SURGICAL CONSCIENCE

Surgical Conscience

Surgical Conscience

Introduction

Somewhere in their curricula, schools of nursing and institutions that teach perioperative nursing usually address the concept of "surgical conscience." Course competency statements and learning outcomes often include criteria mandating that the student will demonstrate surgical conscience as evidenced by consistently exhibiting ethical behavior, promoting patient safety, and doing the right thing even when no external monitors are present (although it is unclear how it could be determined that surgical conscience was being exercised without someone watching). The importance of listening to one's surgical conscience may or may not be drilled into students, depending on the institution and the instructor.

One of the first editorials published on this topic was written for surgeons in 1950. The article proposed that "conscience is the light that guides men's steps...." (1 p315) and warned that without it, irresponsible and unsafe actions could occur. Many would argue, however, that moral decay in today's society has crept into all professions, including perioperative nursing, and that surgical conscience is no longer a working concept in today's world of "any means to an end."

We need to ask ourselves the following questions: Is moral and ethical behavior still taught and valued in nursing school? Is surgical conscience still guiding perioperative care today? Do perioperative nurses always exercise their surgical conscience for the good of the patient?

What is surgical conscience?

A surgical conscience is the foundation upon which the growth and development of a surgical technologist is built. The principles of sterile technique must be scrupulously maintained. Breaks in technique may bring to the wound bacteria which the body's defense system cannot destroy. Lack of knowledge of the principles of aseptic technique and their application does not justify a break in the sterile technique. Even mild infections delay recovery and are costly to the patient in time lost and money spent. A mild infection is potentially a severe one. Moreover, antibiotics have not supplanted sterile technique, which is to be observed for all patients. Principles must be followed meticulously. None of the personnel should ever be reluctant to admit a possible break in technique, even if there is any doubt about it. We are responsible for the patient, whose trust and fate are in our hands(Owen, 2007).

During the operation, the surgeon, surgeon's assistants, and the scrub corpsman must wear sterile gowns and gloves and must not touch anything that is not sterile. Maintaining sterile technique is a cooperative responsibility of the entire surgical team. Each member must develop a surgical conscience, a willingness to supervise and be supervised by others regarding the adherence to standards. Without this cooperative and vigilant effort, a break in sterile technique may go unnoticed or not be corrected, and an otherwise successful surgical procedure may result in complete failure.

Basic Guidelines To assist in maintaining the aseptic technique, all members of the surgical team must adhere to the following principles:

All personnel assigned to the operating room must practice good personal hygiene. This includes daily bathing and clothing ...