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Stress in the Operating Room: 5 Ways to Manage It


More often than not, operating rooms aren't known for their warm, welcoming, friendly work environments, are they? If you've been in an OR for more than 5 minutes you've seen the effects that the tension, stress, urgency, and burden of responsibility have on those of us who call this environment home. The stress of our jobs and the associated feelings are a heavy load to bear, and we carry that weight from clock in to clock out - and sometimes even after we leave as well.


But the seriousness of the work we do, and the associated stress, tension, and urgency, isn't the problem in our operating rooms. Any time another person trustingly places their lives into our hands, we're going to take that responsibility seriously. Of course there's stress associated with that, that's normal.


How these feelings manifest themselves, however, can absolutely affect our team dynamic and our work culture:

  • Stress? Totally normal.

  • Being rude, impatient, or treating another person disrespectfully because you were "stressed"? Not ok.

  • That sense of urgency associated with all cases? Perfectly normal.

  • Using that urgency as an excuse to shorten orientation periods, to leave newer employees out of certain rooms/cases, or being impatient with employees who are still learning? Definitely not ok.

These are just two examples of the ways that the stressors of our work environment can manifest themselves in negative ways. I'm sure you can think of many more examples, and you've probably experienced them personally!


So how do we hold up under the pressure but not break?


If you were to Google "How to manage stress in the workplace" - which I did - you'd find a lot of really solid advice - for workplaces that aren't an operating room. We exist in a very unique environment, and the constant pressure, multitasking, long hours, and demanding personalities can get to us. We can't always control who we get assigned to work with. We have no say when call cases come in and we're on call, we just have to do them. We certainly can't stop periodically throughout the day and meditate. But, there are still some things that we can do to prevent ourselves from crumbling under the pressures and stress of the operating room.


Don't start the day out stressed.

Plan your morning the night before. Give yourself plenty of time to get up in the morning and start the day without a rush. Now, I realize for many of us, that makes an early morning even earlier. Starting your day in an un-rushed state will prevent you from carrying that extra stress into work. Very Well Mind refers to this as a "pre-work ritual" - how you start the day will determine your attitude for the rest of the day.


Prioritize sleep.

We laugh at this one, don't we? I feel like we're all constantly exhausted. Long days, heavy caseloads, and call shifts drain us of our energy and make us more susceptible to stress. So while I realize that every night isn't going to be a full 8 hours of sleep, you can still prioritize sleep. On your days off, go to bed early so that you get a good night's sleep before work the next day. If you've had a long day at work, choose activities after work that help you relax so that when you go to bed it's easier to fall asleep. And do your best to avoid foods, drinks, or activities that keep you awake at night rather than helping you fall asleep.


Take time to recharge.

This is from the American Psychological Association and I found it very insightful: "To avoid the negative effects of chronic stress and burnout, we need time to replenish and return to our pre-stress level of functioning. This recovery process requires “switching off” from work by having periods of time when you are neither engaging in work-related activities, nor thinking about work. That’s why it’s critical that you disconnect from time to time, in a way that fits your needs and preferences. Don’t let your vacation days go to waste. When possible, take time off to relax and unwind, so you come back to work feeling reinvigorated and ready to perform at your best. When you’re not able to take time off, get a quick boost by turning off your smartphone and focusing your attention on nonwork activities for a while."


Talk to your supervisor.

Maybe as a group, maybe individually, but a candid conversation about the work environment is necessary to keep employees healthy, engaged, and productive. If your supervisor won't listen, perhaps it's a discussion for Human Resources. But talk to someone! What can be changed? Can policies be altered? Is there a way to prioritize employee mental health within the department?

For example, your facility may not have a policy that allows staff who worked a call shift to come in late the next day. Allowing staff time to sleep after a long shift should be a priority, for their health and for patient safety. Perhaps this is a policy that could be changed for the benefit of everyone in the OR.


Take a deep breath.

"Deep breathing is a technique that allows you to calm your mind and reduce the concentration of stress hormones in your blood, which can contribute to the enhancement of your health. Deep breathing helps you calm down rapidly, think more clearly and focus on what you are doing." - UPMC

There are many different deep breathing techniques you can try, and they're a really quick way to help deescalate a situation. In the heat of the moment, when you're tempted to lash out due to stress, stop. Take a deep breath, and give yourself time to calm down. You will think more clearly, and you're more likely to respond appropriately.


Out of the 5 things listed, only one is an "in-the-moment" technique to help you control how you respond. The other 4 require a commitment on your part to being proactive. The operating room environment will always have associated stress, it's just the nature of what we do. But that doesn't give us the right to treat our coworkers poorly, just because we're stressed. Take care of yourself, physically and mentally, so that you're better prepared to handle the stress when it inevitably comes along.


Until next time,

Melanie














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