Most people would assume that surgeons become accustomed to carrying out major surgical procedures. But according to a new study published in the British Journal of Surgery, many surgeons are emotionally affected by major surgical complications and feel they need better support.
Researchers from Imperial College London in the UK say that the operating room is one of the highest risk areas for serious complications, and these obstacles can have serious implications for both the surgeons and the patients.
But the investigators note that there is little known on how surgeons respond to these complications and the best way to support them in the aftermath of these events.
The researchers explain that a recent survey of surgeons revealed that those who had experienced a surgical error within the past 3 months were more likely to have a lower quality of life and symptoms of fatigue and depression.
In order to dig deeper on this issue, the investigators, led by Dr. Anna Pinto, looked to how surgeons are affected by surgical complications on a personal and professional level, as well as which factors play a part in their reactions, how they cope with these difficulties and their view on the support provided for them.
The investigators interviewed 27 surgeons from two large teaching National Health Service (NHS) Trusts in London, UK.
To participate in the study, all surgeons had to be involved in general and vascular surgery - procedures that are linked to higher risk of serious complications - and they had to be above registrar level with at least 3 years experience.
All surgeons were required to take part in face-to-face interviews with an investigator who had a background in psychology and patient safety research.
Surgeons affected 'personally and professionally' by complications
Results revealed that 26 out of 27 surgeons said that a surgical complication impacted them emotionally, of which 15 said they felt guilt, and between three and eight surgeons said they had a crisis of confidence, felt worry for the patient and experienced anxiety or sadness.
Furthermore, 21 of the surgeons said the complications had a behavioral impact, while 18 said their surgical practice had been affected.
The researchers say that every surgeon referred to at least one situation when a surgical complication affected them personally and professionally.
Factors that led to their reactions included the preventability of the complications, the surgeons' personalities and experience, the outcomes and reactions of the patients, the reactions of their colleagues and the culture of the institution they were working within.
Commenting on the findings, the researchers say:
"Surgeons are typically regarded as more tough-minded than other healthcare professionals and there is indeed some evidence that this is the case.
The present study found, however, that there is a considerable variation in both the nature and severity of reactions to complications, with some surgeons being much more affected than others."
Support for surgeons 'inadequate'
The investigators say that in general, surgeons feel the support given to them by their institution during the aftermath of surgical complications is "inadequate."
It was found that the surgeons see more "formal arrangements" in terms of support after the occurrence of serious incidents as very valuable, as well as training in how to cope with these events.
From these findings, the researchers suggest that surgeons could significantly benefit from strategies aimed at coping with serious implications. They recommend that these initiatives should be in the form of surgical training, mentoring, mortality and morbidity meetings, focus on teamwork and psychological interventions.
The investigators conclude that further studies are warranted in how to implement support structures that meet the needs of surgeons who are affected by complications to the point that their personal and professional life deteriorates.
Furthermore, they note that further research is needed to determine the psychological impact of serious complications on surgeons "within the context of wider influences that appear to affect their psychological well-being."
Surgeons who have had lack of sleep operate as well as refreshed ones, according to a study reported recently by Medical News Today.