Thursday, February 11, 2021

Estoy parte del equipo.

The surgical tech and the OR circulator are two unappreciated yet very important components of the operating room team. To the remainder of the team, the difference between a good tech and a poor tech is noticeable in the flow of an operation, the mood and atmosphere of the room, and ultimately the outcome of the case.

As a chief resident, I am able to spend the majority of my days in the operating room. The OR staff has become as much my work family as my service team is, based solely on the amount of time I spend with them. Just as there are good residents, and bad residents, likewise there are good techs and bad techs, and the more time I spend with them the more I either appreciate them…. or not.

Leaving the OR one day after completing our emergency case, I overheard one of the very good circulators exclaim to her colleague while stuffing the dirtied drapes in the garbage, “well, another life saved!” It made me realize how little I hear such comments, and wondered how techs and circulators view their own role in a patient’s surgical outcome. Do they realize how valuable they are as part of the operative team?

I have noticed three different approaches to a case exhibited by the OR personnel. The surgical gloves are an excellent example to illustrate these three attitudes. Every individual scrubbing into a case must have their gloves opened and on the table prior to scrubbing in, otherwise, they get to stand looking silly with their arms extended in the air while a circulator runs to grab and open them. Not a bad thing, by any means, but oops!

Attitude #1: That is not my job!

This type of tech/circulator will not open gloves unless asked to do so. Nor will they attempt to remember a surgeon’s glove size no matter how many times they scrub with that surgeon. If additional needles or materials are required during the case, it is a bother for them to have to find and open the supplies so that the surgery can progress. As you can imagine, unfortunately type #1 is not desired as part of one’s OR team. Time wasted and lost is frequent, and ends up being expensive if the case is emergent and indeed life-saving.

Attitude #2: Look at me do my job!

This type of tech/circulator enjoys opening gloves. They enjoy guessing one’s glove size, and even more so enjoys the congratulatory exclamation and pat on the back when they guess correctly. Throughout the case they are more than willing to run for that additional instrument or supply that has become needed, and they do so with a smile. As you can imagine, type #2 is an enjoyable and desired member on anyone’s OR team. Time is seldom wasted or lost and overall OR experience better for everyone involved including the patient.

Attitude #3: The job is done.

This type of tech/circulator opens gloves immediately the moment one of the team walks in the OR. They have glove sizes memorized after spending as little as one case with a surgeon, and they have them opened automatically without asking for praise or recognition. Preoperatively they go through the entire case, planning for any and all possible needs that could arise. Needles, supplies and instruments are collected and brought to the OR to have ready and on hand should the potential need for them arise. Furthermore, this is all done intuitively without being asked or prompted. As you can imagine, type #3 is GOLD and easily makes for the optimal team experience in the OR. With type #3 the flow of an operation is smooth and uninterrupted, the mood and atmosphere is peaceful and happy, and ultimately provides for the best possible outcome for a patient.

As I continue to go forward in this career, may I have patience with type #1, continue to encourage type #2, and never take for granted type #3. But, even more importantly, may I never forget to remind each and every one of them the role they have in caring for their patient. That they are valuable and appreciated.

Much Love and Prayers!


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