Features  |   November 2013
Not Them, Not Us, But We: The Importance of Teamwork in the NORA Environment
Author Affiliations
  • Jeffrey M. Feldman, M.D.,MSE
    Committee on Equipment and Facilities
Article Information
Critical Care / Pediatric Anesthesia / Radiological and Other Imaging / Features
Features   |   November 2013
Not Them, Not Us, But We: The Importance of Teamwork in the NORA Environment
ASA Monitor 11 2013, Vol.77, 12-14.
ASA Monitor 11 2013, Vol.77, 12-14.
It is noon on a Friday and the head technician from radiology calls to schedule an MRI with anesthesia for 2 p.m. and says:“I really need YOU people to accommodate this patient and we have a busy schedule today so a long ANESTHESIA DELAY will be a big problem.”
Not long ago, this type of conversation would not have been unusual at the Children’s Hospital of Philadelphia. There are many challenges to providing anesthesia services outside the O.R. while maintaining the same safety and patient flow we enjoy in the O.R. complex. The comments by the technician in the quote highlight one of the most significant obstacles to success, namely a lack of a sense of teamwork when caring for patients in the non-O.R. anesthesia (NORA) environment. Comments such as “you people” and “anesthesia delay” underscore the notion that we are not part of the usual team caring for their patients and our challenges in caring for patients in the NORA environment are not appreciated. There is an intense focus on patient throughput in procedural areas, and the time required to provide safe anesthesia care is often viewed as just delaying the schedule. In truth, anesthesia professionals who do not view NORA locations as having the same importance as the O.R. contribute to the lack of teamwork. It only takes one person to make it clear he or she is not happy to be working in a NORA environment to create a lasting bad impression and difficult working relationship.
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