Understanding the role of the scrub nurse during robotic surgery.

In the operating theatre, the scrub nurse has a wide range of roles, including responsibility for organising and ensuring that the correct instrumentation is available to the surgeon in the operating field, while maintaining stringent adherence to the principles of asepsis. Robotic techniques have revolutionised many procedures, providing surgeons with improved tissue access and tool control compared with open or laparoscopic techniques. However, adopting this technology has created additional challenges in the scrub nurse's role in areas such as team dynamics and the need to gather and disseminate vital patient information. This article explores the role of the scrub nurse and the challenges that may be encountered in the developing area of robotic surgery.

Drought-Induced Civil Conflict Among the Ancient Maya.

The influence of climate change on civil conflict and societal instability in the premodern world is a subject of much debate, in part because of the limited temporal or disciplinary scope of case studies. We present a transdisciplinary case study that combines archeological, historical, and paleoclimate datasets to explore the dynamic, shifting relationships among climate change, civil conflict, and political collapse at Mayapan, the largest Postclassic Maya capital of the Yucatán Peninsula in the thirteenth and fourteenth centuries CE. Multiple data sources indicate that civil conflict increased significantly and generalized linear modeling correlates strife in the city with drought conditions between 1400 and 1450 cal. CE. We argue that prolonged drought escalated rival factional tensions, but subsequent adaptations reveal regional-scale resiliency, ensuring that Maya political and economic structures endured until European contact in the early sixteenth century CE.

Surgical care practitioners: an audit across the surgical specialties.

INTRODUCTION: The Royal College of Surgeons of England (RCS), when devising their curriculum for surgical care practitioners (SCPs), aimed to provide a level of training to produce a practitioner able to work across the surgical patient's journey, providing care to, arguably, an advanced level. This audit planned to examine the reality of this. METHOD: SCPs from a closed group, on the Facebook social media platform were invited to complete an online questionnaire about their role as an SCP. RESULTS: A total of 92 responses were gathered from across the surgical specialty SCP community and from around the UK. Data were collected on the breakdown of the SCP's role and working practices. CONCLUSION: The data collected demonstrated the multifunctional nature of the SCP and their ability to work at a level as envisioned by the RCS curriculum.

Workforce issues: the blurring of boundaries in surgical care.

Bradley Russell and Nicholas Fletcher discuss the need for clear boundaries for those nurses practising at an advanced level in surgical specialties.

The role of the surgical care practitioner during the COVID-19 pandemic: An audit of experiences.

INTRODUCTION: The Surgical Care Practitioner is a medical associate profession role, working to an advanced level, undertaken by registered nurses, operating department practitioners or physiotherapists, on completion of a Royal College of Surgeons accredited course. The COVID-19 pandemic has led to all heath care professionals needing to adapt to help support the health care system as it tackles its effect. AIM: Audit of roles undertaken by Surgical Care Practitioners during the COVID-19 pandemic in the context of Royal College of Surgeons (2014) Curriculum to review the utilisation of this medical associate profession role. METHOD: The online questionnaire service, SurveyMonkey®, was used to collect data on the activities being undertaken by the Surgical Care Practitioner during the COVID-19 pandemic. RESULTS: Eighty Surgical Care Practitioners from across seven different surgical specialties within the United Kingdom completed the online survey. Nearly half stated that they remained mostly working in their substantive role, just less than a third helped in critical care units, with the remaining redeployed in equal shares to emergency departments or assisting on wards with nurses and as part of medical teams. A brief description of their activities was also recorded. CONCLUSION: This audit has demonstrated the versatility of the Surgical Care Practitioner and ability to adapt during the pandemic.