Eva Kučková: Surgery is pure teamwork
Written by: Jasna Sýkorová
Photo: Vladimír Weiss
Eva Kučková, the right hand of well-known
surgeon Pavel Pafko, is a "textbook" head nurse. She
strikes a balance between the needs of patients, doctors, and
other personnel, all the while strictly observing budgetary pressures.
More than twenty years ago you started working as an ordinary
nurse at Surgical Clinic III. You led a station, and you are now
the head nurse. What is the difference between running a small
team in one department and running the large team of an entire
The size of the team is very important. It's easy to run a ward
with six nurses and one station head, because after some time a
cohesive team that communicates well is formed. The larger the
team, the more anonymous and the harder to run it becomes. Although
I'm currently responsible for about 90 nurses, I try to stay in
daily contact with the entire clinic, to make my rounds of all
the wards every morning, and try to ascertain what's new. I try
to remember all the girls' names and to speak with them directly.
It's paid off many times - when people know each other they react
far better to unusual situations, and they're more willing to help
each other out.
Is there any difference between running a purely female team and
running a mixed team? Why are there so few male nurses in this
I don't see any big differences, there are just minor details.
Men bring a better atmosphere to a team. They don't make snide
comments, they'd rather straighten things out among themselves;
while sometimes female nurses get envious and jealous of each other.
Unfortunately, we have only three male nurses here. True, they
aren't as conscientious about cleaning as female nurses are, but
they're irreplaceable where heavy physical work is required. And
why do so few men enter this profession? I attribute it to the
low pay nurses get. You could similarly ask why there's only one
male teacher for every ten female teachers. This is a type of work
that can be done solely for love, not for money. That provides
the general motivation.
Do you have any influence over who is accepted, and what are your
requirements for applicants?
I have a completely free hand when choosing people, yet the criteria
often depend on the situation. If I don't have enough nurses I
try to accept nearly anyone. In ideal conditions I choose girls
who don't wait to be assigned work, who take a more active approach.
Together with the station nurses I've discovered that class valedictorians
aren't as good as average students when it comes to actual work,
because the average students are generally more skillful and practical.
So when I'm interviewing a nurse I ask her how she did in school,
and this influences my decision.
Professor Pafko, the clinic chief who became famous as a pioneer
in lung transplants in the Czech Republic, is your direct superior.
What is it like to be in the middle - the nurses' supervisor and
Pafko's subordinate? Are there any conflicts or misunderstandings
Definitely not. Professor Pafko is a boss who is well aware that
a doctor can't exist without nurses. He knows that surgery is pure
teamwork and that no individual can accomplish anything without
the support of the others. So he places great emphasis on mutual
communication. He's open to discussions, and I can turn to him
about anything. That's because we're united in a common goal -
satisfied patients and personnel.
In 1997 Professor Pafko's team started doing lung transplants.
Could you tell us how such transplants are coordinated?
A transplant operation, in which at least twenty people take part,
has to be done very quickly, because the removed organ must be
used within a few hours. During its transport the operating room
is being readied and the transplant team is being assembled. The
moment the organ arrives the patient must be ready for surgery;
this means that both the patient and the doctors must be reachable
by mobile phone anywhere, at any time. Coordination is very demanding
on the psyche, and if someone can't handle the situation we have
problems. Fortunately we've always been able to coordinate the
procedure, and we are subjected to less and less stress. At the
end the feelings of joy and satisfaction rule, when we see that
we've been able to restore someone to life.
||graduated from nursing
vocational high school and began working as a nurse at
Surgical Clinic III
in anaesthesiology/resuscitation, began working in the
||became a head station
nurse at Surgical Clinic III
the urging of Professor Pafko and his colleagues, accepted
post of head nurse; became a participant in the organization
of lung transplants
||studying for her bachelor's degree
in nursing while holding down her job
A doctor usually spends a few minutes with a patient when he makes
his rounds, while a nurse stays in constant contact. Is it possible
to prevent sensitive emotional ties between personnel and patients?
Although we organize lectures on this theme to help nurses handle
crisis situations, I can't deny that strong emotional pressures
pose problems. I knew the first transplant patients personally,
and I didn't resist forming emotional ties with them. Unfortunately,
some of them have already died, and this has been very hard on
the nurses. It took them a long time to get over these deaths.
Now they know that they should be nice to patients, but should
keep a professional distance from them.
Do you know about any of your managerial weaknesses?
Sometimes I make a decision that I later regret, and I see this
as a weakness. I think that if a person makes his maximal effort
he can never be 100% fair. I would like to find the strength
in myself to praise people who work well and to call people who
perform poorly to task, and to stand by my position and not hesitate.
In addition I try not to bring my personal problems to work.
I don't want anyone to suffer because I'm tired or stressed out.
What is the hardest part of managing your personnel?
It's definitely the ongoing search for balance between providing
appropriate patient care and the nurses' needs. In short, it's
about money. If we had more of it we'd have enough nurses. The
way it is now, we're always looking for ways to save, and we
can't afford to hire even one more person.
You're currently studying for your bachelor's degree in nursing
at the medical school. Why is ongoing education so important to
I want to be able to answer my nurses' questions concerning patient
treatment, or at least to know where to find the information. It's
clear - a person who leads others should be well versed.