REFLECTIVE ESSAY 1
Reflective Essay
Chamberlain University College of Nursing
NR501Theoretical Basis for Advanced Nursing Practice
, REFLECTIVE ESSAY 2
Explanation of Situation
The Operating room is composed of a multifaceted team not limited to the surgeon,
anesthesiologist, physician’s assistant, certified registered nurse anesthetist (CRNA),
circulating nurse and scrub technician. Although this multifaceted team focuses on one
patient at a time in the operating room, errors and adverse events occur, regularly. An error or
adverse event is defined as something outside of the ordinary and something that should not
have happen intraoperatively (Chard & Tovin, 2018). A nurse can feel unprepared
intraoperatively when there are abscesses in communication. These abscesses included
neglecting to complete a “Time Out”, silencing of the circulating nurse due to fear and
abscess of debriefing upon conclusion of surgery. It can also lead to avoidable errors
intraoperatively. The concern inherent to the situation will be discussed and through
reflection using Carper’s Patterns of Knowing, the perspective of a circulating nurse will
offer simple solutions to help improve intraoperative communication and patient safety.
Nursing Issue or Concern Inherent to Situation
One issue that compromises patient safety intraoperatively is lack of communication.
Circulating nurses are often silenced intraoperatively due to a culture of intimidation. Phadnis
and Templeton-Ward (2017) conducted a study showing that team familiarity
intraoperatively is only about 50% andlack of knowing the intraoperative team can lead to
abscess in communication causing adverse events. The culture of intimidation enhances a
nurse’s vulnerability causing emotions of horror, anger, sadness and self-doubt that can cause
silence contributing to a lack of communication. Medical errors compose a third of the
leading causes of death and this topic emphasizes the importance to change intraoperative
practice so errors can be decreased or eliminated encouraging the promotion of patient safety
(Chard & Tovin, 2018).
Reflective Essay
Chamberlain University College of Nursing
NR501Theoretical Basis for Advanced Nursing Practice
, REFLECTIVE ESSAY 2
Explanation of Situation
The Operating room is composed of a multifaceted team not limited to the surgeon,
anesthesiologist, physician’s assistant, certified registered nurse anesthetist (CRNA),
circulating nurse and scrub technician. Although this multifaceted team focuses on one
patient at a time in the operating room, errors and adverse events occur, regularly. An error or
adverse event is defined as something outside of the ordinary and something that should not
have happen intraoperatively (Chard & Tovin, 2018). A nurse can feel unprepared
intraoperatively when there are abscesses in communication. These abscesses included
neglecting to complete a “Time Out”, silencing of the circulating nurse due to fear and
abscess of debriefing upon conclusion of surgery. It can also lead to avoidable errors
intraoperatively. The concern inherent to the situation will be discussed and through
reflection using Carper’s Patterns of Knowing, the perspective of a circulating nurse will
offer simple solutions to help improve intraoperative communication and patient safety.
Nursing Issue or Concern Inherent to Situation
One issue that compromises patient safety intraoperatively is lack of communication.
Circulating nurses are often silenced intraoperatively due to a culture of intimidation. Phadnis
and Templeton-Ward (2017) conducted a study showing that team familiarity
intraoperatively is only about 50% andlack of knowing the intraoperative team can lead to
abscess in communication causing adverse events. The culture of intimidation enhances a
nurse’s vulnerability causing emotions of horror, anger, sadness and self-doubt that can cause
silence contributing to a lack of communication. Medical errors compose a third of the
leading causes of death and this topic emphasizes the importance to change intraoperative
practice so errors can be decreased or eliminated encouraging the promotion of patient safety
(Chard & Tovin, 2018).
