Dealing with conflict in the OR

[lux libertas]

I'm a new grad looking for work in an operating room. I recently had an interview for an OR position that went well (I ended up being offered the job), but I didn't like how one of the questions went and I'm wondering if anyone can share their insight.

I was asked what I would do if I was working as a circulating nurse and I observed a surgeon breaking sterile or I observed that the patient's positioning was unsafe yet the attending surgeon insisted on moving forwards with the case. My response was that I would alert the team of the issue, delay the surgery, and correct the issue to ensure patient safety. I followed this up by saying if the surgeon disagreed with holding the surgery I would re-assert that the surgery needed to be put on hold, call the nurse manger or anesthesia provider for backup, and document the incident.

There's a possibility that I misread my interviewer but I thought they didn't seem satisfied with this answer, but they didn't clarify what kind of an answer they were looking for. Is there something I should have said differently? How are these conflicts resolved in real life?

[WhoDatWhoDare, BSN, RN]

I think they really wanted to know if you could speak up, not necessarily what the protocol is in that event. As far as delaying the procedure, most surgeons would be angry if you had to tear down the drapes because of this, but they know the importance of maintaining your sterile field, so they will reluctantly support this, depending on the type of case, e.g. contaminated/infected case like an I&D vs clean case with risk for infection like a CABG... by the way, patient is in the OR, so not really a putting a surgery on hold. Your start time (time of incision) just isn't as quick as everyone in the room would like.

Congrats on the job offer.

[lux libertas]

Thanks for the insight. You're right, it makes more sense to use that question to get a feel for a person's ability to be assertive than quiz someone who's never worked in the OR on a protocol.

[ggoodman]

thats along the lines of what I would do any doc worth his salt will hold positioning and sterility as important as you should.