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Behind Closed Doors: Recipe for Surgical Success
Delicious Thanksgiving dishes, perfect procedures have plenty in common.
Paula Watkins, RN
Publish Date: November 14, 2022   |  Tags:   Opinion

Fall is the air, and while some of you may be planning luxury foliage-finding trips that can cost you as much as a refurbished piece of capital equipment, I’m thinking about what’s right around the corner. 

The moment the leaves start changing their hue from verdant greens to vibrant oranges and yellows, my mind starts wandering to Thanksgiving. Ah, that glorious day when we all gather and tell one another what we’re thankful for. My family recently let me know they’ve been giving thanks ever since I decided to stop cooking a dish for our holiday get-togethers. 

Not that I blame them. What I cook is usually not only not good to eat, it’s also potentially bad for the environment when it inevitably gets discarded. But every now and then, I can’t help myself and I find a recipe I just must try. The process reminds me a lot of the OR. Every delicious dish is a mix of just the right ingredients, just as every smooth, successful surgery is the amalgamation of the right team doing the right things at the right time. 

For the perfect procedure, I recommend chilling one OR (ideally an integrated one) to a temperature that’s at least a degree or two above the arctic conditions your cold-blooded orthopods crave, and combining the following essential ingredients:

  • 5 competent and experienced (though potentially socially dysfunctional) OR professionals, including:
    • A seasoned, confident surgeon; 
    • An anesthesia provider who can handle even the trickiest airway case without flinching;  
    • A quick, unflappable circulator;
    • A self-assured PA; and
    • A strong and clairvoyant scrub tech.
  • 6 pans of surgical instruments weighing more than you do after a week’s worth of nothing but Thanksgiving leftovers — the type of pans only those in the cult of CrossFit can lift with ease.
  • 2 stainless steel rolling tables able to withstand 400 lbs. per table — an amount those crazed CrossFitters can lift with ease. 
  • 1 extra stainless steel table to accommodate all the multiple sterile packages that the psychic scrub tech knows you’re going to open before this surgical soiree is done. 
  • 1 lighting-quick surgery aide who can find anything and who sometimes places the item just outside the door before you even need to ask. 
  • 1 charge nurse with nerves of steel. This person is a BOSS and can say “NO” to anyone or anything with the stealth of a striking cobra but the tone of honey sweetness, so that you just say “OK” to tasks you’d never agree to from any other charge nurse and walk away wondering if you’d just been hypnotized. This person can produce a room and a crew to do a case at the speed of light even when there wasn’t anyone available to even do a small case.
  • 1 in-the-loop supervisor. Despite their status on the endangered species list, a few can still be found. They’re often spotted lurking around a white board or gazing at a computer-generated megatron board just inside the OR doors — always with their finger on the pulse of the OR. 
  • 1 patient presenting a challenge both physically and hemodynamically.

To prepare, mix together the ingredients, stirring in a pinch of knowledge and two heaping tablespoons of experience on all that can go wrong. Observe constantly with a plan in mind. Fold in a positive attitude. Sprinkle a bit of humor, and serve warm with a generous helping of patience. Happy Thanksgiving! OSM