Behavior in the Operating Room JoAnne Dodson & KrisAnna Ham

Getting to know us

Objectives See the OR experience through the eyes of both a new grad and seasoned nurse See how behavior in the OR can both negatively and positively affect culture, nursing and patients Understand the consequences as well as rewards for the behavior Understand how to prevent and manage negative behaviors Understand how behavior in the OR ties into our ICARE values

Personal Experiences New graduate RN Loud music Mood swings Disrespectful communication Gossip New graduate RN Talking behind others backs He said; She said Communication in tense situations Breakroom Behavior

Impact on Culture Decreases communication Staff hesitant to speak up Bad Behavior Decreases communication Staff hesitant to speak up Increases tension Makes staff uncomfortable Decreases trust and respect among staff Creates a hostile and negative environment Good Behavior Increases communication Decreases tension Keeps the mood lighter Increases trust among staff Creates a happy and positive environment

Impact on Nursing Reluctant to go to work On auto-pilot Bad Behavior Reluctant to go to work On auto-pilot Focus on tension rather than patient Staff turnover Good Behavior Increased productivity Increased employee engagement Team based patient care

Impact on Patient Safety Bad Behavior Shifts attention from the patient to the person conducting the disruptive behavior Increases error rates Increases recovery time Increases patient morbidity and mortality Increases cost for the patient Increases the amount of time that the patient is under anesthesia Good Behavior Keeps the focus on the patient Improve efficiency Increase patient satisfaction

ICARE Values Integrity Compassion Accountability Respect Excellence *I was thinking this would be a good place to talk about care of patient in a hospital room versus in the operating room. We can link our conversation to the iCARE values (so we could just have pictures and remove the words.) Let me know what you think. I’m not married to these pictures either.

Negative Behavior Corrective Action Written Verbal Coaching Suspension Termination Citizenship Committee for physicians Counseling Chain of Command Consider System Redesign Speak up

Positive Behavior Points Employee of the Month Peer Recognition Incentive Program Rewards Employee of the Month Peer Recognition Huddles Recognition Board Bee Award Daisy Award Recognition - During 1:1 conversations with management, during morning huddles, recognition board.

What Can We Do? Suggested Actions Stand up to inappropriate behavior Talk to management Report the behavior Express zero tolerance for such behavior Do not encourage it - actively or passively Stay true to your duty of patient safety Use communication strategies

What Can We Do? Coping Strategies Talking to colleagues and management Coworkers can provide humor, stress relief and support Recognizing the cause of the behavior is often attributed to the surgeon or case Focusing on your own supporting role Reinforcing thoughts of self-worth Self Care Find an outlet outside of work

Questions? Attitudes are contagious. Is yours worth catching?