The findings in this study suggest three different
levels at which perioperative nursing care and technology
interact in highly specialized ORs in public university
hospitals. This categorization of perioperative nursing into
levels is not new. In a quantitative, descriptive, correlational
study of perioperative nurses’ ability to think critically,
Fesler-Birch [3] calculated the average level of critical
thinking to be 2.12 on a scale of 1 to 4, in which 1 indicates
no critical thinking and 4 indicates complex critical
thinking. Because critical thinking may be central to
nurses’ ability to meet patients’ expectations regarding
care and skill, this average level of 2.12 can be costly
from a patient perspective, in that as intraoperative
problems arise, quick clinical judgment decision making
may weaken. Fesler-Birch’s study cannot be compared
to the present study in that the two were based on different
methodologies. However, a number of new questions
are raised when comparing one study to the other. For
example, could a correlation exist between perioperative
nursing at the failing interaction level, which is characterized
by nurses’ lack of self-reflection, and level 1 critical
thinking, which is characterized by the absence of critical
thinking? On the contrary, could a correlation exist between
perioperative nursing at the interaction level, which
is characterized by nurses’ self-reflection, and level 4 critical
thinking, which is characterized as complex? If so,
both the failing interaction level and level 1 critical thinking
can be costly from a patient perspective. Although
there is no solid basis for this conclusion, these questions
may inspire further research and discussion.