Operating theatres
triggers that can be challenging for people with neurodiverse diagnoses. Sensory overloading, social nuances, focus and attention-structured communication are just a few of those triggers. Sensory overload can occur in bright lights, and loud or constant noises can be overwhelming in long operating procedures. This can be a distraction and stress for any of the team members, but for neurodiverse individuals, can be crucial to the perception and quick assessment of the situation. Even the best nurse, surgeon or anaesthetist,
when overwhelmed, can feel tension, stress and anxiety, when communication is not clear in an emergency. That can lead to misunderstandings, conflicts and potential never events. Taking into consideration the specific requirements of individuals with ADHD or dyslexia around maintaining attention, limiting distraction when processing information at a fast pace is a key factor. The neurodiverse professional is not always
recognised by the team, which can result in misunderstandings, conflict situations, lack of direct communication and failure to deliver appropriate messages. Many professionals and people in healthcare are unaware of their neurodiversity, as many have never been diagnosed, but many also do not share their diagnosis for fear of repercussions or discrimination.10 Despite facing some challenges, neurodiverse
professionals often bring valuable strengths to the operating theatre. Their contribution can be especially valuable when it comes to attention to detail, innovative thinking, (hyper)focus, and flexibility. Addressing those benefits can bring strengths
to the team. For example, the benefit of noticing details by neurodiverse professionals might be critical, especially for patient safety. Innovative thinking may improve the efficiency of the list or the effectiveness of the performed procedure. A unique cognitive perspective can guide creative problem-solving and enhance approaches to the surgery. Some surgeons with Autism, ADHD or OCD can concentrate better on the task and can accurately focus on the details that give patients better outcomes from surgery. There is very little literature that can confirm this outcome, which is borrowed from personal observation. Medical professionals with dyslexia, for example, can think ‘outside the box’ and may develop strong problem-solving skills. This is very effective in patient-centred care, innovative solutions and logistic challenges.11 In addition, in certain environments, individuals with ADHD report being able to demonstrate the ability to ‘hyperfocus’ – a state
of intense concentration. Catriona McVey, on behalf of the organisation ‘Attention Deficit Doctor’ also states that: “When you have ADHD, the brain’s decisions are driven by interest, and it is much more productive when it’s engaged in something enjoyable or new. This curiosity-driven information seeking is known as ‘deprivation curiosity’, and is associated with positive effects on learning, and may be positively selected for in medical school applicants. Later in a medical career, it can aid clinical reasoning and diagnosis.”12 In the paper: ‘Autistic doctors: overlooked
assets to medicine’, Moore et al, point out that: “Certain autistic traits are valued in doctors: attention to detail, excellent recall, and creative problem solving.”13
Facilitating effective communication For innovative approaches and effective communication in operating theatres, improving professionalism and trust with colleagues with neurodiverse diagnoses or symptoms is vital. It is important to provide training and education for all. Awareness of neurodiverse behaviours, perception of the situation and communication difficulties, need to be addressed and supported by management. One example of management support is simulation training that can improve orientation, assessment and action plans, not only for professionals with neurodiversity, but for all employees. Introduction of such simulation training exercises encourages discussion during the training. To facilitate a working environment, such as
an operating theatre, for sensory challenges, the implementation of regulated lights and controlling the noise can help improve surgery outcomes, with consideration of all team members’ requirements and agreement. When it comes to decompressing the noise in the operating theatre, as much as it would be great to have a quiet working environment, patient vital monitoring needs to be heard. Therefore, quiet zones for break time are required for all team members.
Communication is a lifelong journey for all medical professionals; acceptance of differences can only create a better working environment. Working in a multicultural and diverse team requires communication that is strategic and clear. That helps to prevent misunderstanding and conflicts and improves the patient hospital journey. Adapting specific communication and
advancing effectiveness can also be achieved by providing regular feedback or written notes. Neurodiverse professionals, with constructive feedback, can adjust their communication
to improve performance and find their full potential. Nevertheless, with strong advocacy and leadership, operating theatres should model the behaviour plan to actively support neurodivergent staff. This involves changing the perception of neurodivergent employees and building a culture of respect and understanding. Using technology and technical evolution, management could provide support groups that are accessible and easy to reach for professionals with ADHD, OCD, dyslexia and other neurodiverse diagnoses. The integration of neurodiverse professionals into operating theatres presents both challenges and opportunities. Effective communication is essential in a high-risk, pressured environment, and understanding the unique needs and strengths of neurodiverse team members will promote enhanced teamworking. By implementing targeted training and
environmental modification, communication strategies and supportive policies, healthcare organisations can create a more inclusive and effective operating theatre environment. Embracing diversity not only benefits neurodiverse professionals but also the entire team – ultimately leading to better patient care and innovative solutions in the field of surgery.CSJ
References 1. The Chartered Institute of Personnel and Development (2024). Accessed at:
www.cipd. org/uk/knowledge/guides/neuroinclusion- work/
2. The Chartered Institute of Personnel and Development.(2024). Creating a workplace for all types of thinkers.
https://www.cipd.org/uk/ knowledge/reports/neuroinclusion-at-work/
3. Resnick, A. (2023), Neurodiversity and What It Means to Be Neurodiverse. Accessed at:
www.verywellmind.com/what-is- neurodiversity-5193463
4. Psychology Today. Neurodiversity. Accessed at:
www.psychologytoday.com/us/basics/ neurodiversity
5. The Nursing and Midwifery Council. The Code of Practice (2018).
6. Royal College of Surgeons (2022). Good Surgical Practice.
https://www.rcseng.ac.uk/ standards-and-research/gsp/
7. Bach & Grand. (2015). Communication & Interpersonal Skills in Nursing. 3rd ed. Sage.
8. Norman K., (2019). Communication skills. For Nursing and Healthcare Students. Scion Publishing.
9. Nahid, N., Behzad, I. & Reza, K., (2021). Operating room nurses lived experience of occupational hazards: A phenomenological study. Perioperative care and operating Room Management, 25, 2021.
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