OR practice!
sns3guppy
I hope I'm not splitting hairs but I am interested in CRM or "Team" rescource management in a healthcare setting, and specifically in OR. I do find topics such as this very interesting and informative as in the mian responsible professionals do behave in similar ways in high-risk situations.
You posted - "The doctor leads a surgical team in a heart operation. Now it's a crew environment. You think the doctor is going to cow down to a nurse when the nurse says "it's my patient, I'll decide what goes on in this operation?" Not hardly. Not even if it's a nurse-practitioner, an experienced OR nurse, or a Physician's Assistant. Not even an intern. The surgeon will remain in charge, period. It's his patient, his operation, and while others may assist, cut, medicate, anesthetize, treat, monitor, or help...it's the doctor's show. the first one to insist that no, it's their patient can certainly expect to be not only removed from the operation, but likely fired or not brought into the OR again. "
The example of the OR is far more complex than that of an aircraft in flight. The surgeon is not entirely responsible in the same way as a captain of an aircraft. The anesthesiologist is responsible for the patient - it should be this way as anaesthesiology is not straightforward and needs a professional to take command of the patients well-being. Although the patient is common to both the surgical and anasthesiological teams, they often work within thier own team structures and conflict arises when the two team objectives diverge.
The surgeon is responsible for the surgery alone... and as for the OR nurse overrruling the surgeon, it happens and should happen. Consider this - a surgeon has left a swab inside a patient and is going to close the wound... the OR nurse knows this and can in fact order a "go around" (if you will permit me to use that term) and insist that the surgeon finds the errant swab and if the surgeon doesnt comply then he may be the one being fired. The power gradient between a junior nurse and a senior surgeon may be huge, but if that a surgeon wants to close the wound and a junior nurse says "swab count incorrect" then the surgoen has no alternative. He MUST comply.
I doi hope that you dont find my post too irritating but please remember that CRM and airline safety in general is being held in high esteem by healthcare professionals and hence my interest in this forum.