Portal de Periódicos da CAPES

Medicine in small doses

2017; Wiley; Volume: 87; Issue: 11 Linguagem: Inglês

10.1111/ans.14226

1445-2197

Bruce P. Waxman,

Hospital Admissions and Outcomes

‘You may be a bully, too! Look in the mirror and reflect on how others perceive your behaviour’ I was sitting at my desk in my Chief of Surgery's office, opening my mail, when I came across one marked, with the hospital letterhead, ‘private and confidential’. Thinking it was just another complaint, I opened it and developed that recognizable tachycardia of anxiety as I read the letter, addressed to me, and signed by 14 nurses from the operating theatre, complaining about my behaviour in the operating theatre, specifically my bullying. The accusations were that during some operations I would raise my hands in the air and say, ‘I've done this operation a hundred times and you still can't get the instruments right!’. The second accusation was that when my mobile phone went off, I would yell at the nurse who answered it ‘who's on the end of the phone? Make sure they leave a message!’. My initial reaction to this letter was denial. How could it be me? And how could these minor, non-physical acts be of any consequence, or even perceived as bullying? It wasn't as though I was throwing instruments. The nurses in theatre seem to like me and ask me to be Father Xmas and the Easter bunny and give out presents. How could I be a bully? I had to reflect. And on reflection I realized, when I looked in the mirror and at the definition of a bully, the accusations were quite correct. It was bullying. I was in a position of power, I was belittling the nursing staff, I was demonstrating anger, it was repeated and though not of a physical nature my behaviour was not acceptable and had affected their mental status and made it uncomfortable for them to be in the operating theatre in my presence. Eventually, I came to realize that this was poor behaviour and that I was neither setting a good example for my junior colleagues, nor for my own self-esteem. Moreover, I needed to attend a potential disciplinary meeting, conducted by my boss, the Director of the Surgery Program, with the Nurse Unit Manager of the Operating Theatre and a representative from Human Resources, in which I faced these allegations and consequently, needed to work out how I would react. Fortunately, I have enough humility and insight to accept that what I did was incorrect and suggested, off my own bat, that I should go and have anger management, see a psychologist. As it turned out, I did and he attempted hypnosis, which did not quite work, but it made me realize that I needed to change my behaviour. And be more controlled when I had the urge to explode. I must say the nursing staff were also understanding, in that they were prepared to look at my ‘FAD’ cards, and to check indeed what instruments I had been using over the last ‘hundred times’. Now, this occurred some years ago and I have used my experience since, as an example in many of the professional development courses I have directed. It is of relevance to my current role as a medical administrator counselling doctors, mainly surgeons, for whom I have responsibility, and I found it very useful in illustrating to them that even a senior surgeon needs to demonstrate humility and insight. Probably, the most important consequence of this experience is that it has taught me how to be self-reflective and how to encourage other medical practitioners to look in the mirror. See how other people perceive you, how other people see your behaviour and, to say to oneself, how can I change my behaviour? Are there ways in which I can improve, control my anger, be more understanding and demonstrate greater empathy? I am also a great supporter of the RACS Let’s Operate with Respect campaign which targets bullying, discrimination and sexual harassment via a range of avenues including a new mandatory training module. The Operating with Respect (OWR) online module aims to improve surgeon's knowledge of unacceptable behaviours and the impact these have on individuals, team performance and, most importantly, patient safety. It is mandatory for Fellows, Trainees and IMGs, and is a requirement of the College's Continuing Professional Development (CPD) Program for 2017. Approximately 60% of these members of RACS have already completed the OWR module, and feedback from participants is showing that the module is hitting the mark. The OWR module takes 45 min to complete with a secure log in for RACS members. A demonstration slide show of the module with videos can be accessed at: https://www.surgeons.org/about-respect/what-you-can-do/operating-with-respect-demo-version/ So, you might be a bully, too? You may need to be self-reflective, look in the mirror, recognize how others perceive your behaviour, but also transfer that clear and important message to others over whom you have responsibility, it may be a colleague!