Marja Silen-Lipponen, Kerttu Tossavainen, Hannele Turunen, Ann Smith, Katharine Burdett
This study explores teamwork in operating room (OR) nursing, and the factors that improve or hinder it, as experienced by Finnish, British and American OR nurses (n = 30). A descriptive phenomenological approach was used to inform the use of a critical incident technique in collecting and analysing data obtained through interviews. The findings established four elements of OR teamwork culture: professional, distracting, organised and physical environment as a marker of teamwork. Good organisation and professionalism improved teamwork, which centred around technical competency and a willingness to co-operate. Teams whose members lacked sufficient skills or motivation, e.g. senior, novice or tired nurses, were thus a source of irritation. OR teamwork was hindered by the presence of distractions such as the unpredictability of some aspects of the work, constant changes in team composition and a need to work overtime. Moreover, excessive perfectionism made nurses worry about mistakes or suppress emotions while working in teams. The four elements of teamwork culture were found in each of the three countries represented in the study. The only finding that related specifically to each country related to the ways in which overtime was organised. Recommendations include the need for further investigation of the ways in which teamwork culture affects patient care particularly with regard to safety issues. In addition, the emotional atmosphere of ORs should be studied with a view to developing positive OR teamwork cultures that attract nurses to work in the OR.
