Human Factors

in Anaesthetic Nursing


Don't blame me.

Blame Pat Croskerry.

He started it.


I read a journal article of his in an anaesthetic journal many years ago, and what he said was fascinating. In the article, he explored Human Factors in the Emergency Department, and it opened my eyes to the possibilities of Human Factors within our own anaesthetics specialty.


The possibility was further reinforced during a simulation session recently, when it again became apparent that it is not only what we know and what we do, but how we do it, that is important.


Whilst I can't reveal any details about the sim, because sims are confidential, what I can do is reflect on the human factors of a reasonably probable event at any given time, the arrival of a full-blown high level emergency case.







So let's imagine that it is 11 AM on Christmas Day.

We have done a few small cases, and maybe a fractured hip or two, but then things seem to have quietened down.


We get out the Christmas cake, the chips and dips, and the Christmas Crackers and pretzels and lollies, and just as we are starting to relax, the phone rings.


Woe to go, the patient is on their way up from emergency. Now.


On the anaesthetic nursing team, each declares what they are going to do.

Carol sets up the Level 1 Blood Warmer;

Bruce sets up the transducers;

Victoria sets up the intubation equipment and the anaesthetic machine;

Then they attend to tasks as they arise.

The anaesthetist tries to communicate to everyone, and tries to ensure that everything has been done.

It is a long, complex operation, but eventually it finishes.

The patient goes to ICU.

The team cleans up, and they retire, exhausted, to cold Christmas Turkey and warm Cranberry Sauce.






In considering this scenario, what we wanted to do was to sit back and look at how we do the things we do.


We wanted to look at such things as:


Task allocation;

Task succession;


Communication pathways;

Traffic flows;


Programmed refreshment of team


Then we asked the magic question:


"So. What would such a thing look like?"


Below Ten Thousand

An international collaboration

Empowering clinicians in safety culture