orm_february-2024 - 22

Leadership
Serving in the Navy OR
Starting in the Navy in 1983 as
a new graduate medical-surgical
nurse in Oakland, California, Brian
Dawson, MSN, RN-BC, CNOR,
CSSM, worked through the ranks
to oversee OR, preop, PACU, and
SPD operations at the Walter
Reed Military Medical Center in
Bethesda, Maryland.
He was the commanding officer
of a US Naval hospital in Okinawa,
Japan, the referral center for all military
hospitals in the Western Pacific. As a junior
officer in the early 1990s, he served
on the USS Guadalcanal off the coast of
Turkey, where the ship had been assigned
to support Kurds driven into that country by
Saddam Hussein. During Captain Dawson's
last 2 years in the Navy, he served the Navy
Surgeon General as chief of staff. In a Q&A,
he reminisced about his extensive career in
the Navy OR and how things have changed
during the last four decades.
Q: What types of patients did you serve in
the Navy? Were these only soldiers and retired
veterans, or were civilians in the mix?
When I was first in the military in the
1980s, we took care of active-duty members.
We took care of retirees. We took care
of the active-duty members' families. So,
we literally took care of everyone. We even
did trauma surgery in Oakland on civilians
because we were a trauma center.
In today's healthcare environment, we
care primarily for active-duty members and
their families. Occasionally services are
provided to retirees if they can't find it at
the VA or the local community. But most of
us retirees get our care in the civilian sector
through TRICARE, which is the healthcare
insurance for retirees and beneficiaries.
Q: What type of procedures did you do?
Were there any limitations on what procedures
you could perform?
We do almost every surgical procedure a
civilian hospital performs except for elective
abortions. But if a patient had a spontane22
OR
Manager | February 2024
ous abortion, or a death of a child,
then we did all the same procedures
that you would have done in
the community.
Brian
Dawson,
MSN, RN-BC,
CNOR, CSSM
Q: Were you seeing people mostly
for orthopedic work or heart surgery,
or was it a mix?
We didn't do a lot of heart surgeries
when I was in the military because
there weren't many heart surgeons.
There were only two heart programs that I
know of in the Navy. There might have been
one or two in the Army. But primarily it was
general surgery, orthopedics, spine surgery,
gynecology, urology, and all the basic surgical
specialties. Almost every specialty that
you would have in a civilian facility, we would
do in our facilities.
Most neurosurgery, complex spine, and
plastic and reconstructive surgical procedures
were done at very large military teaching
facilities, which today would be in Washington
DC, San Diego, and San Antonio.
Q: Can you discuss a rewarding experience
you had as an OR nurse working for
a Navy facility?
One of my most rewarding experiences was
as the commanding officer of the US Naval
Hospital in Okinawa. We were the only hospital
on the island of Okinawa for American
service members and their families, and all
the U.S. people who supported the military.
We had around 52,000 beneficiaries.
The best part was for people at town hall
meetings to tell me what great care they
received and the great service they experienced
from the staff. It was a great honor
to represent such a great healthcare team.
I can think of actual people who came
through our ORs or hospitals, whose lives
we saved, whose lives we improved-retirees
who had knee replacements, hip
replacements. The work that we did with
wounded warriors-not only to save their
lives, but also rebuild them physically and
psychologically-was worth the 28 years I
spent in the Navy. We truly impacted lives.
compasses general surgery, pediatric
general surgery, gynecology, plastics,
and urology. Bravo is all things orthopedics
(sports, totals, trauma, hand,
foot, pediatric spine, and tumor). Charlie
covers specialty services, ear-nosethroat,
vascular, oral and maxillofacial
surgery, and neurology.
The civilian OR nurses and both military
and civilian surgical technologists
providing each group of services take
orders from a division officer (DIVO).
" Leadership is instilled in nurse corps
officers from the minute you join the
Navy, " notes Sherrill.
OR nurses and lead techs for each
service are responsible for pull sheets,
equipment, instrument sets, and consumables.
Service leads work to build
relationships with the surgeons and any
other surgical technologists who work
in that service. " This model builds a cohesive
team that is beneficial to meeting
the needs of our patients, " Sherrill
says.
Multidisciplinary OR teams utilize
TEAMSTEPPs, a system that fosters
safer patient care through a teamwork
approach, using evidence-based
tools to improve outcomes. The Department
of Defense and the Agency
for Healthcare Research and Quality
(AHRQ) developed this program in 2003
to optimize performance of healthcare
professional teams by improving quality,
safety, and efficiency. The program
draws on more than 25 years of research
on teams and uses a curriculum
available online at no cost (www.ahrq.
gov/teamstepps/curriculum-materials.
html).
AHRQ in 2023 updated the program
to address recent changes in healthcare
learning methods and delivery,
as well as to more actively involve the
patient in their care. Health systems
that use TeamSTEPPS have reported
increases in the reporting of patient
concerns, enabling them to proactively
address any such issues.
www.ormanager.com
https://www.ahrq.gov/teamstepps-program/curriculum/index.html http://www.ormanager.com

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