Orientation Handbook for New Surgical Nurses
Operating Theatre (OT) – Cardiac Surgery Unit by Dr. Dhiren Shah, Marengo Asia CIMS Hospital
Welcome to the OT Team
Congratulations on joining the surgical team!As a cardiac OT nurse, you are now part of a high-performance environment where every second counts and every action matters. This orientation handbook will guide you through what is expected, how to prepare, how to anticipate, and how to evolve into a confident, efficient, and reliable OT nurse.
Core Responsibilities of a Cardiac OT Nurse
Pre-operative preparation
Assisting during surgery
Maintaining sterility and safety
Post-operative support
Documentation and communication
Equipment care and inventory
I. Preparing for the Case: Before the Patient Arrives
Understand the Surgery
Know the procedure type (e.g., CABG, valve replacement, aortic dissection, transplant)
Review the surgical plan and patient history (ask seniors if unsure)
Prepare the OT
Check lights, suction, cautery, ECG, warming equipment, heart-lung machine interface
Prepare surgical trays, sutures, drapes, prosthetic valves, and implants
Verify that all implants and devices are sterilized and within expiry
Ensure emergency kits (crash cart, defibrillator) are stocked and accessible
Communicate
Confirm case timing with surgeon, anesthetist, perfusionist
Update whiteboard or electronic board with case information
II. Assisting During Surgery
Your Role at the Table
Be alert and ready with instruments before the surgeon requests them
Anticipate needs: suction, clamps, gauze, needles, cannulas, grafts, etc.
Ensure constant sterile field and quick access to instruments
Communicate Clearly
Respond with confidence (“Yes doctor”, “Suction ready”, “Pledget coming”)
If unsure, don’t guess—clarify silently or discreetly
Count Matters
Instrument, gauze, and sharps count at the start, before closure, and end
Ensure proper documentation of counts with the circulating nurse
III. Sterility and Infection Control
Follow WHO five moments of hand hygiene
Maintain strict sterile technique throughout
Report any suspected contamination immediately
Keep surgical field clean, dry, and protected at all times
IV. Post-Surgery Duties
Assist with dressing, drain securing, and line management
Help anesthetist and ICU staff with transfer documentation
Clean and sterilize instruments as per hospital protocol
Replenish sutures, blades, and emergency stock used during surgery
V. Communication Protocols
Brief incoming nurse (handover) clearly on patient’s condition and any intra-op events
Maintain professionalism and calm tone at all times, especially with families and surgeons
Ask for feedback after each case—use it to improve and grow
VI. Emergencies in the OT
In cardiac surgery, emergencies can escalate in seconds.
Your Actions:
Stay calm, do not panic
Retrieve required items: sternal saw, crash drugs, defibrillator pads
Increase suction or adjust lights as requested
Communicate briefly and clearly
VII. Daily Personal Readiness Checklist
Before you begin each day:✅ Nails trimmed, no polish✅ Freshly laundered scrubs✅ OT badge and ID visible✅ Watch for timing medication✅ Good hydration, alert mind✅ Positive attitude
VIII. Key Qualities of an Excellent OT Nurse
Preparedness – You know the case and the surgeon's preferences
Anticipation – You think two steps ahead
Discipline – You maintain sterile field and calm presence
Responsiveness – You listen, acknowledge, and act promptly
Emotional Strength – You stay calm under pressure
Team Spirit – You support your surgeon, anesthetist, and fellow nurses equally
IX. Respect, Teamwork, and Culture
Respect patient dignity always—before, during, and after surgery
Encourage a culture of silence, focus, and professionalism in the OT
Handle instruments with care and purpose—not casually
Build trust with the surgeon by being consistent, humble, and proactive
X. Final Thoughts – You Are the Backbone of the OT
“A surgeon can only do his best when the nurse knows what’s needed before it’s said.”– Dr. Dhiren Shah
You are not “just assisting.” You are a critical part of saving a life. Every suture you pass, every sponge you count, and every moment you stay alert contributes to a successful outcome.
Wear your scrubs with pride. You are not just a nurse—you are a lifesaver.
Imported from Dr. Dhiren Shah’s Education portal. For a personalised interpretation of this information, request an appointment with Dr. Dhiren Shah.
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