Dr Edward Gibson1, Mr Darren Molony1, Dr Michelle Lodge1, Dr Amy Jeeves1, Ms Linda Quinn1, Dr Rebecca Cooksey1, Mr Bernard Carney1
1Women’s And Children’s Hospital, North Adelaide, Australia
Managing fatigue in the operative environment is of upmost importance and no where is this more evident than in a burns theatre. The theatre is heated for patient care, operations are challenging, can run for extended periods and the stress placed on the operative team is high. Research is increasingly showing the physical and mental toll that this takes on the surgical team and the resultant impact on patient care. This review examines the various techniques that have been utilised in surgical units and similar high performance industries to manage fatigue.
The unit’s practices were examined and an extensive literature review has been completed. Industry groups, such as the Port Adelaide Football Club and Royal Australian Airforce, were consulted. The principle areas investigated concerned the impact of fatigue on performance and how fatigue was measured, prevented and managed.
Studies on surgeon fatigue are limited. Much of the research struggles with how to measure fatigue and is focused on managing fatigue, for example with stretching intra-operatively. This is in comparison with other industries, such as the airforce and AFL, which utilise validated tools for measuring fatigue, have clear techniques for training to prevent fatigue and strategies to manage fatigue once it has set in
Fatigue can have a significant impact on patient care, surgical performance and surgeon satisfaction. Assessment and management of fatigue remain a challenge. Presented here is a comprehensive understanding of fatigue in the operative environment.
Edward is the burns registrar at the Women’s and Children’s Hospital. He is pursuing a career in plastic and reconstructive surgery and has a particular interest in burns care and paediatric plastic surgery. He is a graduate of the University of Adelaide and has a Masters in Surgical Science through the University of Edinburgh.