Maybe you’ve been watching EBOOKSTORES.NET or my favorite, Scrubs. Yet surgery isn’t just about the surgeon, but an entire healthcare team that ensures the patient is cared for when they’re under the knife.
Surgery is a fast moving, complex, multi-faceted aspect of medicine that is deeply dependent on effective teamwork.Without proper respect and communication between all team members, surgery comes to a grinding halt, and the risk of errors and complications shoots up.
The surgeon is who we most commonly think of when we think of surgery.
This is the attending physician who is responsible for the patient, as they are the one who made the decision to operate on the patient in the first place, and they are the ones in charge.Before even getting to the operating room, however, there’s usually significant workup including labs and tests, that must be performed prior to deciding to operate on a patient. This is obviously not the case with emergency surgeries such as traumas, but the majority of surgeries are planned in advance
This generally includes a clinic visit with the patient, where the surgeon approaches their concern, performs the appropriate workup, and presents the various options of how to best proceed, often including surgery. When the patient first comes to the hospital or surgical center and is waiting in pre-op the surgeon speaks with the patient, obtains informed consent, meaning they again explain the procedure and it’s possible risks, and answer any questions the patient may have .They’ve also done this during the clinic visit, but doing it again on the day of surgery is essential.
Given that the surgeon bears the weight of the greatest responsibility in the operating room, they are subject to the highest degrees of stress
This is often when you see the stereotypical surgeon personality rear its ugly head.This stereotype is generally “decisive, well organized, practical, hard working, but also cantankerous, dominant, arrogant, hostile, egocentric, and a poor communicator. But stereotypes aren’t entirely true, and most surgeons I know don’t fit the mold
in terms of these negative qualities. I would say, however, that most surgeons I know are more direct, efficient, and pragmatic than most, and perhaps not afraid to be rough around the edges in order to get the job done
Some studies have concluded the surgical personality certainly does exist, but rather highlight their novelty seeking, competitive nature, and reward dependent qualities, in addition to scoring higher in self-discipline and achievement but lower in compliance and vulnerability
At teaching hospitals, the surgeon enters the operating room once the patient is under anesthesia and ready to be operated on. They may have their residents drape, but many surgeons are highly particular and prefer draping the patient themselves.
The surgeon performs the surgery and must remain by the patient’s side until he or she is extubated, meaning the breathing tube is removed and they are wheeled out to post-op The surgeon operates in a sterile field to minimize the risk of surgical infections.
On the other side of the drape is the anesthesiologist.
Think of anesthesiologists as the guardian angel for the patient as they approach a scary time in their life.The anesthesiologist is the other attending physician in the room, and can generally be thought of as second in command But don’t tell any anesthesiologists that.
The surgeon is the captain of the ship, but the anesthesiologist is right by their side.That doesn’t mean their job isn’t equally foundational Just like the surgeon, the anesthesiologist will visit the patient in pre-op, but rather than the procedure, they’ll be focusing on explaining how they’ll keep the patient comfortable during the case
This often includes general anesthesia, where the patient goes under, meaning is unconscious, and requires a breathing tube.
However, anesthesiologists can also provide sedation, where the patient is deeply sedated and often doesn’t remember the procedure, but they’re able to breathe on their own
Local or regional anesthetic doesn’t interfere with the patient’s consciousness, but rather numbs the area that the surgeon will be working on
This may include providing certain pre-op medications via IV and intubating the patient if they’ll be receiving general anesthesia.
During the case, they monitor the cardiopulmonary status of the patient, ensuring they’re safe and comfortable.
This is done through cardiac leads on the patient’s skin to monitor heart activity, a pulse oximeter on the finger to monitor oxygen saturation of the blood, and a blood pressure cuff to monitor circulation.
After all, this is how attending surgeons are made — they must learn in residency.Senior residents have taken on additional responsibility and generally take ownership of the case, performing the majority themselves with oversight from the attending.They will soon be out in the world as attendings themselves handling cases on their own.
There are several other key members who are directly related to surgery that don’t step foot in the operating room
The OR supervisor manages all operating theaters, ensuring things run smoothly. They book and schedule cases, assign rooms, and act as a coordinator between the preoperative
holding area, OR, and PACU.The preoperative holding nurse preps the patient before the case, checking them in, organizing consent, notes, and orders
They also check vitals, start the IV, and administer medications.
The PACU or recovery room nurse accepts the patient from the OR and provides a secure environment for recovery.
There may be additional team members in the OR depending on the case or the institution. Surgical techs provide further assistance and are key in preparing the operating room tools, and equipment
Medical device reps in the OR help the surgeon use their company’s devices properly. CRNA’s provide anesthesia under anesthesiologist supervision. Together, all parts working in harmony translate to a successful and nearly seamless experience for the patient. It’s not about you or your ego, or who said what or whose toes whoever stepped on. And at the end of the day, it’s all about the patient.
Which surgical team role most resonates with you?
Let us know with a comment down below.