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Teamwork And Attitude

By Lorenzo Garagnani, MD, FRCS, EBHS Dip Hand Surg

I practice as a Consultant hand and wrist surgeon at Guy’s and St Thomas’ NHS Foundation Trust in London (UK). Guy’s and St Thomas’ Hospitals are busy central London teaching hospitals and a tertiary referral centre. The team regularly working with me in the OR includes a senior Hand Fellow, a senior Orthopedic resident, an Upper Limb PA, a consultant anesthetist specialising in regional anaesthesia, and dedicated operating theatre staff.

Everyone in our team has a well defined role, and constantly goes above and beyond to ensure that the list runs smoothly and the best possible care is delivered to each of our patients. Undergraduate Medical students from King’s College London and other Universities, as well as international visiting surgeons and Fellows also regularly attend our operating room. It is my opinion that it is the surgeons’ duty to create an efficient, effective, safe and at the same time pleasant work environment in their OR, and this target can only be achieved if everyone in the team participates equally in the OR activities and respects the other members of the team. I firmly believe in the value of teaching, training and fueling the enthusiasm of junior colleagues who are eager to learn. I find it incredibly rewarding to see that sparkle in their eyes when they are taught something new for the first time.

I also regard as an additional bonus the fact that surgical procedures on the hand and wrist can be carried out under regional or local anesthesia. This also makes the patient an active member of the OR team, and not just a person receiving treatment passively. I usually involve patients in their own treatment, explaining any findings to them and encouraging them to participate in any discussion should they wish to do so.

An appropriate music selection also contributes to the creation of a pleasant work environment in the OR, and it often even sets the pace of a procedure. When I perform lengthy surgical procedures I tend to listen to some music, the style of it depending mainly on the type of procedure and on the preferences of the other team members present. If the patients are awake, we ask their preference too, as I wish their experience to be as stress free as possible.

My clinical and research work focuses on reduction of surgical morbidity and minimally invasive adult and pediatric hand and wrist surgery.  As a consequence of this, state of the art surgical techniques and tools are used in our OR, and I have recently introduced into routine use a piezoelectric surgical saw, an ultra-safe device that allows for high precision osteotomies whilst protecting the surrounding soft tissues. We are the first hand and wrist surgery service in the UK to use this piezoelectric surgical technology, and I look forward to presenting my cases at the forthcoming 73rd ASSH annual meeting in Boston in September.

Ultimately, what makes a workplace special is the attitude of those who work there.

“Attitude is a little thing that makes a big difference” (Winston Churchill).

Lorenzo Garagnani, MD, FRCS, EBHS Dip Hand Surg
Consultant Orthopedic Hand and Wrist Surgeon
Guy’s and St Thomas’ NHS Foundation Trust, London (UK)
Hon Senior Clinical Lecturer, King’s College London

 

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