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My Story as a Surgical Care Practitioner

I am Russel. I arrived in the UK in 2008 and started working as a Theatre Scrub Nurse. Four years later, I discovered a job role that is quite uncommon to most nurses at that time. I’ve never thought that Theatre Nurses could progress to greater heights in their career and still be in the clinical side. An opportunity to work and think like a surgeon but still fulfill every patient's needs as a nurse, this is my role as a Surgical Care Practitioner. 

In the first few years of my career, I have developed my skills in the operating theatre environment with scrub and circulating roles for various surgical specialties. When I realised that a Surgical Care Practitioner post existed, I researched about its roles and responsibilities and decided to pursue this career path. Luckily, when I moved to the Cardiac Surgery Department, they were looking for trainee SCPs. I applied and got the post. In 2013, I started my journey as a SCP in Cardiac Surgery in London and found a fulfilling aspect to my career path as a Theatre Practitioner. 

My Typical day

As a Cardiac SCP, I provide support to the surgical team. Normally, we have two cardiac operations in the list per day. My day starts with attending a team brief with the multidisciplinary team to discuss the patients and the type of operation. During surgery, I assist the primary surgeon and provide technical support that eases the surgical workload. For instance, in a Coronary Artery Bypass Graft (CABG) surgery, the surgeon might need a vein graft to use as a conduit in the heart. My main role in this crucial operation is either to harvest a vein graft from the legs of a patient by either using open technique or vein stripping, or harvest a radial artery from the patient’s forearm. This is the moment where I use my surgical skills such as suturing, knot-tying, tissue handling and use of surgical instrumentation. 

My role is not only confined in the Operating Theatres. I do preoperative checks to patients having surgery the next day and join the surgical team during their ward rounds. I support the Senior House Officer or Registrar either by doing some documentation or ordering some investigations. Part of my role also includes on call shifts (6pm- 8am) after my regular shift (8am-6pm) during the day.

How were you able to get this job?

I moved to the Cardiac Surgery Department and worked as a scrub nurse. One day, the Clinical Lead for Cardiac Surgery asked me if I am interested in becoming an SCP... and without hesitation I said yes because I was very interested in the role. Eventually, they opened the post, interviewed me and gave me the job.

Why did I choose this area of nursing?

I always see myself working in the surgical field. The SCP role gave me an opportunity to learn the skills that are normally performed by medical/surgical doctors. It is an area of nursing where you work and think like surgeons.

What does it mean to be a SCP?

One of the articles published calls us “surgeons who are not doctors” since we can do surgery (mostly minor and under supervision) but not medically qualified.

The road to become a SCP takes a lot of hard work, perseverance, dedication and flexibility. In order to get qualified, you have to undergo a 2-year Master’s degree in an accredited university, and clinical practice. After completion of your training, for Cardiac SCP, you have to pass the Royal College of Surgeons (RCS) Exam for Cardiothoracic SCP.

Do you think you are making a difference as a nurse in this field? How?

Definitely yes. Being an SCP gives me a perspective both of a nurse and of a surgeon. It helped me understand more about the patient's needs during their hospital stay. Positive feedback from the patients motivates me to do better in my craft. It is very fulfilling when you see your patients improve their condition and quality of life.

Benefits of working as a SCP

It is a great career path for nurses who love working in the operating theatres. In the NHS, as a trainee you start as Band 6. Once qualified, you move up to band 7/8. Also, surgeons may ask you to assist with their cases in private hospitals and pay you directly as extra income. Furthermore, you get a Master’s degree for free as your employer pays for the university fees.

The role of SCP is much more appreciated recently compared to a few years ago. It is very popular now in areas such as Cardiac, Orthopaedics, Robotic Urology and Laparoscopic Surgery.

Challenges of an SCP

As a Cardiac SCP, one of the challenges is to harvest a good quality conduit during CABG surgery. Some patients may have existing problems in the leg such as varicosities, diabetes or oedema which may alter the quality of the veins. 

For me, one of the occupational hazards of being a Cardiac SCP is getting back pains. We do odd positions when harvesting the vein grafts from the patient’s legs, or assisting the surgeon. You also have to stand for long hours due to the nature of surgery. Most SCPs have to stay late until the case is finished but may vary depending on where you work. 

Advice to consider the role

If your goal is to become a SCP, start by working in the specialty you like, or a department that offers the SCP role. From there, build up your experience and show your interests about the surgery by understanding the procedure. Surgeons will appreciate it if you know how to anticipate what they need without asking.

As nurses, we can either progress through a managerial or clinical route.  For me, I have never seen myself as a manager sitting in the office, doing a lot of paperwork or answering work emails. I always love the action, feeling the adrenaline rush upon opening a chest to save a patient during cardiac arrests. If you have the same passion as me and you like working in the surgical field, then you can become a Surgical Care Practitioner.

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