Conference Proceedings - School of Nursing & Midwifery - Trinity ...

School of Nursing & Midwifery, Trinity College Dublin: 8 th Annual Interdisciplinary Research Conference
Transforming Healthcare Through Research, Education & Technology: 7 th – 9 th November 2007
Conference Proceedings
“I think they kind of use you as their scapegoat, you
know? You’re there, like, you know, I will use a spine case for
example. I had this happen before, a surgeon couldn’t get
the screws in right. And, then all of a sudden, everybody in
the room’s getting yelled at because he’s frustrated, a case
isn’t going right, you know, so, he’s got to yell at somebody
and take it out on somebody, so there we are.”
“It’s frustrating. You know, when I first got into
nursing, it was really hard for me. Because I’m like, hey, I
didn’t do anything wrong, why am I getting yelled at? And
over the years, I guess I’ve just grown accustomed to it.”
“And that’s just because when we do our time outs
either the doctors make a joke about it and, you know,
they’re just like, ‘Okay’ or they just ignore you completely and
then they don’t observe that and the same with the counts.”
“Maybe they have that attitude going into med school
that I’m a physician and you’re an RN, and I’m above you . . .
I see it with some of the older ones, the ones that have been
around for a long time, the ones that started back in the day
when it was ‘I’m the physician, you’re the RN, end of
discussion. I am better than you.’ I see some of the newer
ones coming in that look at everybody as equal, . . .”
“I think, part of it is changing the culture, and it’s
coming. It’s progressing . . . the older physicians and the
newer physicians . . .”
In these responses each participant has a unique story yet there is
a common thread which reflects a dominating and at times
disruptive type of relationship between the team member and the
physicians. The stories reflect the notion that there are unwanted
repetitive patterns (URPs) in communication which lead to
ineffective team partnerships in an atmosphere where we are trying
to establish open and respectful communication.
Unwanted repetitive patterns (URPs). Thus, the URPs can
perpetuate ineffective communication interactions. To elaborate the
URPs help to define the disruptive communication patterns, and
URPs have the potential to develop into strange loops of
communication (Pearce, in press). The participants describe the
operating room as an atmosphere of hierarchy that can perpetuate
intimidation and avoidance. It is the intimidation and avoidance
within the context of conversations that perpetuate the unwanted
repetitive patterns. In this type of constrictive and suppressive
communication atmosphere there are usually many untold,
unknown, unheard and untellable stories such that these stories are
buried within the constraints of the hierarchal communication
environment. Therefore, the voices that are considered to be of
lesser importance within this hierarchy such as the nurses,
technologist and non-clinical personnel do not have a chance to
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