Non-technical skills in operating room nursing: Ethical aspects

Non-technical skills are cognitive and interpersonal skills underpinning technical proficiency. Ethical values and respect for human dignity make operating room nurses responsible for nursing decisions that are clinically and technically sound and morally appropriate.

To learn what ethical issues operating room nurses perceive as important regarding non-technical skills.

Qualitative individual in-depth interviews were conducted. The interviews were analysed using Braun and Clarke's six phases for thematic analysis.

Eleven experienced perioperative/operating room nurses working in an operating unit at a Norwegian university hospital.

Approval was given by The Norwegian Social Science Data Service in care of the hospital's Data Protection Officer.

Three main themes were found: respect and care for the patient, making the patient feel safe, and respect within the perioperative team. These features or themes, which incorporate collaboration and communication, are closely connected to patient safety.

Defending the patient's dignity is part of caring for and respecting the patient. The manner in which the operating room team collaborates is important for the patient to feel safe and secure. Poor teamwork may have dire consequences. Reciprocal respect within the team includes respect for each other's tasks and responsibilities and to talk to one another in a friendly manner.

Being respectful and contributing to a caring atmosphere are central ethical skills in the operating room. To patients, harmonious teamwork translates into a feeling of safety and being cared for. The nurses see respect and patient safety, and respect and reciprocal politeness among the members of the perioperative team as central ethical non-technical skills. Lack of respect influences the team negatively and is detrimental for patient safety. Good communication is an important safety measure during surgery and creates a feeling of good 'flow' within the operating room team.