NOVEMBER 2006, VOL 84, NO 5 • AORN JOURNAL • 811 Alvisa Palese, RN; Stefania Infanti, RN D uring an awake craniotomy pro- cedure, a patient is conscious during the middle portion of the procedure after the surgeon has exposed the cortical surface of the brain. This al- lows the surgeon to directly or indirectly monitor and map the neurological func- tions that correspond to the locations on the cerebral cortex that are being electri- cally stimulated. After mapping the nec- essary areas with the cooperation of the patient, who actively responds to oral in- structions (eg, “move a finger,” “count from one to 10”), the neurosurgeon can proceed to remove a tumor while simul- taneously protecting the areas that sur- round it. In this way, it is possible to limit or prevent postoperative deficits. 1,2 This function-controlled neurosurgi- cal procedure can be conducted in one of two ways. A patient who is fully anes- thetized with a general anesthetic can be awakened during the mapping phase of the procedure and then anesthetized again. Alternatively, the patient can be consciously sedated so that he or she is protected from pain, but in a state from which he or she can be awakened. After the patient is awake, the surgeon can perform the mapping and then anes- thetize the patient for the remainder of the procedure. Awake craniotomy is a widely ac- cepted technique with successful out- comes, and patients have been shown to cope well with the experience; 3-5 howev- er, the experiences of the theatre nurses in attendance at these procedures have never been reported. One of the authors, Stefania Infanti, has been an instrument nurse (ie, a scrub person) for awake craniotomy procedures and has experi- enced the emotional and technical diffi- culties associated with the procedure. We therefore sought to examine how nurses feel about this complex surgery, which is performed on a patient who is conscious, and for which the results significantly de- pend on the patient’s cooperation. METHODS The aim of this study was to investi- gate the experiences of nurses involved in the intraoperative care of patients under- going awake craniotomy surgery. To cap- ture the essence of this situation, a phe- nomenological study was conducted using the Husserlian perspective. Accord- ing to the theories of Edmund Husserl, a German philosopher born in 1859, phe- nomenology is the universal underpin- ning of both philosophy and science. 6 Phenomenology is the study of human experiences, irrespective of any objective- subjective distinctions. 7 Phenomenology © AORN, Inc, 2006 The Experiences of Nurses Who Participate In Awake Craniotomy Procedures • AN AWAKE CRANIOTOMY is a unique neuro- surgical procedure in which the patient is con- scious during part of the procedure. • LITTLE HAS BEEN DOCUMENTED about how instrument nurses (ie, scrub persons) react to this complex procedure and to the tasks of caring for a conscious patient. • A PHENOMENOLOGICAL investigation was conducted to document the experiences of nine in- strument nurses. • THE NURSES WERE CHALLENGED by having to manage the conscious presence of the patient, they placed great importance on controlling the sur- gical situation, and they reported that participating in this procedure had a compelling emotional effect on them. AORN J 84 (November 2006) 811-826. © AORN, Inc, 2006. ABSTRACT