Peri-operative nursing encompasses the care provided to patients before, during, and after surgical procedures. This specialized field requires a seamless transition of responsibilities across three distinct phases: the pre-operative phase, the intra-operative phase, and the post-operative phase. Nurses in this field act as the central coordinator between the surgical team, the patient, and the patient's family. Understanding the entire surgical continuum allows the nurse to anticipate complications, reduce patient anxiety, and ensure a smooth recovery journey in busy Nigerian healthcare environments where resources may sometimes be constrained.
The pre-operative phase begins when the decision for surgery is made and ends when the patient is transferred to the operating theatre. Nursing duties here focus heavily on physical preparation and psychological support.
Inside the operating theatre, nurses play vital roles divided into two main categories to maintain a sterile and organized environment.
Surgical counts of sponges, needles, and instruments are a critical intra-operative duty performed jointly by the scrub and circulating nurses to prevent retained foreign objects.
Post-operative care begins immediately after surgery when the patient is transferred to the Post-Anesthesia Care Unit (PACU) or recovery room. The immediate priority is maintaining a patent airway, supporting adequate breathing, and monitoring hemodynamic stability. Nurses frequently assess vital signs, check surgical dressings for excessive bleeding, evaluate pain levels, and monitor urine output. As the patient regains full consciousness, nursing focus shifts toward preventing common complications such as deep vein thrombosis, atelectasis, and wound infections through early mobilization and deep breathing exercises.
Patient safety is the bedrock of peri-operative nursing. Nurses act as unyielding patient advocates, especially when patients are vulnerable under anesthesia. Universal safety protocols, such as the World Health Organization (WHO) Surgical Safety Checklist (Sign In, Time Out, and Sign Out), must be rigorously implemented before every procedure. The nurse speaks up to verify patient identity, correct surgical site marking, and confirm allergy status. Advocacy also extends to protecting patient dignity, ensuring informed consent is truly voluntary, and preventing positional injuries during long surgical operations.
Accurate, timely documentation in peri-operative nursing serves as a legal record of care and a communication tool for the healthcare team. Every medication given, sponge count verified, and vital sign recorded must be documented objectively. Ethically, nurses must uphold patient autonomy, beneficence, and confidentiality. A common pitfall is delayed documentation, which can compromise patient safety and lead to legal vulnerabilities in malpractice claims. The nurse ensures that all entries reflect the actual care rendered without generalized or biased remarks.