Nursing and patient safety in the operating room
How are mistakes prevented?
This means thinking ahead, trying to imagine everything that can go wrong, and taking steps to prevent such occurrences by using guidelines and checklists. Good Preoperative patient-centered information that reflects individual patients’ needs and vulnerabilities is essential.
“Our nursing aim is prevention, yes, preventing surgical complications. I think that’s our main purpose…. It embraces everything!”
How do you work in teams?
By dividing the work into teams, operating room nurses develop advanced knowledge of particular operations and a high level of performance.
“It’s [nursing] more professional, our nursing is better after we introduced teamwork in the operating room. You know the skills and knowledge of your team colleague, everyone knows what to do and things go smoothly. We’re just more competent.”
How do you support each other?
The relationship among the nurses working in both departments was described as supportive. They know each other personally and have developed relationships of mutual trust and co-operation. Many participants described a positive feeling of belonging to a team.
“You know your colleagues very well and it’s kind of another family when you have worked together for such a long time.”
Is concentration a problem?
Participants described the work as complicated and demanding full, undivided concentration. Forgetting something can be detrimental, and being tired is cause for alarm. To withstand the pressure and ensure maximum performance, the nurses have become more cognizant of methods of relieving stress.
“You have to be alert all the time, being tired isn’t an option. This kind of work demands full attention.”
Do you feel in control?
When asked what they thought causes error or mistakes, the nurses mentioned ignorance, lack of experiences, distraction and haste. This was experienced most acutely when they were placed in a novel situation.
“When you try to do too many things at once in a short time with little prior experience. you run the risk of making a mistake.”
How do you make sure you are organized?
To function at the speed currently expected, staffing must be adequate and the team must be competent. Imbalance in staffing, which may be either under or over staffing, may lead to unsystematic preparation or distraction. The division of labour and responsibility within the team needs to be clear.
“The work must be organized. There are some surgical operations that need special staffing and when this happens those resources must be available… you must have the nurses who are trained for those operations.”
Do you feel under pressure?
The time schedule for operations is tight, and many patients will be waiting for their operations. The pace must be kept up at all costs. The work processes are timed and, while the surgical procedure cannot be rushed, the nurses sense pressure to reduce time for preparation and time between operations.
“Usually I am very, very tired when I get home. I am not tired while at work – it is fun to be at work and I like my job and I’m very proud of it – but I am very tired when I get home.”