Intraoperative care
is patient care during an operation and ancillary to that operation. Activities
such as monitoring the patient’s vital
signs, blood oxygenation levels, fluid therapy, medication
transfusion, anesthesia, radiography, and retrieving samples for laboratory
tests, are examples of intraoperative care. And the intraoperative phase starts
when the patient arrives in the operating theatre (OT) and ends when he/she is
transferred to the postoperative ward.
Surgery performed
under regional or local anaesthesia allows the patient to remain conscious
during the procedure and is rather common in Swedish healthcare today. In this
study, the authors aimed to obtain a deeper understanding of the main concerns
of operating theatre nurses (OTN) when caring for conscious patients during the
intraoperative phase.
The study was
carried out in 23 OTNs of five different hospitals in Sweden, selected for convenience
because of its location. Data was collected from focus group and individual
interviews between September 2016 and March 2017 and analyzed according to
grounded theory.
The results
indicated that the main concern among the OTNs was to take the patient in
consideration. The core category “achieve and maintain ethical treatment of
patients” in the operating theatre (OT) was a strategy used throughout the
intraoperative process. Ethical treatment was described as moral behaviour at
different levels and included the team’s behaviour, respectful and individualized
patientcare, and the working-morale of the professionals. Being vigilant and
being flexible were the categories related to the core category. The OTNs
constantly assessed where to pay most attention as they balanced between the
needs of the patient, the team, and the surgery procedure.
In conclusion, the findings illustrate
the importance of a common vision of high ethical standards within a surgical
team to ensure that the patient is taken in consideration. This study also reveals
how vulnerable ethics can be in an unfamiliar team, both from a technical and
non-technical standpoint, and suggests that ethics should be strongly
considered, especially when it comes to surgery utilizing local or regional anesthesia.
The OTNs concern about considering the conscious patient, and the skills they
develop and apply to address this concern, can be added to further describe the
professional competencies of OTNs.
Article by Kerstin
Brodin, et al, from Mid Sweden University, Sundsvall, Sweden.
Full access: http://mrw.so/15tXDi
Image by Andy G, from Flickr-cc.
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