Page 14 - CASA Bulletin of Anesthesiology 2019 Issue 1

CASA Bulletin of Anesthesiology
better relay their needs. Most CASA members received medical education with inadequately cultivated professionalism before undergoing residency training in the US. We tend to less fully understand the surgeon’s religious and cultural background, social connection and hobby. Because the English is not our mother tongue, it creates a barrier which makes our argument less constructive in explaining to the surgeon in a clear way, particularly under an urgent and conflicting circumstance. Instead, inappropriate nonverbal expressions may be used, further complicating and potentially worsening the situation. Therefore, good communication skills are essential to avoiding and resolving OR conflicts. Some misunderstandings and arguments can be resolved by simply adding a bit of humor to the exchange. If a verbal confrontation occurs, an explanation or apology can be worked out via a private setting after the operation concludes. Even a complaint, if appropriate, can be filed to the administration for consideration later.
Secondly, it is crucial to have mutual respect. Lack of recognition of and failure in appreciation of the anesthesiologist’s role by the surgeon, as well as poor social interaction with the patient, could lower the anesthesiologist’s self-esteem. Furthermore, some patients disregard the anesthesiologist’s instructions and are wholly unaware of the anesthesiologist’s vital role
in the care. All of these factors eventually cause frustration and can possibly trigger a conflict between anesthesiologist and surgeon. It is important that both parties understand and respect each other’s role in the OR. Egos must be set aside before entering the OR. Any bad-mouthing, derogatory or sharp remarks behind the other party when he or she is not in the OR should be avoided.
Next, getting to know each other can help limit potential conflict. The first communication of the day between anesthesiologist and surgeon should never be, “The blood pressure is too low or patient’s blood sugar is too high”. Developing a warm rapport is crucial in evolving
a relationship. Being aware of the surgeon’s hobbies can be a starting point in engaging the surgeon in friendly conversation before developing a comfortable level of communication. For example, it may be a good idea of sharing with the surgeon your good weekend golfing rounds on Monday morning if the surgeon is a golfer. This way, a BBB-like (blood brain barrier) “mental drape” between two parties is avoided: on one side is the mindful anesthesiologist, and on the other side, the bloody surgeon. Potential OR issues, whether before or during the surgical procedure, can then be discussed together without fear of misunderstanding. The more comfortable we are with the surgeon, the more likely everyone will freely address the thoughts and concerns about the surgery in an open manner. Knowing some personal aspects of a surgeon’s life outside the OR; such as their family, kids, hobbies, etc., will develop a comfort level that will help build a good professional relationship. A lifelong friendship may even develop that further helps foster open communication and cordial behavior in the OR.
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