Reading in the Operating Room

The observation that some anesthetists were observed to read journals or books casually during patient care^[344] led to a vigorous debate of the appropriateness of such an activity.^[133] Although it is indisputable that reading can distract attention from patient care, there are no data at present to determine the degree to which reading does distract attention, especially if the practice is confined to low-workload portions of a case. Furthermore, many anesthetists pointed out that reading as a distraction is not necessarily any different from many other kinds of activities not related to patient care that are routinely accepted, such as idle conversation among personnel.^[131] Many comments about the issue were related not to the actual vigilance decrement induced by reading, but rather to the impact of the negative perception of the practice (and of those who do it) by surgeons, and by patients (if they were aware of it).

A noted researcher on human performance in anesthesia, Matt Weinger, was asked to comment on the practice of reading in the OR.^{[345] [346]} He pointed out that reading can combat boredom, which can be a significant distractor in its own right. He concluded that in the absence of data specifically on the topic, it is unscientific to condemn the practice outright, but that reading—like all other distractions—should not be allowed to impair vigilance and patient care.

In our training course on anesthesia crew resource management (CRM), we teach that the anesthetist is responsible for modulating all controllable distractions—for example, allowing music during routine work (if all agree) but eliminating it when the situation becomes complex or urgent. Similarly, although our own institutions do not have a policy against reading in the OR (or against casual conversation for that matter), we do expect the anesthetist to terminate all incidental activities when necessary and to have a very low threshold for abandoning potential distractions.