Shinobi and Ballet


The clinical performance of a multi-disciplinary Operating Theatre team is a Ballet resplendent with a highly choreographed and aesthetic interplay of psychology, physiology, pharmacology, anatomy and human factor ergonomics performed all at once by a surprisingly diverse and skilled cast.


So says Pete!


This ballet is performed on a daily basis under the weight of overwhelming needs and expectations….. functioning despite the lack of political investment in human resources and infrastructure whilst the elite cast struggles to not buckle under the pressures of both manufactured and emergent workloads… in contradiction to the implementation and establishment of a well-­being based team safety culture.


As Airline Safety Researchers found:


Team Safety Culture can only be based on personal resilience and restorative behaviour, underpinned by effective personal self-‐care strategies, symbolized metaphorically by the image of “Shinobi”.


Our Recovery team has been engaged in a Pilot Study of self care strategies designed to be

•Low cost,

•Easy to implement,

•Effective at relieving stress,


Shinobi challenged firmly held personal beliefs and values with respect to: Investment in Self As opposed to reinforcing belief in the unsustainable work ethic…. of tireless matyrdom.


The self-­care environment is divided into two inter-dependent subsets of factors,


the physical and emotional spectrums.


These in turn comprise elements of


acute (mainly situational)

and chronic (mainly systems of work)


Self-­imposed limitations were that no negative impact is allowed on productivity.


Team performance should not be negatively affected by the implementation of self-­care strategies.


Ideally, management should see no changes in Key Performance Indicators.


They should be left only to wonder why sick leave, inter­‐personal conflict and other worker dissatisfaction measures are happily low.


Why would we not want to move the goalposts?


Because this is a clinician-led initiative, not a top down initiative:


Only by being cognoscente of my own emotional needs

Can I get my managers to uphold

Their commitment to implementing a clinical framework

Which facilitates emotional support.




Below Ten Thousand

An international collaboration

Empowering clinicians in safety culture