OCTOBER 1997, VOL 66, NO 4 R E V I E W S

F11.111 REVIEW

EFFECTIVE CONFLICT RESOLUTION STRATEGIES IN THE OPERATING ROOM

his videotape begins with sev- eral real-life scenarios of ver- T bal abuse in the OR. The

videotape also presents the effect of disruptive behavior on self- esteem, staff morale, productivity, and patient care.

The main focus of the film is to suggest strategies for effective conflict resolution. The strategies are presented on two levels. The first scenarios present individual interpersonal conflicts and one- on-one strategies for resolution. Assertive techniques are intro- duced and role-playing is pro- posed as a means of practice for staff members.

resolution is a systems approach with four major components:

identify the problem, m create interventions, m look at outcomes, and m evaluate progress regularly. Each step is discussed in detail and examples are provided in both the videotape and in the accompa- nying study guide.

One of the strengths of the videotape and study guide is the presentation of a sample code of conduct and examples of nursing core leadership values that can be adapted to any perioperative envi- ronment. The expected norms and processes for conflict resolution are presented in the code of con- duct. The core values are articulat- ed and operational examples are presented for patient and family- centered care, concern for one another, professional develop- ment, integrity, teamwork, and balance. Finally, a social contract

The second strategy for conflict

for creating a healthy workplace is outlined. The use of the videotape and study guide is an excellent learning tool for all members of the perioperative team.

The videotape and and study guide can be purchased for $95 by contacting Cine-Med at (800) 633- o004.

AILEEN R. KILLEN RN, PHD(c), CNOR

NATIONAL COMMITTEE ON EDUCATION

RESEARCH REVIEW

VERBAL ABUSE OF STAFF NURSES BY PHYSICIANS M A Manderino, N Berkey Journal of Professional Nursing Vol13 (JanuarylFebruary 1997) 48-55

erbal abuse typically exists in relationships of unequal power. As a factor in main-

taining disproportional power between individuals, verbal abuse is a critical element in tra- ditional nurse-physician relation- ships. Previous researchers have documented that nurses often are targets of verbal abuse by physi- cians and that this abuse has neg- ative effects on patient care, work productivity, morale, job satisfaction, job security, and error rates.

The researchers designed this descriptive correlational study to explore verbal abuse of nurses by physicians. They used the Lazarus transactional model of stress cop- ing as the theoretical framework for the study. The researchers developed a questionnaire that addressed the frequency and type of verbal abuse directed at staff nurses by physicians as well as staff nurses’ cognitive appraisals and coping behaviors when they encountered this abuse.

The researchers mailed this questionnaire to a random sam- ple of 300 RNs who had classi- fied themselves as staff nurses. One hundred thirty question- naires were returned for a 43% response rate. The respondents primarily were female (ie, 94%), Caucasian (ie, 94%), and married (ie, 75%). They ranged in age from 24 to 73 years (mean age = 40 years). The majority of the respondents (ie, 62%) had nurs- ing diplomas or associate degrees in nursing, although 25% of the respondents had baccalaureates and 3% had master’s degrees. Most of the respondents (ie, 67%) were employed full-time, and they represented a variety of patient care settings and specialties.

The questionnaire was a 65- item self-report scale that defined 11 different forms of verbal abuse and elicited the frequency and perceived stressfulness of the various manifestations of verbal abuse. The questionnaire addressed both the identification of external stressors as well as responses to the remaining ele- ments of the Lazarus stress model (eg, cognitive appraisal, emotional reaction, coping efforts, perceived effectiveness of coping efforts in verbally abu- sive encounters).

Resulls. Ninety percent of the respondents reported having experienced at least one episode of verbal abuse during the previ- ous year. The average number of abusive incidents reported by the respondents ranged from six to 12. The most frequent types of verbal abuse were in the forms of abusive anger, being ignored, and condescension, and the respondents perceived them as mildly to moderately stressful.

738 AORN JOURNAL

OCTOBER 1997, VOL 66, NO 4

The adaptive coping mecha- nisms used most often by the respondents were believing that they did not deserve to be treated in this manner and viewing the abusing physicians as people with problems. The results of the verbal abuse were negative rela- tionships with the offending physicians and negative effects on the respondents’ job satisfac- tion. There were no significant associations between respon- dents’ stressfulness scores and age, marital status, years of expe- rience, education preparation, type of hospital, or area of clini- cal expertise.

The study had several limita- tions. The respondents were mostly Caucasian. If verbal abuse most often is directed at people of unequal power, it would be important to know more about the racial and ethnic group frequencies in the sample and the coping strategies related to verbal abuse.

The second limitation was that the researchers mailed the questionnaire to a general group of “staff nurses” whose frequen- cy of contact with physicians was unknown. This fact is important because more frequent physician interactions probably increases the chances for verbal abuse to occur.

Perioperative nursing impli- cations. It would be interesting to replicate this study with ai

sample of perioperative nurses who work closely with phyai- cians in stressful situations. Researchers also could explore and design interventions to eliminate physicians’ abusive behaviors.

MICHELLE M. IBYRNE RN, US, CNOR

NURSING RESEARCH COIWMIITEE

BOOK REVIEWS

IN TEGRA TED PHARMACOLOGY By Clive P. Page et a1 1997,606 pp $49.95 paperback

T h e concept of integrated phar- macology is well illustrated and well presented in this

book. The content follows the indicated purpose as stated in the book’s preface and foreword. The book’s formatting is well planned, and it can be used as a reference.

The material is presented pre- cisely and lends itself to learning. The book features illustrations that are explained clearly. The concept of integrating systems with the medications indigenous to that system makes this not only an excellent textbook but also a use- ful resource guide. This book will be of great value to pharmacology and medical students but it might be difficult for students in related fields to comprehend.

This book is available from Mosby-Year Book, h c , 11830 Westline Industrial Dr, St Louis, MO 63146-3318; (800) 826-1877.

ELIZABETH HUNT RN, BSN, MBA, CNOR

STAFF NURSE 111 HARRIS METHODIST-HE6

BEDFORD, TEX

GERIATRIC EMERGENCIES: EMT TRAINING MANUAL, second ed By Teresita M . Hogan 1 9 9 6 , 1 2 7 ~ ~ Free spiralbound

ne only needs to hear that the average age of AORN mem- 0 bers is 40 years or more to

know that the population is “gray- ing.” Combined with daily inter- actions with elderly patients, nurs- es realize that health care needs

change as one ages. The introduc- tion to this manual states that it was developed to address the unique care needs of geriatric patients (ie, people older than 65 years of age).

Each of the 10 chapters includes objectives, assessment tips, information related to the par- ticular chapter, and a case study with a review. Various charts and tables help make the chapters easy to read, as well as attractive. Top- ics include environmental aware- ness, normal aging changes, and specific disease processes, such as myocardial infarction and acute abdomen.

The book is simplistic in its approach, and some of the materi- al is disappointing (eg, the sugges- tion to pat patients on their heads when they are resistant to treat- ment). The author seems to gener- alize geriatric patients, especially patients in extended care facilities, and also about nurses. The infor- mation, however, is not specific to geriatric patients but can be applied to patients of all ages.

This book is available from MedicAlert, 2323 Colorado Ave, Twlock, CA 95382; (209) 668- 3333.

DONNA N. HERSHEY RN, MSN, CNOR

MANAGER, SURGICAL SERVICES ST JOSEPH HOSPITAL

LANCASTER, PA

CRITICAL ISSUES IN OPERATING ROOM MANAGEMENT Edited by Mark A. Malangoni 1996,304 pp $69 hardcover

ffective management is essential in today’s rapidly E changing ORs. The issues

facing managers have become increasingly complex and varied,

739 AORN JOURNAL