An Environment Is More Than a Climate

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Modern anesthesia is the product of industrial revolution. Knowledge and experience gained in other medical faculties helped to achieve the ground-breaking discoveries made in anesthesia. A neuropsychiatrist (Sigmund Freud) influenced Karl Koller to use cocaine for ophthalmic anesthesia. Another neuropsychiatrist A. E. Bennett, who used curare to modify the convulsion caused by electrical convulsive therapy, transmitted the idea to anesthetists of achieving muscle relaxation during surgery. History of anesthesia is full of such instances. Outside our medical community, there is also wide range of influences, from the queen to the circus comedian who contributed to the development of anesthesia. In recent times, anesthesia has gained knowledge and benefited from the aviation and nuclear industry to help develop safety within the workplace. We also owe to the business industry for introducing us to the science and art of consumer, or in our case, patient satisfaction.
There are many other dimensions of our specialty about which either we are not fully aware or possess limited knowledge. Workplace environment is one of them. Most of the literature written on the operating room environment including the recently published article by Katz1 discusses the temperature, humidity, and airflow of the workplace. Katz1 searched the literature published during the past 6 decades. All of 8 but 1 search terms he used are all directly related to the physical characteristics of a climate. Undeniably, the workplace environment does include its climate, but it is more than that. There are innumerable quantitative and qualitative factors that affect the operating room environment. Quantitative factors that affect the quality of an environment, such as operating room light, temperature, color, area, noise, congestion, and traffic are easily measured, whereas less quantifiable factors are mostly related to workplace culture, personalities, hospital policies, etc, that provide the worker (patient’s care provider) the encouragement, respect, fairness, meaningfulness, health, and well-being.
The article by Katz1 discusses the operating room environment from the patient safety point of view. He correctly correlates patient safety with the well-being of the service provider. Unfortunately, there is an underwhelming amount of literature that comprehensively addresses anesthesiologist’s environmental needs. For >30 years in the operating rooms, I have been sitting on uncomfortable stools and chairs, have had to lift many heavy patients, worn clogged shoes, and have frequently had to miss my lunch. Our job as an anesthetist is one of the most taxing specialties in the field of medicine, and chronic exposure to suboptimal operating room environment negatively contributes to the well-being of anesthetists.
In our effort to improve operating theater environment, we can learn from business organizations. Their workplace models focus on quality, creativity, and production. They firmly believe that their success is directly related to their workers’ well-being. Successful business organizations have invested and provided excellent modern workplace environment. Google, ranked the best company in the world, has provided an ideal workplace environment. Thousands of its workers can take advantage of perks like free meals, laundry, fitness facilities, and on-site childcare.2 For us, the Google workplace is a utopia. Presently, we are in the initial stages of improving the workplace environment. We have to broaden our concepts about the operating room environment and can learn a lot from such models.
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