There is a dearth of publications on the history of theatre nursing within the UK, but the earliest reference is in Florence Nightingale's Notes on Nursing (1868).
She described being instructed on ‘how to wait at operations’ and as to ‘the kind of aid the surgeon requires at her hands.’ The history of the operating department practitioner (ODP) is also concealed within other titles of theatre personnel, including handlers, surgery-men, box carriers and beadles, all appearing in notes from the 18th and 19th centuries. In 1947, theatre technicians were being trained at St Thomas' Hospital, with the number of nurses choosing to work within the operating theatre slowly increasing. Theatre nurse Daisy Ayris founded the National Association of Theatre Nurses (NATN) in 1964. At the inaugural meeting, 235 members had enrolled and by 1966 their 1000th member had joined.
In 1970, the Lewin Report on the staffing and organisation of operating theatres was released by the Department of Health and Social Care, with the ultimate aim of addressing the national shortage of theatre staff. This initiated the city and guilds certificate training of operating department assistants (ODAs), who would predominantly work within an anaesthetic role. The change of professional name to ODP came in 1991, with the training moving to a formalised NVQ level 3 qualification. In 2000, the training was again developed to a Diploma of Higher Education level, with a national register of the Association of ODPs following a year later. In 2004, ODPs became regulated with the Health and Care Professions Council, and most recently in 2017, the profession was taken in under the umbrella of allied health professions.
During this timeline, the interprofessional working of theatre nurses and ODPs increased, with both professions working side by side in all three disciplines of perioperative practice. This side-by-side working has not always been harmonious, with the most obvious example being in an article written by two nursing professors in the Journal of the Royal Society of Medicine, entitled ‘The demise of nursing in the United Kingdom: a warning for medicine’ (Shields and Watson, 2007). In it, they said: ‘The technological function of performing the task is covered, but no care is given’, and: ‘Trained to hand instruments to the surgeon, but none have the knowledge of well-educated, specialist perioperative nurses, who provide complete care for patients having surgery.’
For a professional with a degree, who trained in the theatre environment for 3 years to achieve registered status as an ODP, this article was difficult to read. The question must be asked, is this attitude created by a simple lack of awareness of each other's role and profession? With both professions now requiring a 3-year degree programme, there are many more similarities than differences, as historically noted.
We must be proud of our heritage, of how our professions have progressed and fought to be in this privileged position, but recognise that we are better together. In 2005 the NATN changed their name to the Association for Perioperative Practice, to accommodate and celebrate the growing number of ODPs and healthcare support workers in the perioperative environment. The term perioperative practitioner is championed today to celebrate the unity and interchangeability of the professions in the theatre environment, and the common goal shared between them. If you ask an ODP why they chose that career, many will say they had no intention of working outside of theatres, so would not want to spend 3 years undertaking a broader-focused training programme. However, what they do have in common with their nursing colleagues is the passion for caring, being their patients' advocates and contributing to progressing safer surgery.
I have had the privilege of being mentored by knowledgeable and inspiring theatre nurses during my training, and I now teach and mentor perioperative practitioners myself. On 14 May, I will celebrate the 2nd annual National ODP Day, but I will also be celebrating Nurses Day on the 12 May alongside my nursing colleagues. I ask readers to use these days as an opportunity to share with perioperative colleagues and put on a united front for patients. Ultimately, this can only increase staff and patient satisfaction and enhance patient safety.