Surgeon’s stressful procedure no excuse

Doctors often face stressful situations and sometimes these can get the best of the most dedicated doctor, with colleagues often in the firing line. Knowing how to handle stress and manage these situations can avoid the problem growing.

In a case, a cardiothoracic surgeon found himself in this situation when facing allegations of bullying and disrespectful behaviour towards his colleagues, during a surgical procedure.

It was claimed the surgeon made repeated and ongoing comments to a registered nurse while performing the surgery, which had been perceived as disrespectful and bullying. The allegations also centred on the surgeon’s failure to comply with the Medical Board of Australia’s Code of Conduct when he was disrespectful towards other operating theatre staff. This included using profanities and raising his voice.

The hospital undertook an investigation and found the allegations were substantiated. The surgeon filed a public service appeal against the decision and the case was heard by the state’s industrial relations tribunal.

Surgeon’s claims

The surgeon largely conceded he made the comments, but argued the procedure was complex, and the stressful situation mitigated his conduct.

The Commissioner accepted the occupation of a heart surgeon is one of the most stressful occupations, and the stakes on a day-to-day basis are “literally life and death”. It was noted the surgeon displayed a deep concern for patient welfare and a strong commitment to putting patient safety above all else.

The Commissioner appreciated the procedure was extremely complex and produced significant levels of stress for the surgeon, notwithstanding his many years of experience and expertise. He also recognised how a stressful environment might prompt such statements from even a seasoned professional.

However, while it was found the surgeon was a highly skilled and experienced professional, and pressure was part of his daily life, he should have been at a point in his career where he could manage his reaction to stress. The Commissioner said the surgeon cannot use the pressure of his working environment as an excuse to denigrate colleagues.

It was accepted the surgeon did not intend to cause offence and was genuinely contrite for any upset he caused. However, this only mitigated his conduct and was not an excuse or defence.

Decision fair and reasonable

The tribunal accepted there were significant mitigating circumstances, notably the stress the surgeon was under while performing the surgery. However, it found the hospital’s decision to substantiate the allegations was “fair and reasonable”.

The employer’s proposed penalty to reprimand the surgeon was the lowest sanction capable of being imposed, indicating they had considered these mitigating circumstances.

Confronting the root cause

It’s easy to get caught up in the pressure of work but identifying the ‘real’ source of your stress and managing your reaction to stressors is key.

Whether it’s a stressful surgery or a demanding patient that leads you to lose your cool, really figuring out what the root cause is and making changes, is the first step. Then, by recognising your stress triggers, you can find better ways to deal with stressful situations.

This could involve taking a short pause to calm down, listening and trying to understand the other person’s point of view or delegating duties or talking to someone you trust if you feel overburdened.

It goes without saying, that respect is a cornerstone of good medical practice and doctors have a duty to comply with the Medical Board’s Code of Conduct, which emphasises there is no place for discrimination (including racism), bullying and sexual harassment in the medical profession or in healthcare in Australia.

Courteous, clear and prompt communication with other healthcare professionals will not only foster good working relationships, but also lead to better patient outcomes.

If you find yourself in a similar situation, apologise for your behaviour immediately and reassure the team it will not happen again. Prioritise making changes to manage your stress and contact Avant’s Personal Support Program on 1300 360 364.

You can also access peer support through Hand-n-Hand.

Managing work stress

Inevitably, a degree of stress comes with the job, but how you deal with it and recognising when you need support, can make all the difference.

To relate well with colleagues and provide the best patient care, you need to take good care of your own health and wellbeing. Here are some tips: 

• Actively seek out someone you trust and respect to confide in when something is bothering you – it will help you through it.
• Know your limits – working excessively long hours can lead to fatigue and burnout, impairing your judgement and increasing the risk of errors.
• Ensure you take regular breaks throughout the day.
• Have your own treating GP and attend regular appointments.
• Maintain a good work-life balance by incorporating exercise, time out to do activities you enjoy and holidays.

Key lessons

Stressful work situations are never an excuse or defence for disrespectful behaviour or bullying.

Identify your stressors and their root causes, then work on techniques to manage your response to stress.

Resources

Health and wellbeing.

Tackle stress like the SAS, Part 1: Building your professional resilience.