Incivility in Surgery

Hospitals and medical centers are increasingly beginning to appreciate that disruptive behavior in the operating room (OR) is a problem deserving of serious attention. The costs associated with incivility in the OR can be substantial, oftentimes leading to increased staff sick days and decreased nursing retention, both of which are associated with medication errors. Exposure to incivility among surgeons often begins in their formative years. Frequently, perpetrators of belittlement or harassment are residents, fellows, and clinical professors, the same people who serve as role models for the next generation of physicians. The Perils of Incivility in Surgery Incivility can lead to social isolation or exclusion, the devaluation of someone else’s work, verbal threats, and even physical confrontations. Furthermore, research shows that rude behavior is bad for both mental and physical health. Conversely, other studies have demonstrated that civil behavior within the workplace can lead to a “helper’s high,” in which others in the OR feel empowered and contribute to improving outcomes in the patients they treat. The challenge for those entrusted with teaching the next generation of surgeons is to nurture the important surgical traits of ego strength, confidence, focus, work ethic, and dedication without forgetting the need to be committed to being civil to each other. Surgeons are people in the position of power who are typically hired on the basis of their knowledge, training, and technical accomplishments. ORs, however, are social environments where everyone must work together for the patients’ benefit. Fostering Civility in Surgery To establish a positive OR culture, increased emphasis should be placed on non-technical skills, such as leadership, communication, teamwork, and situational awareness....