The topic that I chose to cover was one that I have experienced in my career as a nurse. Operating room nurses experience high levels of stress and as a result this leads to fatigue and possible accidents, and errors. To help avoid this, the first step is to understand where these stressors are originating. Is the problem a singular item or a combination? Operating room nurses often times have to cover long call shifts that can extend into the 18-24 hour range. This in conjunction with no scheduled breaks and lack of food/sleep can make for a dangerous combination for both the patient and the nurse. Journal Club Critique Form-Andrew Heimann fishbone_template – Andrew Heimann
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There are lots of reasons that might cause fatigue or stress for the operating room nurses. According to a research article, the reported stress levels of operating nurses are high, and the most common causes of occupational stress identified are insufficient communication and teamwork. The recommendations included improvement for the work environment and conditions in hospitals, improvement in teamwork, and programs to help nurses cope with stress should be developed collaboratively (Ugurlu et al., 2015). Another research article reported that 30-40% of operating room nurses were mentally stressed during surgery. According to the research article, increased support leads to safer surgical procedures and better patient outcomes (Sonoda et al., 2017).
References
Jarvis, P. R. (2016, June 30). Improving emergenct department patient flow. Retrieved July 6, 2020, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5051606/
Ugurlu, Z., Karahan, A., Unlu, H., Abbasoglu, A., Elbas, N. O., Isik, S. A., & Tepe, A. (2015). The effects of workload and working conditions on operating room nurses and technicians. Retrieved July 6, 2020, from https://journals.sagepub.com/doi/pdf/10.1177/2165079915592281
Sonoda, Y., Onozuka, D., & Hagihara, A. (2017, July 25). Factors related to teamwork performance and stress of operating room nurses. Retrieved July 6, 2020, from https://onlinelibrary.wiley.com/doi/full/10.1111/jonm.12522
Jarvis, P. R. (2016, June 30). Improving emergency department patient flow. Retrieved July 6, 2020, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5051606/
Ugurlu, Z., Karahan, A., Unlu, H., Abbasoglu, A., Elbas, N. O., Isik, S. A., & Tepe, A. (2015). The effects of workload and working conditions on operating room nurses and technicians. Retrieved July 6, 2020, from https://journals.sagepub.com/doi/pdf/10.1177/2165079915592281
Sonoda, Y., Onozuka, D., & Hagihara, A. (2017, July 25). Factors related to teamwork performance and stress of operating room nurses. Retrieved July 6, 2020, from https://onlinelibrary.wiley.com/doi/full/10.1111/jonm.12522
Outstanding information. The comments about ineffective communication is a great topic in and of itself. I often times find myself asking the same, repetitive questions in order to keep the process moving when there are actual hospital staff that are in charge of those tasks.
This is a wonderful topic! I worked OR for 3 years and I definitely have to agree this is an issue. There are multiple times that you don’t get a break, no lunch, no bathroom (just like any other nursing area). The part that we often had trouble with was going on call come 3pm on Friday afternoon when the “regular schedule” still wasn’t even completed yet and the physicians had “added on” 3-4 more on top of it already. Then finding out that ED had some lined up already, and Saturday was already being scheduled as well as Sunday. It was pretty common to work until 10 or 11 pm, if not later on Friday after starting at 6am, start again by 6am on Saturday and work until 9 or 10, if not later on Saturday, and turn around and do it again on Sunday, just so you could start the week up again on Monday by 6 am….BURN OUT CITY!!! Very easy for for mistakes to occur and fatigue to set in.
Nurse Burnout. (06/11/2019). nursing.org
A regular schedule is not something any of us nurses have, but it is especially evident when taking call. Burn out city is a perfect way to describe the experience.
According to the study burnout is far higher in surgical settings. I can see this. I used to work as a PACU nurse and we would take call. There were often times I would go in early and it would be my day for call. I can remember on several occasions still being there when the morning nurse came in for pre-op the next day. I think that this is something that should be addressed for patient safety and to prevent nurse burnout. What are your thoughts about scheduling staggering shifts? What I mean is the nurse that is on-call comes in later in the afternoon.
References
Akansel, N., Akansel, M., & Yanik, H. (2019). Association of Organisational Stress with Fatigue in Operating Room Nurses. International Journal of Caring Sciences, 12(2), 627–638.
Scheduling does help but the financial burden of having several OR teams on call is not one that facilities are willing to shoulder. I believe a better effort in scheduling procedures and preoperative duties being carried out can help the process the most in my personal experience.
When reviewing this study, I noticed that the burnout was higher in the surgical setting. I personally am not shocked as I worked on a surgical unit for 3 years. I have not had a lot of contact with OR nurse’s however the ones I have talked to stated that it was high stress and depending on the surgeon if the case was less stressful. I think as a nurse as a whole you can only take some much from a job weather it’s the stress of it, long hours or even the atmosphere before you want to throw in the towel. Have you thought about re-arranging the schedule? Making it so the on-call nurse isn’t having to turn around and come in after being called in?
Ugurlu, Z., Karahan, A., Unlu, H., Abbasoglu, A., Elbas, N. O., Isik, S. A., & Tepe, A. (2015). The effects of workload and working conditions on operating room nurses and technicians. Retrieved July 6, 2020, from https://journals.sagepub.com/doi/pdf/10.1177/2165079915592281
I am seeing a common theme that there are alot of nurses that worked in a surgical setting. The key word is worked. I am curious, what made you leave? The hours, the physicians, other nurses?
I think this is a great topic. I worked as an OR RN for about 3 years before leaving for my current position. I loved my job, however, it was very stressful. I would have to take call approximately 54 hours weekly. That doesn’t count the extra time away from your family if you have to go in for an early case or stay late because the doctor is running behind from the clinic. Working in a small rural hospital we were also on call for OB. Those cases were never quick either. The setup, count, and time out procedures were just the beginning. Then if the surgeon ran into something unplanned it could take longer. Then you are dealing with patient families that are angry and delayed as well. We also had to cross-train being a small department so sometimes you would be the circulator and other times you would be involved as an RN scrub. Communication is also an issue at times as well when the surgeon decided at the last minute to change the procedure after the patient has been put to sleep or the consent has been signed. It is a great field but very stressful at times.
Kazimėnienė, A., & Grigaliūnienė, V. (2016, April 28). Chronic exhaustion relation to stress that is experienced by operating room nurses. Retrieved July 11, 2020, from https://www.lsmuni.lt/cris/handle/20.500.12512/94448