Hospitals should do the right thing for staff, as well as patients

This article originally appeared in Becker's Hospital Review.

All patients who enter the doors of Dosher Memorial Hospital in Southport, North Carolina, rightly expect to receive high-quality care in a safe, clean environment, but I’d wager that few patients in any hospital consider whether it is also safe and clean for the medical professionals who provide that care.

The truth is, we talk about safety for our patients a lot at hospitals; but providing a safe environment for the team that takes care of them? Not so much. Obviously we want to make sure we provide safe, quality care for our patients, but we also have to make sure we provide a safe work environment for our teams. That’s why Dosher made its operating rooms smoke free.

Of course, I’m not talking about tobacco smoke, as all hospitals ban tobacco smoke; I’m talking about surgical smoke, which is a common presence in operating rooms around the country. Surgical smoke is created when surgeons use electrical devices to cut skin and tissue or to cauterize blood vessels.

The medical literature on surgical smoke is startling — breathing surgical smoke is equivalent to smoking six cigarettes in 15 minutes. Surgical smoke contains the same carcinogenic chemicals (and even more toxic chemicals) as cigarettes. Despite these clear dangers, there are no federal or state regulations mandating that hospitals protect surgeons and nurses from exposure.

In the past it was difficult to prevent exposure. Though operating rooms are extremely clean, machines that purify the air for the whole room aren’t capable of capturing surgical smoke before it reaches doctors and nurses. However, new advancements in technology allow surgeons to capture smoke at the source before it wafts into the room.

Surgical smoke smells terrible, so removing it from the operating room makes for a more pleasant experience for everyone. But most importantly, removing smoke protects patients and staff from the potential harmful effects of inhaling it.

What’s special about this initiative at Dosher is that it started with the people closest to the procedure. The nurses who experience the most exposure to surgical smoke identified the issue and came up with solutions that our chief nursing officer and other administrators could pursue.

That’s not to say it was easy for us. Anyone who’s ever worked in a hospital knows how difficult it is to get surgeons to change their habits and preferences. When we first floated the idea of introducing the Smoke Evacuation Pencil, one of our top surgeons said something to the effect of, “Absolutely not. I like exactly what I have and don’t need any changes.”

His resistance was understandable. Surgeons perform important and extremely precise work, and any disruption to their normal way of doing things makes it harder to do their job—at least initially. But he agreed to try the E-SEP Smoke Evacuation Pencil because he bought into our team culture and the philosophy of doing the right thing for the right reasons.

That surgeon is now one of the biggest advocates for smoke evacuation. He won’t operate without an E-SEP pencil.

As an independent hospital, Dosher is more suited than most to take quick action to address our staff’s concerns, but any hospital can do what we’ve done about surgical smoke. In fact, any hospital that cares about the wellbeing of its staff should do what we’ve done.

The right thing to do isn’t always the easy thing to do, but if the choice is between right and easy, hospitals should always choose right.