Surgeons are notoriously resistant to accept, that they feel stressed during surgery. Do you ever feel stressed, and what factors do you consider stress inducing? Should surgeons be more open about accepting the tiredness or stress of work.
I may feel stressed before and during the operation of a complicated case. Otherwise, I enjoy operating. The general condition of the patient and increased risk of complications, a too much expectant patient and/or family all increase stress. Surgeons I believe should accept the stress of work and their tiredness, if any present.
What is stress? Stress is often a mismatch between demands and capability or ability. So novel situations, when things go wrong or when you are asked to do an unfamiliar procedure you will experience stress. Stress should be greater in novices and it is a driving force to learn and develop. In experts, the absence of stress even in unfamiliar situations may make them prone to errors, by not being cautious. Consider mistakes with unfamiliar anatomy, when the patient is in surgery for distension, adjustment. blockage, etc their anatomy is non-standard. Could cutting or cauterising this be an issue? Is it the vein or the nerve?
Often it is not the surgery that causes stress but the surroundings and corcumstances. For example distractions, phone calls, excessive noise - generally when you are in full control of a surgical situation the level of stress falls. Emergency work with risk of serious harm / death for your patient coupled with surgeon fatigue are stressors. Training should encourage young surgeons to understand how to deal with stress, recognise stress in themselves and others and also to learn how to perform well in stressful situations?
Sonal Arora at the Imperial College has done work measuring stress and its impact on team interaction and individual function in simulated OR settings. This work included measuring objective indices related to stress.
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