Perioperative staff knowledge

Our understanding is not always explicit - very often, it is implicit and internalised in the processes and activities of our clinical practice. We test our existing knowledge when new perioperative methods, complex patient medical histories, new equipment and new research data present themselves - but do they allow us to continue to influence the future developments of safer surgery?

A critical aspect to our delivery of care is reflecting on our practice. Reflection helps us to make sense of events and situations that have occurred in the workplace. Taking time to consider what occurred provides the practitioner with opportunities to refine their thoughts, skills and management of risks. Action plans developed out of our reflective thoughts can influence policy and processes within the operating department. We will cover reflection much later in this module; for now, we encourage you to start to think of what reflection means to you in your role and daily activities.

Timmons and Tanner (2004) highlighted a divide between two roles in the operating department: the operating theatre nurse and the operating department practitioner (ODP). Their study suggested that a tension between the roles had unusually come out into the open and had manifested in occupational boundaries. Let us consider what tension caused difficulties in perioperative communication.

The conclusions of this report highlight professional boundary disputes between the two roles, where one group was seen to be particularly territorial in the anaesthetic domain, leaving the other professional group to care for the patient. Moreover, the interviews and observations within this study suggested that one group was more attuned to completing patient care documentation. Two interview accounts from this study were:

... whenever I make a suggestion [the ODPs] roll their eyes and say 'oh that's the nursing mentality' (Interviewee J).

...and when equipment is bloody [ODPs] don't seem to worry about cleaning things and washing things, and I feel very strongly about things like that. But I get it thrown in my face, 'oh, here comes the nursey bit' (Interviewee L).

Timmons and Tanner (2004:654)

Over ten years on, practitioners continue to ask if this divide still exists between perioperative professions. Anecdotal comments might suggest that it exists in perioperative environments. Perhaps we need to consider how each role contributes to patient care and the promotion of safer surgery. Let us consider the ODP's role.

The ODP role is unique to the United Kingdom; many countries do not have such a grade. Hybrid roles, known as anaesthetic technicians, exist in New Zealand and Australia; in other countries, the composition of an operating team can vary. See the video below:

Linked to this first unit are the 'patchwork' discussion activities. Each activity is a helpful way to stimulate your thoughts and to encourage you to debate with others on the module. At this point, read Activity 1.1 and formulate a discussion post. Great postings are those that are not too lengthy and articulate your point, supported by references. Once you have authored your discussion post, please go to 'Discussions' and post your submission for all your colleagues to read. You are very welcome to read and comment on other students' postings.

Activity

On the Discussion Board, we invite you to introduce yourself to the group. You may wish to share which country you work in and the structure of your operating theatre team. Perhaps you have noticed tensions of separations between perioperative roles - if you have, please give examples without including any personal details. To help, you may wish to read Timmons and Tanner's (2004) full paper by visiting it here: A disputed occupational boundary: operating theatre nurses and Operating Department Practitioners (The link to the Discussion Board is not available in this course taster).