Impaired or Disruptive Behavior Reporting (Interdisciplinary Healthcare Team)

Guidelines:

• Demeaning
• Throwing
• Pushing
• Yelling
• Avoiding protocols
  • Neutral zone
• Removes likelihood of“speaking up”
• Minimum input from staff
• Reporting
  • Leadership
  • State board
  • Legal

Considerations:

• Huddle before cases
• Anticipate needs
• Directly confront behavior
  • Factual statements
  • Appropriate time in case

Nurse’s role:

• Advocate for staff
• Documentation
• Advocate for patient
• Avoid inflammatory statements
  • “You always..”

Pitfalls:

• Emotional response
• Fire with fire
• Allowing mistreatment to continue
• Poor leadership
• Poor environment

Examples:

• Surgeon reputation for anger scheduled for today (huddle before cases, directly address standards and expectations, encourage open dialogue vs confrontational)

Linchpins (Key Points):

• Maintaining an environment of safety is critical to avoiding errors in the OR