In this study, nurses at the interaction level combined
nursing care and technology with self-reflection and a
great understanding of the interdisciplinary team. Nursing
practice was characterized by flexibility and excellence
because the same nurse interacted with all three
modes of action [37] in that she managed all tasks in the
OR. Nurses at the declining interaction level prioritized
either the technical or the nursing care dimension, and
self-reflection was directed toward elements of the tasks
in the OR. A match between two different nurses in the
OR is required to ensure interaction among all three
modes of action. This limits the implementation of perioperative
nursing because the nurses cannot perform all
of the tasks in the OR. Nurses at the failing interaction
level lacked self-reflection and showed no interest in the
patient. New technological challenges were limited by
the nurses’ lack of technical skills. Nursing practice was
characterized by inflexibility and rigidity because the
nurses worked in isolation with limited collaboration
with the other staff members. This interpretation was
confirmed by Coe and Gould [43] and Finn [44], who
claimed that well-functioning interdisciplinary teamwork
is described as excellent. Thus, the present study’s findings
regarding flexible versus inflexible nursing practice
add to the discussion on generalist versus specialist
nurses [45], as well as to the discussion on seeing the
big picture in nursing, which indicates a desire to provide
good care to both patients and staff [46]. An individual
who fails to see the big picture might act rigidly,
rather than appropriately, resulting in blind action due
to mechanical and automatic thinking.