From domestic services to perioperative care: Ivo's inspiring NHSScotland career journey

My journey to perioperative care in NHSScotland

As an operating department practitioner at Woodend Hospital in Aberdeen, I’m at the heart of perioperative care. And now that I’ve completed the national training programme, I’m also a surgical first assistant, ready to jump in and support our surgeons whenever required.

From domestic assistant to operating department practitioner

I’m from Bulgaria and had no healthcare experience before moving to Scotland. I started working in the NHS in March 2014 as a part-time domestic assistant. It might sound like an unlikely start, but it was the first step in my NHS career.

Over time, I progressed, working two jobs within domestic services and then becoming a domestic supervisor. I then took a secondment as a training manager, responsible for the mandatory training of all domestic staff at Aberdeen Royal Infirmary. 

I loved the job and teaching others, but I told myself I could do more. Most of all, I wanted to be involved more closely in patient care. I saw lots of amazing opportunities in the NHS to expand my knowledge and skills. So, I applied for roles delivering direct patient care to see how far I could progress.

In September 2017, I started work as a theatre support worker in elective orthopaedic theatres at Woodend Hospital. Over the next couple of years, I gained valuable knowledge, skills, and experience. I also found my passion for perioperative care and knew it was where I wanted to spend the rest of my career.

I knew a career in the operating theatre was for me

Initially, I planned to study adult nursing with the Open University. With my manager’s support, I started an Access to Nursing course at a local college. It was a stepping stone to help me get into the Open University degree programme. But by the time I finished the college course, a new career opportunity had presented itself.

I was offered a place on the operating department practice training programme. I knew a career in the operating theatre was for me, so it was the perfect pathway.

I completed my training in 2021 and was awarded a Diploma of Higher Education in Operating Department Practice. After I qualified as an ODP, I returned to elective orthopaedics at Woodend Hospital, where I started practising in my new role with passion and a thirst for knowledge. 

Mastering Intraoperative Cell Salvage (ICS) in Aberdeen

It’s worth mentioning that I picked up another invaluable skill during my ODP training. It has helped shape my career into what it is today. Intraoperative cell salvage, or ICS, helps reduce the need for donor blood transfusions, which is safer and more beneficial for patients.

Early in my ODP career, I trained a colleague in ICS. The procedure starts with collecting the patient’s blood lost during surgery, processing it, and reinfusing it into the patient. With the support of the clinical perfusion team at Aberdeen Royal Infirmary, my colleague Jen and I established a training framework for theatre staff to learn and safely practice the procedure.

Becoming a surgical first assistant: training and impact

Fast-forward to 2023, when I started my surgical first assistant training with the NHSScotland Academy! The 34-week programme is accredited by the Royal College of Physicians and Surgeons of Glasgow, and credit-rated by Glasgow Caledonian University at SCQF level 10.

The training programme is delivered using a hybrid of in-person workshops and work-based learning, supported by online resources. This gave me the flexibility to study alongside my clinical role.

The workshops included simulation training, where I developed my knowledge of surgical procedures and practised my skills with the support of educators and peers. I also completed ongoing work-based learning here at the hospital, supported by my clinical supervisor.

Developing my clinical skills

During the programme, I spent 6 days training at the Royal College of Physicians and Surgeons of Glasgow. In the practical workshops, I developed my clinical skills in a simulated area, which helped me to prepare for the role. Getting practical experience was one of the best things about the course.

I qualified in November 2024, which means I can work as a surgical first assistant when needed and as an ODP the rest of the time.

Natural career progression for me as an ODP

The opportunity to become a surgical first assistant was exciting. Unlike registered nurses, there are fewer career development opportunities for ODPs, as we are trained only to work in the perioperative environment. In my opinion, it was a natural progression for me as an ODP. 

My patients also motivated me to become an SFA. I wanted to develop new skills, improve workflow within the operating theatre, and increase my knowledge and understanding of the orthopaedic surgery specialty.

I firmly believe that being an SFA also makes me a better ODP, as now I have a unique perspective on my work and how to do it efficiently and safely.

The daily life of a surgical first assistant at Woodend Hospital

As a surgical first assistant, I provide direct hands-on support to the surgeon during a surgical procedure. My role extends beyond the traditional scope of perioperative support. It requires advanced training and a deep understanding of anatomy, surgical techniques, and aseptic practice. 

The thing I love most about being a surgical first assistant is that every case presents different challenges, and I leave the operating theatre learning something new after every procedure. When I started my NHS career, I never thought for a moment that I would be working in this amazing role. I love every single minute of it!

Delivering safe patient care

A typical work week involves assisting the surgeon during surgical procedures when required. I also meet patients before their surgery, scrub in for surgical procedures, ensure a smooth workflow within the operating theatre, and promote clear and prompt communication within the theatre team.

Why is it important? I’m not just a pair of hands in the operating theatre. I have a critical role in delivering safe patient care and providing technical support. My expertise, judgment, and hands-on involvement lead to efficient surgical procedures, lower complication rates, and better patient experiences.

On the days I’m not needed as a surgical first assistant, I take on the role of an ODP for the theatre I’m rostered to work in. I also coordinate Intraoperative cell salvage when and where required, providing training opportunities for colleagues who want to develop the skill.

A physically demanding role

One thing that might surprise you about being a surgical first assistant is how physically demanding it can be! Many people assume it is a purely technical or observational role. I often have to stand for hours, maintaining intense focus, while holding retractors, applying pressure, or assisting with tissue manipulation. It’s common to leave the operating theatre sore, sweaty and exhausted!

Making a difference in patients' lives

The best part of my day? Seeing my patients recovering on the ward, then smiling and waving goodbye as they leave the hospital pain-free. Knowing I’ve made a difference in their lives, giving them back a quality of life that’s normal for many of us – that’s what gets me up in the mornings.

Skills for a successful career in perioperative care

The most crucial skill for my role? It’s hard to pick just one, but collaborating is vital. I work closely with registered nurses and healthcare support workers - the backbone of the theatre team. The ‘can-do’ attitude is contagious. We look out for each other, support each other, and learn from each other. I have no words to describe how lucky and proud I feel to be part of the team.

Why I'm proud to be a surgical first assistant in NHSScotland

What makes me proud to be a surgical first assistant in the NHS is knowing I play a vital role in life-changing procedures every single day. I’m part of a team that delivers high-quality, person-centred care with compassion and precision. The trust patients place in us during some of the most vulnerable moments of their lives is humbling, and I never take that responsibility for granted.

Working in the NHS means serving a diverse population with equity and integrity. It also means contributing to a system built on core values of care and compassion, dignity and respect, openness, honesty and responsibility, and quality and teamwork. I take pride in supporting surgeons to achieve the best outcomes while advocating for patient safety and dignity. Whether assisting in theatre, preparing for complex procedures, or mentoring junior staff, it all provides an opportunity to make a difference.

My mentor's continuous support and guidance

My mentor, Nanci, influenced many of the decisions I’ve made throughout my career. She now oversees the area I work in. I’ve had Nanci’s continuous support and guidance every step of the way. I am forever grateful that I have the privilege to work alongside her and the amazing team at Woodend Hospital.

My next career step

My next career step? I’d love to train as a surgical care practitioner – a step above my current role. I’m always striving to be the best practitioner I can be for my patients.

Be the quiet strength in the room

My advice to anyone thinking about a career in perioperative care, as an ODP or a surgical first assistant, is to step into the theatre with purpose. You are the quiet strength in the room – steady hands, a sharp mind, and a calm presence. It’s about anticipating the surgeon’s next move, compassion behind each suture, and preserving the patient’s dignity.

If you’re driven by excellence, empathy, and a desire to make a difference, this is where you belong. As I always say, from a quote that perfectly describes my career journey: “If you are not willing to learn, no one can help you. If you are determined to learn, no one can stop you.”