orm-orbmc_feb-2025 - 12

Navigating difficult conversations as a perioperative leader
STAFFING
erioperative leaders navigate
some of the most challenging
dynamics in healthcare. The
precision required in the OR coupled
with multidisciplinary teams and diverse
personalities often lead to missteps
or misunderstandings that can quickly
brew into conflict. Effective communication
is essential, particularly when
addressing behavior, managing team
dynamics, or delivering difficult news.
How to be comfortable leading diffiP
Brian
Dawson, MSN,
RN, CNOR, CSSM
cult conversations? How to confront toxicity
without alienating the entire team?
How to best navigate generational divides
in the fast-paced, high-pressure
environment of surgery? These were
just some of the questions posed during
the panel, " Managing difficult conversations-How
to respond effectively
to your team, " held at the 2024 OR
Manager Conference in Las Vegas.
The three panelists were:
* Brian Dawson, MSN, RN, CNOR,
CSSM, CEO and president of BD Perioperative
& Healthcare Consulting,
LLC and former system VP of perioperative
services at CommonSpirit
Health
* Cindy Hess, MSN, RN, FNP-C,
CNAMB, director of nursing at Northeast
Missouri Ambulatory Surgery
Center
* Vikram Tiwari, PhD, professor of anesthesiology,
biomedical informatics,
biostatistics, management, and senior
director of surgical analytics at
Vanderbilt University Medical Center
and Vanderbilt University.
Drawing on decades of combined experience
across different areas and facilities,
these seasoned leaders shared
practical approaches and field-tested
strategies to navigate difficult conversations
while maintaining team morale,
ensuring professionalism and empathy,
and prioritizing patient safety.
Q: Describe a difficult
conversation or dynamic and
how you handled it.
12
OR Manager | ORBMC Show Issue
Cindy Hess, MSN, RN,
FNP-C, CNAMB
Vikram Tiwari,
PhD
" I try to drive
home that
they belong to
something bigger,
and when they
perform at the
top of their game,
everyone benefits. "
-Vikram Tiwari, PhD
Dawson: One case involved an SPD
[sterile processing department] technician
whose performance repeatedly fell
below expectations. As a leader, I try
to exhaust all options before making
decisions that impact someone's employment.
With this individual, I initiated
several meetings involving union representatives
and direct supervisors to provide
clear feedback and set measurable
goals. Despite extensive remediation efforts,
the performance did not improve.
I ultimately facilitated his transition to
another department, thinking he might
succeed elsewhere. Throughout the process,
my focus was on fairness and
support. I never have these conversations
alone or while angry. Instead, I
think how I'd want it handled if I were in
their position. Staying calm, collaborative,
and transparent are key elements
of my general approach.
Tiwari: A difficult situation I faced
involved an employee who repeatedly
made inappropriate comments, causing
discomfort among colleagues. At first,
the staff member most affected hesitated
to report the behavior formally,
fearing it would escalate into an HR
[human resources] issue. I took a twotiered
approach. First, I addressed the
issue informally with the employee's
supervisor to prompt a change in the
problematic behavior. When that failed,
HR became involved, and we made the
tough decision to terminate the employee.
This case taught me two lessons:
Leaders must act decisively when
behavior jeopardizes workplace culture,
and providing a safe, judgment-free
space for employees to voice concerns
is essential for resolving conflicts early.
Hess: There was a question from the
audience. Someone mentioned receiving
repeated complaints about a manager
with military background in charge
of clinical education, and how some of
the student nurses were feeling anxious
and unsupported during the too-rigorous
training. They [audience member] held
several one-on-one conversations with
that manager, outlined specific concerns,
and saw promising changes at
first. But that manager eventually fell
back on old habits. I think sitting down
to directly address the communication
style issue was the right approach,
even if it didn't work long-term. I'd establish
regular check-ins with that manager
and find a balance between direct
feedback and ongoing support to drive
lasting change. I work at an ASC [ambulatory
surgery center], and we don't
have HR. I wasn't given the tools or the
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BY TARSILLA MOURA
http://www.ormanager.com
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