There are several types of bullying found in the operating room on a daily basis. We will discuss four of the most common types of bully present in the OR. Some of these behaviors may be warranted due to the strange nature of the operating room.
Bullying may be hard to define in an operating room. Sometimes it is hard to determine if people are bullying or just doing their job. The OR can be a harsh place. We care more about patient safety than we care about co-worker’s feelings. People may perceive they are being bullied when they are merely being corrected.
Bullying consists of many negative behaviors. In the operating room these behaviors are often displayed as unreasonable scrutiny of work, verbal aggression, withholding information and excessive criticism.
These four reasons work together to make bullying an everyday occurrence in the OR. Most of the bullying in the OR consists of one or more of these behaviors. But, because of the way the operating room works, one or two of these behaviors may be warranted.
Unreasonable Scrutiny of Work
An unreasonable scrutiny of the work performed by another member of the OR team may lead to excessive criticism. However, scrutiny of work is very common in the operating room, as It is each team member’s job to watch over the actions of others. Operating rooms are in a state of continuously watching what you and each other are doing.
In the operating room you are taught to never trust anyone until they prove themselves trustworthy. Unlike America, in the OR you are guilty until proven innocent. Whether you are new to the operating room, or just new to the facility, all of your co-workers are going to place you under microscopic examination concerning your aseptic technique.
Every person is put under this excruciating monitoring by the other team members. However, this is not always considered bullying in an operating room. This monitoring is just expected behavior and performing due diligence. Any deviance from the policies and procedures will get the new person a public dressing down. This is not bullying, but it can cross the line into bullying. It is the frequency and duration of these actions that tell whether or not it is bullying.
Verbal aggression is probably the most common type of bullying that occurs in an operating room. This aggression may be found anywhere. It is common behavior both between peers and between surgeons and nurses and techs. Verbal aggression may also come from your supervisors, housekeepers and x-ray techs, to name just a few.
I do not think verbal aggression is ever justified, unlike some of these others. Verbal aggression often consists of attacking an individual on a personal level. In the operating room I think most verbal aggressions are of this type. I have been on the receiving end of verbal abuse more times than I can remember.
The OR is a jealous place. Between staff members this jealousy may show up as withholding information. I have seen this occur multiple times in the operating room and it is never warranted. One staff member enjoys being a favorite of a specific surgeon. They do not update preference cards or share information with other staff members because they do not want to lose their standing with the surgeon.
The people who do this think it makes them seem smarter to the surgeon in question. Only they know what the surgeon needs, only they can help correctly and only they are paying attention. The same people who withhold information may misrepresent and malign others while at the OR table when no one can overhear, due to this same jealousy.
Excessive criticism is another bullying technique encountered in the operating room. A tech may criticize the nurse for how they do the prep in every. single. case. A surgeon may criticize the tech every case for not loading the stick tie correctly.
These behaviors may happen between two people or between two groups or between a group and an individual. Often one clique decides they do not like an individual. The group will each individually criticize an individual for the same perceived lack of skill or knowledge. This may lead to an individual being criticized every case, every day; also known as bullying.
If the lack of skill or knowledge is real and not just perceived, excessive criticism may be justified. If a member of an OR continually makes the same or similar mistakes it will need to be called to their attention. They may feel as if they are being criticized unreasonably. Actually others are trying to teach them the correct way.
Bullying in the OR
Bullying in the operating room happens often. Most facilities include workplace violence as one of their yearly competencies. Bullying falls into this category. Until we decide to conquer this problem on all levels it will persist.