Performing Crucial Surgery in Crunch Time - Tips to Stay Calm

Performing Crucial Surgery in Crunch Time – Tips to Stay Calm

Apr 4, 2015 | 10:00 am

Some of the crunchiest times in the operating room can be the best learning experiences. However, it is recommended that before the rookie surgical tech or registered nurse goes into a critical procedure, there should be ample support staff available who knows what to do in the event of emergency.

The Heart Room

The operating arenas where coronary arteries, heart valves, and aneurysms are repaired, are always considered holy ground. Usually, cardiothoracic surgeons are extremely particular about their staff, instruments, music, and environment overall. They all have little idiosyncrasies that must be honored and obeyed.

The greatest way to stay calm and be effective in the heart room is to know these surgeons’ preferences and be prepared for anything. It is a good idea to have everything in the room that the surgeon might need, in the face of a worst-case scenario. Performing surgery when there is no prior preparation is not only frustrating to the surgeon, but can be lethal for the patient. The nurses and surgical technicians should have a well-organized, well-prepared plan for the absolute worst possible outcome.

Surgeons like to know his or her staff is well prepared. This instills confidence in the surgeon and therefore, he or she will relax and be able to perform his or her skills to the best of his or her ability in this stressful atmosphere.

Trauma Rooms

Trauma centers are famous for the term coined “door busters.” This is where there is barely time to open all the surgical supplies before the patient is on the operating room table being prepped for surgery. Many times these types of surgeries are started with only a scalpel and suction. When patients are shot, stabbed, or have endured other types of trauma, the first thing to do is get them open and address the bleeding. This will in turn get pressures stabilized and eventually save a life.

Again, the best way to avoid tension and stay calm is to be ready with everything from suture to sponges and a good suction that works. Knowing where everything is on the surgical setup is helpful, so the surgical assistant and surgical tech are able to pay attention to what is happening in the wound instead of fumbling on the back table for suture or clamps. Excellent repetitive habits during non-emergent surgeries can hone the skill of performing surgery when things are less than optimal.


When things are hectic in the operating room, it is imperative that each and every person knows what his or her function is in that setting. In the operating room arena, each individual character has a well-defined role as to what he or she is expected to do. If there is squabbling over who will assist vs. who will run the instrument tray, the surgeon will usually make a choice over who is preferred in which role. Every person performs his or her role like a machine. It is a beautiful thing to see an operating room team put all issues aside in order to work together in unison to save a life in a professional and honorable manner.


Solid communication among personnel is a great stress reliever. If the circulating nurse knows the surgical tech has all the suture and supplies needed, it will take stress off of him or her to run and leave the room to get supplies that should have already been gathered. The surgical tech should also communicate clearly about sponge and instrument counts, so everyone in the room is aware of any suspicious missing items. Instruments, sponges, needles, and anything small enough to leave inside a body cavity must be counted.

It is also very important not to take any shouting or cursing personally. Many surgeons get snappy when the patient is in grave danger and there may be exchanges made that otherwise would never happen.

Be Skillful

The ability to manage your emotions and remain calm under pressure has a direct link to your performance. TalentSmart has conducted research with more than a million people and we’ve found that 90% of top performers are skilled at managing their emotions in times of stress in order to remain calm and in control.