CONFLICT RESOLUTION IN THE OPERATING ROOM

The aspect of management that most OR directors find least desirable is their role in dealing with OR conflicts. Individuals who attempt to circumvent the established OR policies and rules to gain advantages for themselves may create a dysfunctional system and generalized dissatisfaction among the OR staff.^[47] The first step in controlling this behavior is to have clear-cut and widely available policies on OR performance. Scheduling rules, presence in the OR, chart requirements, and physical presence for care are examples of issues that need to be well understood. When a new physician or nurse joins the OR, a policy and procedures manual should be provided to them so they know what the expectations are.

Another issue that the OR director may encounter is not merely someone who does not follow policies, but someone who is disruptive. The OR is an environment of high intensity and frequently high stress. For this reason, the OR represents one of the most common sites for disruptive physician behavior. It is imperative that the OR be a professional environment where mutual respect for all parties is maintained. This is especially critical during periods of OR nursing shortages when staff retention is vital for maintaining coverage of nursing shifts.

The first step in controlling disruptive behavior is to have a clear hospital-wide policy on this issue. Definitive steps

Figure 86-4 Improved schedule utilization.