeon (the first assistant) before and after closing the body cavity to prevent the body cavity or tissue from being left behind, and count again after the incision is closed.

7) Stick to the post, do not leave the operation post without leave, and supply the required items in the operation process at any time. Closely observe the changes of the condition, fully estimate the possible accidents during major surgery, prepare for first aid and cooperate with the rescue in time.

8) Keep the operating room clean and tidy, supervise the aseptic technical operation of operators, and immediately correct any violation. Pay attention to all conditions of the operating table at any time to avoid pollution. Care about the situation of surgical personnel and solve it in time.

9) After the operation, assist the operator in dressing the wound and point out the items carried by the patient to the accompanying personnel. Clean up the operating room, replenish various items in the room and put them back. Disinfect the air and cut off the power.

10) When changing visiting nurses in the middle of the operation, it is necessary to make detailed handover at the scene, including the patient's condition, the implementation of the doctor's advice, infusion, blood transfusion, medication, etc. , sign each other in the register, and notify the operator when necessary.