The aim of this reflective essay is to evaluate my professional development whilst undertaking the role of the Developing Intra-Operative Practitioner/ Advanced Scrub Practitioner (ASP). Using a reflective model I want to see how my new role affects me as an Operating Department Practitioner (ODP) and any legal implications it has for me as an employee. For this assignment I have decided to use the Gibbs (1988) date model of reflection and will base the assignment on prevention of Surgical Site Infection (SSI) in relation to the operative procedure of a total hip replacement.
The Perioperative Care Collaborative (PCC) defines the ASP role “as the role undertaken by a registered perioperative practitioner providing competent and skilled assistance under the direct supervision of the operating surgeon while not performing any form of surgical intervention”, (2007, Role & responsibilities of the Advanced Scrub Practitioner).
(Deighton, 2007) describes the ASP role being performed by junior doctors. With the introduction of the European Working Time Regulations (EWTR) for junior doctors, it has been necessary for other healthcare professionals to take the lead on this role. From 2004 junior doctors in the National Health Service (NHS) were included in the EWTR, reducing their working hours to a maximum of 56hrs/wk initially, then down to 48hrs/wk in 2009. This has reduced their ability to assist the surgeon in theatre.
The PCC recommends that a registered practitioner performing the ASP role must be a member of the surgical team, with a clearly defined role and job description. They should not ‘double hat-ted’ and be performing the job of the scrubbed assistant. If an employer wishes dual role to be performed the relevant policy statement and risk assessment need to be completed to ensure patient safety. This will certainly be sometimes the military need to investigate this, with the ODP’s on Operational tour being expected to extend their role. Any of these changes or extension to roles effects vicarious liability and so need to be documented in roles and responsibilities of the practitioner.
Vicarious liability is where an employer is liable for an employees’ actions. The employer will be liable for acts and omissions of the employee during the “course of their employment”. Therefore if new roles of the practitioner are not covered in their job description they could be held accountable under common law for any damage to the patient.
As well as PCC guidelines I need to adhere to the Health Professionals council ‘code of conduct’ and ‘scope of practice’ for ODP’s. This states that my scope of practice is in the areas of my profession in which I have the knowledge, skills and experience to practise safely and effectively, to meet standards and ensure that I do not put anybody at risk. Undertaking the ASP training is extending my scope of practice and so I need to use personal judgement to ensure I am competent to complete the training and gain the relevant experience. This then negates any professional conflicts of interest. The Royal College of Nursing (RCN, 2007) defines competence as “processing the skills and abilities required for lawful, safe and effective professional practice without direct supervision”.
Reflection (Bolton 2010) is described as an “in-depth consideration of events or situations, the people involved, what they experienced and how they felt about it. It is an ongoing practice and can enable practitioners to learn from experience. It can also enable the practitioner to find out the following: * What you know, but do not know you know.
* What you do not know and want to know.
* What you think, feel, believe, value, and understand about your role and boundaries.
* How your actions match up with what you believe.
* How to value and take into account personal feelings.
Reflection is a dynamic and ongoing...