Fatigue and pain
I realized that just training somebody on how to hold a scalpel or how
to handle a suture needle — the things we consider standard — aren't
enough. You have to look at all the different components involved,
including teamwork, the cognitive aspect and the physical challenges
associated with surgery. These aspects are interrelated and each
aspect affects the others.
Surgery can be extremely physically demanding. Take, for example, a
surgical tech who's assisting with an orthopedic case. She might have to
hold a retractor for 2 hours or more to help keep the operative field open.
But she can't be in the surgeon's way while she does it, so she may have
to stand off to the side with her arm fully extended.
That's an ideal scenario for developing localized fatigue, and eventually
pain. When you're in pain, you're distracted. It saps your attentional
resources and creates the potential for errors and injuries. The techni-
cians were very forthcoming about it. They felt it in their shoulders, their
necks, their arms, their hands, their wrists — just about everywhere.
The same was true of surgeons. Some complained about neck pain
after long procedures, caused by sustained head and neck postures,
particularly when the OR table height or the overhead monitors
weren't properly adjusted relative to their eye level. The point is that
fatigue and pain can force us to let our guard down. When you're dis-
tracted, it's easy to take your eyes off a moving suture needle or to put
your hands in the wrong place at the wrong time.
Listen to your body
Fortunately, there are things you can do to reduce the risk factor
caused by fatigue. We explained how small things could interrupt the
fatigue process whenever they got the opportunity.
We know from ergonomics studies in industry that certain move-
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