How Perioperative Nurses Uphold Patient Dignity in the Operating Room
Perioperative nurses uphold patient dignity by maintaining privacy, using respectful communication, allowing patients to retain personal items and clothing until necessary, and ensuring the patient is treated as a person rather than a procedure. 1
Core Principles of Dignity Preservation
Respectful Communication and Identity
- Confirm and consistently use the patient's preferred name and pronouns at all times as a fundamental way of showing respect and decreasing psychological distress 1
- Make yourself known to the patient and maintain a compassionate presence throughout their perioperative journey 2
- Allocate adequate time for patient interaction, particularly with elderly patients who may require additional time to prepare themselves for surgery 1, 3
Privacy and Physical Protection
- Maintain the patient's privacy and dignity at all times through appropriate draping and limiting unnecessary exposure 1
- Shield the patient's body from unnecessary viewing by staff not directly involved in their care 4
- Ensure single-sex waiting areas when patients change into theatre gowns 1
- Protect the patient's intimate sphere by being mindful of conversations and actions around the unconscious or sedated patient 4
Preserving Normalcy and Autonomy
- Allow patients to remain in their street clothes for as long as possible before surgery to maintain dignity, warmth, and comfort 1
- Keep functional aids (glasses, hearing aids, dentures) in place until just before induction of anesthesia 1, 3
- Enable patients to walk to theatre and transfer themselves onto the operating trolley when possible 1
- Invite the patient to participate in their care decisions and keep them informed throughout the process 4
Practical Implementation Strategies
Pre-operative Phase
- Provide side rooms for patients requiring increased sensitivity or special needs 1
- Create processes for patients to privately and safely disclose personal information during pre-operative assessment 1
- Minimize fasting times to reduce patient discomfort and maintain dignity 1
Intra-operative Phase
- Confirm the patient as a person, not just a surgical case, by maintaining awareness of their humanity even when unconscious 5
- Avoid backbiting or inappropriate conversations about the patient during surgery 4
- Systematically plan and organize work to protect the patient from unnecessary risks 5
- Maintain appropriate temperature control, as hypothermia is associated with adverse outcomes including postoperative delirium and prolonged hospital stay 1, 3
Common Pitfalls to Avoid
Communication Failures
- Never discuss the patient in derogatory terms or engage in casual conversation that treats them as an object 4
- Avoid alienating the patient through impersonal or rushed interactions 4
- Do not share the patient's personal information (including transgender status or other sensitive details) beyond those directly involved in their care 1
Physical Dignity Violations
- Prevent unnecessary exposure of the patient's body during positioning, preparation, or procedures 4
- Avoid leaving patients exposed during transitions between care areas 1
Ethical Framework
The operating theatre nurse must always keep the patient in mind, balancing formal external responsibilities with personal ethical values 5. This means:
- Acting as the patient's advocate when they are most vulnerable and unable to speak for themselves 6
- Recognizing that preserved dignity is both an ethical and caring act that requires conscious attention 2
- Understanding that patients expect the same level of dignity and care regardless of age, gender identity, or other characteristics 1, 3
Professional Accountability
- Reflect on ethical dilemmas and use previous experiences to guide future practice 6
- Engage in discussion and reflection on dignity preservation both in educational settings and clinical practice 2
- Recognize that protecting patient dignity, autonomy, and confidentiality are fundamental nursing responsibilities 6