I see our role as PAs as leaders. I hate to hear about PAs in the OR who just “hold hooks.” It drives me nuts. I was talking with a few of my teammates the other day, and I was explaining to them that when I’m in the OR I see myself as being in charge of the OR.
Is that arrogant? Maybe, but it’s effective.
Isn’t the surgeon in command? Sometimes.
Isn’t the anesthesiologist in command? Sometimes.
Here’s the lesson. Sometimes the circulating nurse is in command. Sometimes the scrub tech is in command. At any point the scrub tech can say, “NO, STOP.” And suddenly they’re in command of the room. Plain and simple.
If they see something wrong, someone not following sterile technique, something that might harm the patient, they are 100% within their rights to take control of the room.
But for my part, I always want to be in charge. This is how I see it. The surgeon is focused on the surgery. The anesthesiologist is focused on the patient. The scrub tech is focused on the equipment. The circulating nurse has a whole lot of other things going on that I can’t explain here.
I’m the one who knows the surgery. I’m the one who knows sterility. I’m the one who can manage the relationship between the surgeon and the nurse or the tech. I’m the one who can communicate with the anesthesiologist. Why? Because I’m not one sided. I’m looking at the whole picture and trying to make everything run as well as possible for the best possible outcome.
I’m the only one focused on the whole thing, and that makes me in charge. There are about five surgeons out of 60 or 70 that I work with that see this power too because they are on it. They don’t miss a beat, and they run the room. Every other room is mine.
As I was telling my teammates, I want the anesthesia team to ask me if they have an issue. I want the nurse to ask me if they have question. Why? Because asking the surgeon slows down the room. It removes their focus from what they have to do. Not to mention, I’ve seen lots of surgeons who aren’t so good in a crisis, and I want the people in the room to have the upmost faith in me. Not the surgeon, but me. If the surgeon is on it, that’s great and a huge bonus, but I can’t always count on that.
That may be arrogant, but that’s how I approach every situation. I don’t fight for control. I don’t argue or raise my voice ever.
Let me give you the secret to being in charge of a room.
1) Understand what’s happening
2) Listen when it makes sense
3) Be decisive
4) Communicate clearly
That list is just off the top of my head, but I think it’s sufficient. Now I don’t care if you’re in an office setting, a hospital setting, or whatever. The title is not what makes you in charge. I promise you that 100% of the time. Your knowledge, your character, and your ability to take responsibility and communicate are what make you in charge.
I was talking about this last week, and then this morning I came across it again, so I wanted to share it with you since obviously it’s on my mind.
Here’s how it came up this morning.
My wife bought me Tim Grover’s book, “Relentless.” I was looking over the book jacket and reading the table of contents this morning and saw one of the chapters titled “When everyone is hitting the ‘In Case of Emergency’ button, they’re looking for you.”
That’s always been my dad. He was the guy who couldn’t pack lunches. He couldn’t find his wallet on most days. He doesn’t know my birthday, and I’d be a little surprised if he knew my kids’ names. But he was always the in-case-of-emergency guy. He was always in charge in a crisis. My mom ran the day-to-day, but when I wrecked the car (more than once) there was only one person to call.
I’ve always strived to be the person in charge when sh&t hits the fan, when it really matters. And that’s what I want for you.
Sorry if this one rambled a little, and I missed the mark. Sometimes I use these emails as a thrashing process for my thoughts.
Thank you reading and giving me room to do just that.
Brian Wallace