The author of the comment only signed himself or herself as "Anonymous". But he, for simplicity sake, starts off by berating me, and my readers, by writing, "Shame on all of you." He goes on to claim that surgeons and nurses sometimes work for 8 to 12 hours at a time without a break. Therefore anesthesiologist should just tough it out and do the same thing or talk to the administration to hire more anesthesiologists to give us breaks. He chastises us for bringing food into the operating room and possibly jeopardizing the sterility of the surgical field.
Okay, I don't know if Anonymous is a surgeon, a hospital administrator, or a Joint Commission lacky, but his statement that nurses work without a break for half a day is clearly ignorant. I don't know of any operating room nurse who works that long without being given some time out of the room. As a matter of fact, during a single four hour case there may be as many as three or more shifts of nurses moving in and out of the room. Most states have pretty strong rules about how often nurses are supposed to be given relief. And if a hospital is found in violations of overworking their nurses, major lawsuits can ensue.
As for the surgeons not getting breaks, well that is their choice. They can operate twelve hours straight if they wanted to but the truth is that they have options. In a long case, there is always some point where the surgeon can scrub out and take a quick five to ten minute break to go to the bathroom or get something to drink. Rarely is a procedure so intense for the entire period that the surgeon cannot leave for even a few minutes. In addition, the surgeon usually has an assistant in the room that can continue working or at least watch the patient until he comes back.
By contrast the anesthesiologist is almost always working alone. By moral and legal grounds he can never leave the operating room with the anesthetized patient unmonitored. While the surgeon is making a quick run to the restroom, the anesthesiologist is watching the patient diligently to make sure every is going well. It doesn't work the other way around.
Now let's get to the crux of the matter, the reason food is banned from the operating room. Like I said in the original post, food is never, ever, ever permitted in the OR. And the reason for this is the fear that it would somehow contaminate the sterility of the operating field. But is that really the case?
|Not a hospital operating room|
By contrast, really the only sterile part of the operating room is the few inches surrounding the patient's open wound and the instruments and hands that reach in. The surgeons gown up mainly to protect their own clothing. Nobody wants to get splattered with disease ridden blood and body fluids. If you wanted to you could operate in your street clothes and I bet the infection rate would not change as long as you wear sterile gloves. As for the mask, think of it as more of a sneeze guard than a true protector of sterility.
For the same reason I find it hard to believe that me eating a little grape under my mask behind the ether screen will somehow contaminate the operating field. I'm usually at least six feet away and frequently BELOW the level of the the open wound while being behind a sterile drape. The surgeons' bushy eyebrows, which are obviously uncovered, are within inches and above the patient's wound. Same goes for the caps they wear on their heads. Those caps are definitely not sterile, nor are the tendrils of hair that often peek out from under the edges of the caps. Should all surgeons shave their heads to prevent dandruff and stray hair from falling out and infecting the patient?
Now I'm not advocating that anesthesiologists should be allowed to bring in gourmet lunches into the operating room. And again pretty much all hospitals frown upon any food or drinks in the OR's. But most see the practicality of allowing some sustenance for the anesthesiologist. As long as one practices common sense and and discretion, a few snacks are usually tolerated. Otherwise cases will just have to be delayed so that the anesthesiologist can go to the cafeteria and eat to prevent his blood glucose levels from collapsing. Which wouldn't really matter to the surgeon or the hospital but it might endanger patient safety, which you know, might not look so good on the local evening news.