Do nurses run the hospital?

Professor Frits van Merode had already said it to me in the early days of my PhD research: hospitals are actually run by nurses. I think his statement did not fully hit me or maybe in my subconscience I thought it was one of those things that is also said about ‘the wife behind the man’. Something true, a nice statement, well said, but uh, what about it.

But now the social networks of how tasks for OR patients are performed have been finalized, I see much more clearly what he meant: nurses are the glue in the hospital network. As an example below you see the network position and connections of one anesthetic nurse. The network shown here includes all interaction links between persons (nodes in this network) who are involved in patient surgery, from the outpatient or emergency department where patients are admitted to hospital discharge. The red lines are all connections that one Nurse Anesthetist has.ANNU

This Nurse Anesthetist has interactions with 390 other agents  for performing tasks for surgery patients. All Nurse Anesthetists have a central position in the network, as shown by the central position in the network figure. Besides assisting the Anesthesiologist in surgeries, they call the nurses in the wards to tell them to administer premedication to the patient, then they ask the nurses to take the patient to the holding. From the holding until the recovery the Nurse Anesthetist accompanies the patient along the way and with each transfer (from holding to OR, from OR to recovery) the Nurse Anesthetist makes sure all relevant information is transferred. In the OR they stay with the patient and the Nurse Anesthetist is the eyes and ears of the Anesthesiologist, who serves multiple operating rooms at the same time. And just in case anyone wonders: the 19 Nurse Anesthetists in this hospital are both male and female.

There are other nurses as well: operating room, recovery, holding and ward nurses. A total of almost 400 nurses in this hospital take care of surgery patients, and they all perform logistical, communication and coordination tasks along side with patient care.


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