Working as a nurse in the Major Operating Theatre (MOT) at Singapore General Hospital is not for the faint-hearted. The hospital sees an average of 140 surgical cases across 26 Operating Theatres (OT) in a day. Senior staff nurse, Ms Lim Han Ying, 27, sheds lights on a typical day in the Operating Theatre (OT):

A fresh start



Ms Lim Han Ying doing her routine check at the start of her shift. PHOTO: SINGHEALTH



8AM:

I kickstart my shift with a routine check to ensure that all equipment and instrument sets required for surgeries are in good working condition. Then I report for a team briefing – this is when introductions are made as we work with a different set of colleagues every day. The team comprises the surgeon, anaesthetist, scrub nurses, circulating nurses, anaesthesia nurse and healthcare attendant.



Getting to know her team members during team briefing. PHOTO: SINGHEALTH



As an Obstetric and Gynaecology nurse, some of the operations I’m involved in include caesarian sections and hysterectomies. But my role is never fixed – it depends on the manpower allocation and complexities of the surgery. There are days when I take on the role of a circulating nurse who works outside the sterile field and assists the team with various tasks during the surgery. On other days I take on a supervisory role to train junior nurses.

For my first surgery today, I serve as the scrub nurse. It is my duty to ensure that all instruments are ready and assist the surgeon during the procedure.

8.20AM: Before the first patient is wheeled in, I conduct a check in the induction room to verify the patient’s identity and ensure that he or she is going for the right procedure.

Going for surgery can be nerve-wracking, so I use this time to reassure the patient and soothe his or her anxiety. I always try to put myself in their shoes or treat them like a family member.



Making sure that patient's details are correct before proceeding with the surgery. PHOTO: SINGHEALTH



8.30AM: I help to strap the patient securely on the operating table, while the anaesthesia nurse assists the anaesthetist to intubate the patient (insert a tube into the trachea to assist with breathing during anaesthesia) and administer anaesthesia.

Hive of activity



Ms Han Ying's role as a scrub nurse is to assist the surgeon closely during a procedure. PHOTO: SINGHEALTH



9AM: As a scrub nurse, I need to be alert and constantly think on my feet. I have to be one or two steps ahead of the surgeon during the operation to anticipate his next move in order to prepare the right tools. This is where a good foundation in anatomy helps. Towards the end of the procedure, I ensure all tools and instruments are accounted for before the surgeon can proceed to close the wound and finish the surgery.

11.30AM: After surgery, each team member completes their own checks and documentation for handover. Patients usually stay in the Post-Anaesthesia Care Unit (PACU) for about two hours before being transferred to the ward. This is where I pass the patient’s care instructions and essential information to the PACU nurses, who will in turn relay them to the ward nurses.

Taking a break



Having her much-needed break to recharge. PHOTO: SINGHEALTH



12PM: It’s time for me to take a step back from the long, hectic hours in the OT.

Working in the OT is tough as you have to pick things up quickly in a fast-paced environment. Break times are an opportunity for me to unwind, speak with fellow colleagues for advice, and recharge.

The final stretch



Attending to one of her many surgeries for the day. PHOTO: SINGHEALTH



1PM: I scrub in and prepare for another procedure. On average, I attend to four to six surgeries daily.

We encounter different cases daily, and some of them can be quite unpredictable. Some cases even challenge us emotionally but as a team, we need to remain level-headed and professional.

5PM: Before my shift ends, I make sure that everything is properly documented and handed over to the night shift team. Then it’s time to head home and rest before the cycle begins again the next day.

When I was first posted to the OT, I found it to be an unfamiliar and demanding work environment. But when you put your heart into learning, there are a lot of things you can achieve. As an OT nurse, I’ve learnt to anticipate, sharpen my analytical and crisis management skills, and learn how to work effectively within a team. Life in the theatre can be physically and mentally challenging, but it is a satisfying job as there is so much to learn and master.

Behind the scenes with fellow nurses



Sarah Khairunnisa, senior staff nurse, Changi General Hospital. PHOTO: SINGHEALTH



"We are masters of non-verbal communication. Since our faces are covered by masks, we communicate with our eyes and gestures. With enough experience, we can tell what the surgeon needs without any verbal cues!" - Sarah Khairunnisa, senior staff nurses at Changi General Hospital



Ong Jing Qing, senior staff nurse, KK Women's and Children's Hospital. PHOTO: SINGHEALTH



"A single surgery may involve more than 10 medical professionals. As OT nurses, we must have good problem-solving and interpersonal skills to ensure that every operation goes smoothly." - Ong Jing Qing, senior staff nurse at KK Women's and Children's Hospital



Tan Leng Leng, assistant nurse clinician, Sengkang General Hospital. PHOTO: SINGHEALTH

