Three Barriers to Communication

Abstract

Harold Korolenko is the Personnel Oficer at the Veterans Administration Hospital, Bronx, New York. He has had over 15 years experience as a Personnel Oficer responsible for the direction and implementation of a comprehensive personnel management program in the Veterans Administration Hospital system. While in military service he was a member of the Air Inspector’s Ofice of the Army Air Force Personnel Distribution Command, charged with the responsibility for the inspection of civilian and military personnel ofices. He has an M.A. in Public Administration from New Yolk University and is currently President of the Metropolitan New York Chapter of the Public Personnel Association. This article is based on a talk given by Mr. Korolenko at the 12th Annual Congress of the Association o/ Operating Room Nurses, New York City, February, 1965. by your own working relationships in the operating room. There the issue of life and death is so vivid, so dependent on optimum teamwork, that every member often takes his orders from the demands of the situation rather than from the normal channels of command. “The changing needs of the patient, as they develop in the course of the operation, determine what everybody does. When a surgical team has worked long enough together to have developed true teamwork, each member has such a grasp of the total situation and of his role in it that the needs of the patient give unequivocal orders. A small artery is cut and begins to spurt. In a chain-of-command organization the surgeon would note this and say to the surgical nurse, ‘Give me a hemostat,’ and thus coordinated effort would be achieved. What actually happens is that the bleeder gives a simultaneous command to all three members of the team, all of whom have been watching the progress of the operation with equal attention. I t says to the assistant ‘Get your hand out of the way until this is cantrolled.’ It says to the instrument nurse ‘Get a hemostat ready,’ and it says to the surgeon, ‘Clamp that off .’ This is the highest and most