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Key Responsibilities and Required Skills for Orthopaedic Scrub Nurse

💰 $ - $

🎯 Role Definition

This role requires an experienced Orthopaedic Scrub Nurse (Orthopedic Scrub Nurse) to join a high-performing perioperative team. The orthopaedic scrub nurse is responsible for maintaining a sterile field and providing direct surgical assistance during orthopaedic procedures—arthroplasty (total hip and knee replacement), fracture fixation, arthroscopy, spinal instrumentation and trauma cases. This role requires mastery of orthopaedic instrumentation, implants and power tools, impeccable surgical counts and sterile technique, excellent situational awareness in the operating theatre, and strong multidisciplinary communication to ensure patient safety and efficient case flow.

📈 Career Progression

Typical Career Path

Entry Point From:

  • Registered Nurse (RN) moving into perioperative/operating room roles
  • Certified Surgical Technologist or Operating Department Practitioner (ODP) transitioning to orthopaedics
  • Scrub/ circulating nurse trainee from general surgery to a specialist orthopaedic team

Advancement To:

  • Senior Orthopaedic Scrub Nurse / Lead Scrub Nurse
  • Charge Nurse, Perioperative Services / Operating Room Manager
  • Clinical Nurse Specialist in Orthopaedics or Perioperative Education Lead

Lateral Moves:

  • Surgical First Assistant (with additional education)
  • Instrumentation/Implant Representative liaison roles
  • Sterile Processing or Perioperative Clinical Educator

Core Responsibilities

Primary Functions

  • Prepare, maintain and manage the sterile field for orthopaedic procedures, ensuring aseptic technique and sterility of instruments, implants and disposables throughout the case to minimize infection risk.
  • Scrub in and provide direct technical assistance to the orthopaedic surgeon during procedures including total hip replacement, total knee arthroplasty, hemiarthroplasty, intramedullary nailing, plate-and-screw fixation, spinal fusions and arthroscopic interventions.
  • Accurately perform and document instrument, sponge and sharps counts pre-, intra- and post-operatively in accordance with hospital policy and national safety standards to ensure patient safety and regulatory compliance.
  • Anticipate surgeon needs and orchestrate the timely passing of instruments, implants, sutures and specialty equipment to maintain efficient operative flow and reduce procedure time.
  • Prepare and verify implant trays, prostheses, cementing systems and instrument sets prior to cases, including confirming implant sizes/cards and assisting with implant selection under the surgeon’s direction.
  • Operate and manage orthopaedic power tools (drills, saws, reamers, oscillating saws) and ancillary devices safely, ensuring appropriate setup, sterilization and maintenance coordination with Central Sterile Services.
  • Apply and assist with intraoperative haemostasis techniques specific to orthopaedics including tourniquet application, suction management, and bone wax or topical haemostatic adjuncts.
  • Ensure correct labeling, handling and documentation of specimens (tissue, cultures, bone graft) collected during orthopaedic procedures and coordinate with pathology and microbiology as required.
  • Conduct pre-operative instrument and equipment checks, including verification of functionality of C-arm compatibility, navigation systems, arthroscopy pumps and camera stacks as relevant to orthopaedic cases.
  • Facilitate safe patient positioning (e.g., fracture tables, lateral, supine) and apply sterile padding and restraints in collaboration with anaesthesia and theatre staff to protect neurovascular structures and maintain surgical exposure.
  • Maintain accurate and comprehensive perioperative records and operative notes (scrub nurse documentation), including implant lot numbers, expiration dates and implant tracker entries for traceability and audit readiness.
  • Perform immediate postoperative tasks such as assisting with wound closure materials, dressing application, and transferring necessary post-op instructions and implant information to the recovery team and implant registries.
  • Triage and manage equipment or instrumentation issues intraoperatively—troubleshoot broken instruments, request backup sets, coordinate with sterile processing or vendor reps to avoid case cancellation or delay.
  • Train, supervise and mentor junior scrub staff, surgical trainees and students in orthopaedic scrub technique, instrument identification and case setup to build departmental capability and maintain standards.
  • Comply with infection control protocols, sharps safety programs and hazardous material handling when dealing with cement, bone grafts, or biohazardous specimens to reduce risk to staff and patients.
  • Participate in multidisciplinary briefings and debriefings (time-out, sign-out) to confirm patient identity, procedure, side/site, implants, and special equipment needs, supporting WHO surgical safety checklist adherence.
  • Support orthopaedic trauma call rosters and emergent surgical lists by rapidly mobilizing necessary instrument sets, implants and sterile supplies to facilitate timely operative intervention.
  • Coordinate with implant vendors and clinical application specialists for complex cases requiring navigation, robotics or custom implant systems to ensure vendor presence and device readiness when needed.
  • Maintain stock control for orthopaedic consumables and implant inventory, liaise with procurement and central stores to pre-order case-specific implants and single-use items for elective and trauma lists.
  • Participate in quality improvement initiatives, morbidity and mortality reviews, and theatre governance meetings to identify trends, reduce complications, and implement evidence-based perioperative practice changes.
  • Ensure compliance with documentation and regulatory requirements for implant registries and national joint registries, submitting required data on arthroplasty or fracture fixation cases.
  • Monitor and record intraoperative equipment usage, contribute to cost-effective practice by providing feedback on instrument/set optimization and single-use device selection.
  • Respond to intraoperative emergencies (e.g., massive haemorrhage, instrument miscounts) with rapid coordination, clear communication and adherence to escalation procedures to protect patient safety.
  • Maintain continuous professional development through attendance at orthopaedic workshops, implant vendor training and internal in-service education to keep abreast of evolving surgical techniques.

Secondary Functions

  • Act as a clinical resource for orthopaedic nursing policies and procedures; help update protocols and checklists to reflect best practice.
  • Support implant inventory audits, track implant lot numbers and expiration dates and collaborate with supply chain to minimize stockouts.
  • Assist in departmental training programs, simulation sessions and competency assessments for scrub practice and orthopaedic-specific instrumentation.
  • Participate in equipment procurement evaluations by trialing new instrumentation, providing user feedback and drafting recommendations for leadership.
  • Contribute to patient education by preparing discharge implant information packs and coordinating with ward staff and physiotherapy regarding postoperative instructions.
  • Support research and clinical trials when orthopaedic procedures are involved by ensuring protocol adherence for specimen handling and documentation.
  • Participate in on-call and extended-hours rotas for emergency orthopaedic theatre coverage, maintaining readiness to mobilize for trauma cases.

Required Skills & Competencies

Hard Skills (Technical)

  • Expert sterile technique and maintenance of the sterile field specific to orthopaedic surgery.
  • Proficient in instrument identification and handling for arthroplasty, trauma fixation, spinal instrumentation and arthroscopy.
  • Competent with implant management: verification, handling, recording of lot numbers and implant registry submission.
  • Skilled in surgical counts (sponge, instrument, sharps) and use of count boards or digital count systems.
  • Experience operating and troubleshooting orthopaedic power tools (saws, reamers, drills) and pneumatic devices.
  • Familiarity with arthroscopy towers, fluid management pumps, camera systems and endoscopic equipment.
  • Knowledge of bone cement preparation, mixing protocols and safety handling.
  • Ability to assist with patient positioning devices (fracture table, traction systems) and apply surgical positioning safely.
  • Understanding of antibiotic prophylaxis timing and intraoperative aseptic guidelines for orthopaedic implants.
  • Competence in using theatre information systems and electronic documentation for perioperative records and implant tracking.
  • Familiarity with C-arm use and intraoperative imaging workflow to support surgeon and radiographer.
  • Sterilization principles and working knowledge of central sterile processing requirements for orthopaedic sets.

Soft Skills

  • Excellent communication skills with surgeons, anaesthetists, theatre staff and ward teams to ensure coordinated patient care.
  • Strong situational awareness and the ability to anticipate surgical team needs under pressure.
  • Team-player attitude with proven ability to collaborate in multidisciplinary environments and contribute to positive theatre culture.
  • High attention to detail and meticulous record-keeping for patient safety and regulatory compliance.
  • Calm temperament and decisive problem-solving during emergencies or unexpected intraoperative events.
  • Teaching and mentoring ability to upskill junior staff and support continuing professional development.
  • Time management and organizational skills to prepare complex cases and manage rapid turnover.
  • Professional integrity, confidentiality and adherence to clinical governance and ethical standards.

Education & Experience

Educational Background

Minimum Education:

  • Registered Nurse (RN) with active license, OR
  • Certified Surgical Technologist / Operating Department Practitioner with perioperative scrub training.

Preferred Education:

  • Bachelor of Science in Nursing (BSN) or equivalent.
  • Post-registration perioperative qualification (e.g., CNOR, perioperative diploma) or evidence of specialized orthopaedic training.
  • Vendor-specific implant system training and certifications.

Relevant Fields of Study:

  • Nursing
  • Perioperative Science / Operating Room Practice
  • Surgical Technology / Operating Department Practice

Experience Requirements

Typical Experience Range: 2–5 years of perioperative experience, with at least 1–3 years focused on orthopaedic surgery.

Preferred:

  • 3–5+ years’ experience as a scrub nurse in orthopaedics with demonstrated competence in arthroplasty, trauma fixation, spinal instrumentation or arthroscopy.
  • Previous experience working with implant registries, vendor-managed inventory and complex orthopaedic instrumentation.
  • Evidence of continuous professional development through orthopaedic workshops, implant vendor training or perioperative certifications (e.g., CNOR).

If you are an experienced Orthopaedic Scrub Nurse passionate about excellence in perioperative care, infection prevention and efficient theatre practice, we encourage you to apply. This role suits someone who thrives in high-acuity orthopaedic environments and who wants to contribute to outstanding surgical outcomes and continuous improvement.

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