The team leadership model can be applied to many situations. We’ve all heard the saying “It takes a village”. The operating room is one of those places. Each member of the team has a role to perform and together, the team sets forth to accomplish a goal.
The operating room of a hospital is pretty much the way it is depicted on television. It’s a sterile, cold environment where life-changing things can take place. However, the way an operating room staff functions isn’t exactly like it is on television. It’s not always perfectly organized with an absence of chaos. Let’s face it. As we are dealing with human life and no two humans are exactly alike. Now, of course, we do want our surgical cases to go smoothly, but that isn’t always the case. That’s when strong team leadership becomes of utmost importance. In order to better understand the relationship between the team leadership model and the operating room, we need to identify the team members. Of course, you have the surgeon and the anesthesiologist. These two are the MDs (or Dos) that are in charge of the patient. They are the leaders of the OR and are the ones who are who make the decisions that are best for the situation. “A team leader also needs to recognize and interpret what is getting in the way of the team’s goal accomplishment and make a strategic choice and respond with the appropriate action” (Northouse, 2016, pg. 377). The goal of the operating room staff is to safely perform surgery on a patient with minimal complications and allowing the patient full recovery. In the operating room, anything can happen and a lot of times, it happens fast. The doctor’s need to quickly assess the situation and determine what should be done to so that the patient can recover so that the goal is met. Another member of the team is the surgical technician. During a usual surgery, two technicians are present but for larger, more complicated cases, there may be more. They are responsible for assisting the surgeon during the case and anticipating what he/she will need. Their job is vital and it is important for them to have a strong working relationship with the surgeon. Surgeons are known to say, “Give me what I need, not what I ask for.” The circulating nurse is the next vital component to this team. This is the registered nurse who is responsible for the patient care in the operating room and ensures the safety of the patient throughout the experience. He/She is responsible for making sure that all consents are signed and filled out correctly, that the right operative sight is marked and that the patient knows what the procedure entails. All of these things are details that are of utmost importance to the safety of the patient. The circulator also performs what is called a “time-out” where he/she states the patient’s name, procedure to be done, operative sight, any allergies and whether or not all the equipment that is needed is present.
Now, how does this all relate to the team leadership model?
- Clear, Elevating Goal: The staff has a clear and effective goal – the care of the patient during surgery. All the people in the operating room understand these goals. If you are assigned to the room that is doing all the total joint replacements, you know that it is your responsibility to work with that team to ensure that the surgery is completed with minimal complications and that the patient will leave the OR suite with a new joint.
- Results-Driven Structure: As a team, the circulator and the scrubs will determine what task each is responsible for completing. The team in the OR can be defined as a tactical team since each individual is well aware of what his/her task is and when he/she needs to do it (Northouse, 2016, pg. 369).
- Competent Team Members: Every member of an OR team is well educated and trained. The anesthesiologist and the surgeon have gone through countless years of education and training as well as have passed board exams. Surgical techs and circulating RNs have completed their education and training as well as passed any board exams. Circulators that have no operating room experience are also often required to undergo preoperative training courses.
- Unified Commitment: It goes without saying that the focus of everyone in the operating room is on the safety of the patient. Team members are committed to performing each individual task to reach the end result.
- Collaborative Climate: Collaboration is a big part of what makes an operating room team successful. Although team members each have their own unique roles, it is not uncommon to help another team member when he/she needs it. Surgeons put a lot of trust on his/her team. It is expected that all the equipment that he/she needs will be readily available and that the patient will be positioned and prepped according to his standards, sometimes even before he even gets to the room. Failure to perform an assigned role can lead to a dangerous situation. The main thing in the operating room is to have the ability to work with one another. This is accomplished by developing “trusting relationships based on honesty, openness, consistency and respect (Northouse, 2016, pg. 370).
- Standards of Excellence: Hospitals and its individual units are required to uphold extremely high standards. Operating rooms are no different. Surgeons expect that the staff maintain a high standard of when in the operating room. Of course, it can be a casual atmosphere where the staff talks and laughs, but it goes without saying that only happens when appropriate. We have all heard the stories about patients that are aware of things being said about them while they are under anesthesia – yet one more reason that it is extremely important to always act professionally. Surgeons also have a set of expectations of his/her team.
- External Support and Recognition: “The best goals, team members, and commitment will not mean anything if there is no money, equipment, or supplies for accomplishing goals” (Northouse, 2016, pg. 371). Rewards are seen in good patient outcomes as well as bonuses and raises for team members. The surgeon (team leader) will also often compensate staff with lunches, holiday parties and push administration to get equipment and supplies. The greatest satisfaction is seeing a patient or family member of someone that you’ve treated in the OR long after they’ve left the hospital. They usually remember you and are usually grateful for what you’ve done for them. Seeing how you’ve had a positive impact on a person’s life is something that can not be replaced.
- Principled Leadership: The physicians (anesthesiologist or surgeon), who serve as the team leaders, are the ones who typically set the tone for the OR. “The leader helps the team handle stressful circumstances by providing clear goals, assignments and strategies” (Northouse, 2016, pg. 371). They clearly state what they need and who is responsible for what task. Having an effective leader will lead to having an effective team.
It goes without saying that the operating room is a stressful environment in which to work. However, it is also one of the most rewarding. I have worked in environments where the leadership of the team has been not effective and although the patient outcome was favorable, it was a miserable experience for everyone in the room. The team leadership model can be applied in a lot of situations and prove to be effective. In the operating room, it takes a good team to provide adequate care and ensure patient safety. Being part of an effective, cohesive OR team with a strong leader is a highly rewarding experience. Yes, “it takes a village”.
Reference:
Northouse, P. G. (2016). Leadership: Theory and practice (7th ed.). Thousand Oaks, CA: Sage.