Dealing with Difficult Personalities in the OR
Simple, real-life tips to keep your cool and protect your patient.
The OR is full of strong opinions, fast decisions, and tight timelines. People get stressed. Voices get sharp. It happens. Your job is to keep the patient safe and the room moving—without losing yourself in the chaos.
Here’s a plain guide that works in real rooms with real people.
Ground rules to remember
- Patient first. Safety beats ego, every time.
- Be brief. Short, clear words land better under pressure.
- Use your inside voice. Calm is contagious.
- Name the plan. Facts and steps, not feelings and drama.
Quick scripts for tense moments
1) The snappy surgeon
What it sounds like: “Why isn’t this ready yet?”
Try this:
- “I hear you. We’re ready for Step 1 now: ____.”
- “Need X now or after trialing?” (Give a choice that moves things forward.)
- “Confirming: you want ____ next?”
Reset line if it keeps going:
- “Let’s keep it about the case. What do you want next?”
2) Anesthesia and you aren’t aligned
What it sounds like: “We’re not ready. Stop rushing.”
Try this:
- “Copy. What’s the blocker?”
- “What do you need from us to be ready?”
- “Let’s call it out: start after ____ is done.”
If the room is stuck:
- “Team huddle: timeline is ____. Tasks: ____, ____. Agreed?”
3) Scrub/tech gatekeeping info
What it sounds like: “That’s not how we do it.”
Try this:
- “Cool—show me your way. Then we’ll update the preference card.”
- “Let’s read the card together and fix it if needed.”
- “Can we put sizes on the field now and talk details later?”
4) Pushy rep
What it sounds like: “Open the next tray. You’ll need it.”
Try this:
- “Thanks. We’ll open when the surgeon confirms. Please hold.”
- “We’ll follow sterile and cost guidelines. Staying closed until ‘go’.”
5) Side comments or sarcasm
What it sounds like: eye rolls, jokes at your expense
Try this (short and neutral):
- “Let’s keep it professional.”
- “Not helpful—moving on.”
- “Focus on the plan, please.”
In the moment: your 4-step play
- Breathe once. In through the nose, slow out.
- State the fact. “We’re waiting on antibiotics at 07:42.”
- Ask for the next step. “Do you want the 10 blade or 15?”
- Close the loop. “Got it—10 blade now.”
If voices rise: “Team pause. Patient first. Here’s where we are: ____. Next is ____.”
After the case: clean it up fast
- Two-liner debrief: “In that case we got stuck at ____. Next time, let’s ____.”
- Update the card: Add sizes, timing, reps, and “pause” moments.
- Log the issue: Short note to charge/manager if it affected safety or culture.
When it’s a pattern (not a one-off)
- Track it: Dates, cases, exact words/actions. Keep it factual.
- Loop in leadership early: “We’ve had three repeats of ____. Asking for help to fix.”
- Offer a solution: Standard script, card update, or short huddle before wheels in.
When it crosses a line
- If it’s unsafe, stop. “Safety pause. This isn’t safe because ____.”
- If it’s abusive, name it and step out. “That language is not OK. I’m stepping out to get our charge nurse.”
- Use policy. Report through the set pathway. You’re not alone.
Keep yourself steady
- Personal rule: “I don’t match tone; I match the plan.”
- Body basics: water, snack, quick stretch between cases.
- Reset phrase (in your head): “Patient first. Next right step.”
- Find your people: a teammate to debrief with for 2 minutes. Then let it go.
Tiny habits that help a lot
- Start with a huddle. Call allergies, imaging, implants, “top two risks,” and who to call.
- Say times out loud. “Cefazolin 2g at 07:42.”
- Use read-backs. “Implant size, type, lot—confirmed.”
- Write it down now. Fix the card the same day.
Pocket phrases (copy/paste)
- “Help me understand the next step.”
- “Let’s stick to the facts.”
- “We can discuss style later; right now we need ____.”
- “What do you need from me to move forward?”
- “Safety pause—here’s the concern: ____.”
Bottom line
You don’t have to win an argument; you have to win the day for your patient. Keep it short, keep it steady, and keep it moving. Use clear words, simple steps, and the same calm tone—no matter who’s in the room. You’ve got this. 💪🩺
If you want, I can turn these scripts into a one-page printable you can hang at the core or share with new staff.
