MEDICO-LEGAL ISSUES FOR THE OPERATING THEATRE ORDERLY

The legal system requires that all personnel involved with a patient's care are responsible and accountable for their actions. Many different government acts form the guidelines we must act within. A recent change to the Queensland Privacy Act, 2000 has an implication on the patient's personal information we receive daily within our working environment.

A patient provides personal information as an act of trust, and we must take this seriously. We are legally obligated under the privacy act to maintain a patient's confidentiality. The act prohibits the disclosure of information about a patient by an employee (or former employee). This includes discussing any information regarding a patient, including their diagnosis, or their length of stay. A breach of this trust may cause the patient to charge the person and hospital for unauthorised disclosure; the person shall be liable for actual damages occurred. This may be punishable by fines or imprisonment.

A patient may file a complaint regarding an act of negligence; this could apply to the way in which they were positioned for their surgical procedure. Recognising your own limitations and communicating within the health-care team to seek information when you are unsure of how to position is extremely important.

If you are asked a question regarding the surgeons' skill or who is the 'best' anesthetist, your reply should be that you do not know, as any preferred surgeon in your eyes is hearsay and would not hold up in a court of law. The patient could decide to file a complaint should the outcome of their surgery be unfavorable.

Interaction with patients, and all members of the healthcare team forms the basis of safe patient care delivery. When all members within the perioperative environment use effective communication skills a common goal may be achieved more readily. The closeted environment of theatre requires a team approach to patient care.

We communicate to send and receive information, verbal and non-verbal communication is used to convey the message. Actively listening is required to show that you understand the message being transferred.

All employees have their part to play in the smooth running of the workplace. Every person has a unique set of skills, knowledge and attitudes that contribute to the success of the team's work. Consulting all employees regarding any issues/changes to their area of work is significant as their direct knowledge of the job makes their input valuable and necessary.

Establishing a rapport with a patient may assist in developing a bond of trust. This trust is essential for the patient to be able to share any concerns they may have. Communicating with a patient and their family may take a variety of forms including:

Verbal exchange - Touch  -  Music  -  Non-verbal interaction

As an employee of the healthcare facility you work at, you are a representative of that organisation. This may allow the patient at the outset to feel more comfortable expressing themselves to you. All of those that we communicate with should be considered our customers; this would include the patient, surgeons, nurses, receptionist and visiting representatives.

Showing respect for the values, customs, spiritual beliefs and practices of those we interact with is important. Many of our colleagues and patients are representative of the wide diversity of ethnic background that society presents us with. Adjusting and recognising these differences is necessary to avoid conflict with others we come into contact with.

REFERENCES

ACORN, 2010, Standards, Guidelines and Policy Statements.

Ethicon Endo-Surgery, INC. Ultracision Generator Manual, 1997.

Gruendemann, B. & Fernsebner, B. (1995). Comprehensive Perioperative Nursing. Jones and Bartlett Publishers, Inc. USA.

Meeker, M. & Rothrock, J. (1999). Alexander's Care of the Patient in Surgery. (1 I ^th Ed). Mosby. USA.

Queensland Health, Infection Control Guidelines, 2010.

Queensland Government Publishers, Workplace Health and Safety Act, 1995.

Queensland Government Publishers, Privacy Act, 2000.

Valleylab, (2001) Principles of Electrosurgery, Tyco Healthcare, Australia.