One Morning, Seven Roles

In practice

The case is a planned gallbladder removal at a community hospital. Before the patient arrives, Dana, a surgical technologist, helps Marcus, the circulating nurse, prepare the room, then scrubs, gowns and gloves, and lays out the instruments on the back table and the Mayo stand. Marcus opens supplies onto the field and checks every package before it reaches Dana. When the patient is brought in, Priya, a nurse anesthetist working with the supervising anesthesiologist, confirms the patient's name, date of birth and allergies. Marcus leads the time out. Everyone states their name and role, the procedure is read from the consent form, and the surgeon, Dr. Okafor, confirms the marked site. Dana and Marcus count the sponges, sharps and instruments aloud together. During the case the first assistant retracts while Dr. Okafor dissects, and Dana passes instruments before they are asked for, because she has read the preference card and knows the next step. Priya watches the heart rate and oxygen level and tells the team when anything changes. Near the end, Dana labels the specimen, hands it off to Marcus, and starts the closing count with him. Afterward, Marcus documents the counts, the specimen and the dressing, and the team takes the patient to recovery.