Anaesthetists
Provide direct medical care to patients requiring general, regional or local anaesthesia for surgical, diagnostic and other procedures such as prevention of pain and maintenance of body function.
The morning list in theatre
You are an anaesthetist at a regional hospital, responsible for patients' safety and comfort during their operations, with a team of nurses and a surgeon relying on you. It is 7:15am. Four patients are booked for the morning list, the surgeon wants to start on time, and you are going through the first patient's details before they come in.
Choose what you would do. Then see what happens. There are often good reasons for each choice.
I'm so scared. I've never had an operation before. I keep thinking I won't wake up. I'm sorry, I know it's silly. Please just tell me it will all be fine.
Acknowledge her fear, explain what you will do and how you'll watch over her
She takes a long breath and asks two good questions. She goes into theatre calmer. Honest information often helps more than a bare promise.
Tell her it will all be fine, nothing could possibly go wrong, and she is worrying too much
She smiles, but your words ring hollow, and she grips the bed tighter. Because you cannot promise that, she is not sure she can trust what you say.
Tell her that she's in good hands and she doesn't need to worry about the details
It's a kind thing to say, but she has asked for information and hasn't got it. She nods and says nothing, and her fear stays.
We're already behind schedule. I need you to get this patient under quickly. I don't need the long talk, and we can skip some of the usual checks. I've done this operation a hundred times.
Go along with the surgeon, since he is experienced and the list is running late
A check you skipped would have caught a detail in the patient's record. It is found midway, and the team has to stop and rework the plan.
Say you will do the checks, they are quick, and ask him to start preparing
He sighs, then agrees. The checks take a few minutes and the case proceeds smoothly. He later says that he'd rather start a few minutes late than stop halfway.
Refuse to start until he apologises for pushing you and agrees to wait for the checks
You have made a point, but the theatre is tense for the rest of the morning. A calm no is stronger than a standoff.
I think the equipment check for the machine hasn't been signed off yet this morning. I'm not sure who was meant to do it. Everything looks fine, and I don't want to hold things up. Should I say something?
Thank her, check it yourself and make sure it is recorded before you begin
The check is done and the record is complete. You lose a couple of minutes, and your nurse sees that raising a concern is welcome.
Tell her not to worry, as it was probably done last night and just not signed
The check had not been done. You find out when an alarm sounds partway through, and the team has to scramble.
Thank her, stop and run the check together, and tell the team she spotted it
You find a small fault and swap the machine before the first patient is in. The team notices that speaking up is rewarded, and the next person is quicker to raise a concern.
How it went
The list finishes in the early afternoon. Everyone is tired and nobody was harmed. Anaesthetists spend their days balancing calm, careful checks against the pressure of the clock, and communicating clearly with frightened patients and busy teams. Would you be comfortable being the person who says wait?
This is a simplified, fictional situation to help you explore. It is not professional instruction or a test of your ability.
Case study: The cup of tea that changed the list
A fictional case set in the operating theatres of a fictional regional hospital, on a morning surgical list.
The situation
Dr Lena Hartmann was the anaesthetist on a busy morning list. Her first patient, Mr Ibrahim, was waiting to have a minor operation. During her pre-operation chat, he said he felt bad but that he'd had a cup of tea and a slice of toast at six that morning, just before he left home. He had been told not to eat. The surgeon was already scrubbing in, the theatre was ready, and the list was already tight. Mr Ibrahim apologised and said he didn't want to cause a fuss.
What they did
Lena thanked Mr Ibrahim for telling her, and said she'd be going straight to the surgeon with it. She explained to him that the rules about eating before an operation are there for his safety, and that he had done the right thing by speaking up. She told the surgeon and the theatre team that the case would need to be delayed, and offered a plan for the rest of the list. The surgeon was not happy. Lena stayed calm and gave a clear reason, and the team moved the next patient up.
How it turned out
Mr Ibrahim had his operation later that day and was fine. The surgeon grumbled, then admitted it was the right decision. Lena said her job was often about being the person who says wait, and doing it kindly.
What would you do?
- Why was it important that Mr Ibrahim felt safe to speak up?
- How would you feel saying wait to a surgeon who was in a hurry?
- What do you think makes a good team in an operating theatre?