Archive August 2017 XVIII, No. 8

Anesthesia Alert: Coping With the Boredom of Anesthesia

Do occasional distractions help anesthesia providers stay sharper?

Mike MacKinnon

Mike MacKinnon, MSN, FNP-C, CRNA


non-patient-related activities NEEDED RESPITE? Non-patient-related activities such as reading and conversation have been going on in the OR for decades, with no discernible pattern of negative effects. Studies suggest occasional "distractions" keep providers sharp.

There's a great deal of hand wringing these days about "distracted doctoring" — the idea that computers and cell phones may be dividing the attention of providers and endangering the lives of patients. But are we in danger of oversimplifying the issue?

An ongoing malpractice suit in Dallas, Texas, is front and center. Anesthesiologist Christopher Spillers, MD, is accused of failing to respond to a patient's clear signs of desaturation because he was too distracted by social media ( Surgeon Robert Rinkenberger, MD, also named in the suit, testified in a deposition that Dr. Spillers didn't notice that the patient had critically low blood oxygenation until "15 or 20 minutes" after she turned blue.

"He was doing something either [with] his cell phone or pad or something," says Dr. Rinkenberger. Dr. Spillers initially denied in his deposition that he ever surfed the Internet or posted on Facebook while managing cases. But when confronted with a post from his Facebook account of a picture of an anesthesia monitor displaying a patient's vitals — "Just sittin here watching the tube on Christmas morning. Ho ho ho," reads the caption — Dr. Spillers admitted to sometimes texting and reading his iPad during procedures. The patient, 61-year-old Roseann Milne, had undergone an AV node ablation, a relatively routine heart procedure. She died 10 hours later.

Lesson learned. Social media distractions in the OR are bad and must always be prohibited, right?

Maybe not so fast.

Let's consider a couple of points. One is that non-patient-related activities in the OR are nothing new. Some define anesthesia as 99% boredom, 1% sheer terror. Anesthesia professionals have been reading, doing crossword puzzles and playing Sudoku in the OR for decades, without creating any obvious pattern of negative outcomes.

More to the point, can we assume that any distraction during any part of any case is always a bad thing?

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