Operating Room World: One Day Challenges and Interactions

When sun rises, the hyperactive day begins in operation room (OR). Management of OR needs regular programs for human and material resources. For deciding about OR programs, there should be requirement to obtaining information of multidisciplinary stakeholders (1). It appears that we go to OR, we enter to new world in new time zone and time will stand here (2). It is well known that trained staff are required for coordination between OR and several departments and providing advanced patient care. The major duties of these personnel, especially surgery and anesthesia nursing included to keep patient safety and navigation of various type of surgery throughout their course. OR staff work in closed, relatively isolated environment and spent several hours of their life here! (3). I think that OR environment looks like fish aquarium, we swim in it and everyone has her or his responsibilities, move toward our unit. It seems crowd but substantially beautiful picture. Stress is a main challenge in OR, that is, the personnel must communicate with each other and patients (4), Raji et al concluded in their study that in academic areas is even more in personnel communication, practice, feelings and humiliating experience fields and they must determine priority in few times and coping with their stress (5). Surgeons and anesthesiologists complete this scenario. However, what are the final goal of these precise efforts? It is clear that improving of efficiency plays key role in OR, it can be achieved by increasing work or lowering costs. Parish et al suggested that to prevent delays in post-anesthesia care unit (PACU) and discharge time, it is important to select proper anesthetic techniques, especially because of growing number of outpatient surgery and anesthesia (6- 8). Costs for maintenance of OR environment, numbered staff and different instruments. Start time is a cornerstone of OR (9). On the other hand, nurses of OR interpret efficiency as improvement of knowledge and training for patient care whereas OR manager understands efficiency as production per minute or completing programs (10). Although usage of simpler devices and dressing can help to save time, it means to compromise of any unnecessary parameters which do not affect results. "Eliminate and streamline" are OR mention (11). Oh, I forgot writing about cancellation and its consequences. Cancellation of planned operations is main and long- standing occurrence in OR. It has significant financial, psychological and social implication on patients and their families. The reasons for cancellation vary among between different countries such as lack of medically fitting for operation, lack of bed, unnecessary interventions and occasionally, patient turning up for surgery. Some of them are avoidable but remainder are not (12). So, we have very little knowledge about sound levels in OR environment (13). Now, this time is afternoon, all surgeries were terminated, patients were transported to their departments. You can sit and drink a cup of tea in your pavilion because emergency cases can arrive at any time