... [Former Delta pilot] Bill Mazzone, who flew jet airliners for 23 years, said it’s just as possible they got caught napping. "It’s kind of like being in an operating room. You know the physicians and the nurses…are listening to music, telling jokes, they’re doing what keeps them alert," he said. "Things are happening that if the public knew about it, they wouldn’t understand it, but it’s done. They’ve got the same thing in the cockpit." - Associated Press story,
"Could Letting Pilots Take a Nap Make Flying Safer?" which appeared after a Northwest Airlines flight missed Minneapolis. (Published 10-24-2009)
When I was in medical school many years ago, I was assigned to a surgical service that also had two first-year surgical residents known as "the interns." As a medical student, I was required to stay in the hospital every few nights to help one of them.
Internship was very demanding. The young, newly minted physicians were exhausted from being on-call every other night. Much of the night work was of no educational benefit. Each lab and X-ray report needed to be tracked down from a different corner of the building. All night long, they walked all over the hospital preparing for morning rounds. Just when the interns thought their work was completed, they would get called by the Emergency Room or the floor to see a patient, start an IV, replace a urinary catheter, draw blood, or disimpact a rectum (don’t ask). As the interns stumbled through their assigned tasks the next day, one of the senior physicians would invariably tell them how much easier things had gotten over the years. At the time, I remember dreading my own upcoming internship.
One day after a particularly difficult night of call, one of our interns was standing across the operating room table from me. We were both holding retractors as one of the attending surgeons worked deep in the abdomen. I held a long, curved metal retractor that pulled the liver up and out of the way; the intern held a broad, flat metal instrument to retract the stomach. No talking or extraneous noise was tolerated so we stood silently, leaning slightly backwards — still as posts — hoping to avoid attracting attention. Neither of us could see what the surgeon was doing.
The case dragged on for a long time. I glanced up at the intern and noticed that his eyelids were getting very heavy. Suddenly, he fell over backwards, crashing into a rolling table full of instruments as he headed to the floor. The retractor in his hands flew up and landed with a clang clear across the room. Total chaos ensued.
Within moments, the intern was sent to the lounge. I don’t think he ever scrubbed in with that particular surgeon again, and I am pretty certain he ended up in ophthalmology.
When I ran across the pilot’s comments comparing airliner cockpits to operating rooms, I paused for a moment. Yes, both pilots and OR personnel review checklists before we begin. Yes, we do best work when we are relaxed, careful, and attentive. Yes, there is often conversation and music while we work.
But, naps? Um, I don’t think so. Not a good idea.
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The following is feedback received for this blog:
I agree with the analysis and I always objected to this comparison of the Operating room to aviation for the following reasons; Many air planes are a like but no 2 patients are When the pilot is tired a flight is canceled but when nurses have to work a double shift due to a sick call we do not cancel the shift, we go on. An air plane is a mechanical device our patients are not. In a flight events are most of the time predictable but in the operating room they seldom are.
So what is similar?
thanks
- Gaby Cohen
I have been a Surgical Tech for 16 years, yes you get tired, but you do everthing you can to keep yourself alert. Granted when you are "just holding retractors" it is difficult. That's when you try to make eye contact with your Circulator to say, "Help, this is very tiring!" Usually they pick up on what you need and start up a small, quiet conversation. To help keep everyone going!!!!!! They may even ask the Doctor if they can turn on some music. Most of the time the Doctor will say sure!
The comparison between aviation and operating room work is valid NOT because patients are comparable to airplanes but because the WORK of being vigilant over human life - and the fact that human lives are involved should that responsibility for vigilance be betryed - contains many parallels.
Isabel |