This year, for the first time in my life, I had an experience I'd never had before. I had to have a minor procedure in hospital and opted for a general anaesthetic. Apart from watching hospital programmes on TV, I had no idea what an operating theatre was like or what to expect. Curiosity got the better of me and I decided to delve into the actual happenings of a theatre to take out the mystery of what was to come.

I found out that there can be many health professionals present in an operating theatre, and for many individuals who have never seen one previously, anxiety can be through the roof — mine certainly was. When the day of my procedure came, quite a few clinicians came to me asking questions, and I didn't have a clue who they were.

Who Is in the Theatre?

The number of staff in a theatre will depend on the specialty, but usually there will be: 2 Scrub Nurses, 1 ODP (Operating Department Practitioner), up to 2 Anaesthetists, up to 2 Theatre Support Workers, and up to 3 Surgeons. There could also be additional staff such as Radiology, Clinical Photography, Students and even Reps.

Scrub Nurses

Typically, there will be 2 Scrub Nurses: one will scrub for the procedure and work inside the sterile field, while the other will circulate outside it. Both nurses check that the correct trays and equipment are ready for the list.

Theatre Support Workers (TSWs)

TSWs help to transport patients from wards to theatres and from theatre to recovery. They also ensure the theatre is well stocked with sutures, syringes and swabs, assist in the clean-up, and complete swab checks with the Scrub Nurse.

Operating Department Practitioners (ODPs)

ODPs check anaesthetic machines, ventilators, vital signs monitors and intravenous equipment before the start of every list. They check you in on arrival, check your wristband and consent form, and reassure and keep you calm in recovery.

Anaesthetists

Up to 2 Anaesthetists may be present — a Registrar and a Consultant. Anaesthetists provide anaesthesia and pain management before, during and post-surgery. They monitor vital signs, administer drugs when needed, and create a personalised formula of drugs specifically for each patient.

Surgeons

Usually there will be 2 Surgeons on a list — a Consultant and a Registrar — sometimes 3 in complex cases. The Surgeon is responsible for performing the procedure, maintaining a sterile field and managing post-operative recovery and follow-up care.

The Case for Named Theatre Hats

We need all these people working together, each with their own role performed to optimum levels. Yet many miscommunication errors have occurred in operating theatres — staff being mistaken for another, identification badges unable to be worn in theatres, and the challenge of not knowing who is who.

As a vulnerable and frightened patient, having lots of unknown people around you is a very daunting experience. Even after a clinician has introduced themselves, add in tension, lots of other people, masks and identical scrubs — it is very difficult to remember who is who. From a patient's perspective, we have the right to know exactly who is looking after us. Names and roles play a big part in helping us to feel at ease and less fearful.

— Joy Baker, Patient at Warwick Hospital, July 2023