Edited by Janice Langan-Fox and Cary Cooper
Chapter 3: Surgeon Stress in the Operating Room: Error-free Performance and Adverse Events
Janice Langan-Fox and Vedran Vranic STRESS-RELATED PERFORMANCE DECLINE Surgeons are thought to be one of the few groups in the workforce whose job requires the ability to save people’s lives on a regular basis – to prolong life, in other words. Such a task does not come lightly! And patient expectations are higher now than ever, with the advancement of new technology, techniques and applications. Operating on critically ill patients puts substantial demand and stress upon a surgeon (Arora et al., 2009a) working in an environment saturated with distraction and noise, patient demands and anxieties – all while working with various support staff of different levels of skill and ability (Sevdalis et al., 2008; Undre et al., 2006). Thus, even to the casual observer, surgery is a challenging job, being physically, emotionally and intellectually demanding – conditions that often lead to stress. Acute stress can be defined as physical and psychological reactions when the demands and pressures of a situation exceed an individual’s perceived resources/ability to cope (Lazarus, 1966): low levels of stress can enhance alertness and task efficiency (Klein, 1998), while excessive levels can weaken memory, attention (Klein, 1996), motor skill and concentration (Arora et al., 2010a; Flin et al., 2008). Stress may also be the reconciling factor between increased time pressure, noise, and, cognitive distraction and poorer performance (Goodell et al., 2006; Moorthy et al., 2003a). This has tremendous importance in surgery where the integration of complex cognitive processes with manual dexterity is crucial to performing a successful operation (Arora et...
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