Raised eyebrows. Dirty looks. How do you respond to these and other non-verbal innuendos in the surgical workplace? By calmly and coolly confronting the person with a direct and disarming comment such as...

Wait, Kathleen Bartholomew, RC, RN, MN, knows just what to say: "I see from your facial expression that there may be something you wanted to say to me. It's OK to speak to me directly."

Game over, bully!

Ms. Bartholomew, our featured speaker on day one of OR Excellence and author of the book, Ending Nurse-To-Nurse Hostility: Why Nurses Eat Their Young (2006), armed her audience with righteously indignant take-home tips they can use to defuse hostile colleagues of all shapes and sizes.

Let's say you have the pleasure of working with someone who is always making negative comments behind your back. Ms. Bartholomew, the former manager of a 57-bed surgical unit in Seattle, Wash., laid out the DESC method of communication for dealing with this backstabber.

• Describe. Lead with the facts. I heard you making several negative comments when you found out that you had to float yesterday, and the day before you were angry about an assignment.
• Explain. Let them know the impact. I understand that everyone has bad days, but your comments are affecting my morale.
• State. Be descriptive in explaining what you want. I need you to understand that your words have a big influence on my mood.
• Consequences. Describe the impact. If I have to listen to this every day, I'm concerned that the negativity will affect my morale and health.

Ms. Bartholomew presented research that showed that 60% of new nursing school grads leave their first position within 6 months because of some form of lateral violence. She described bullying as a consistent (hidden) pattern of behavior designed to control, diminish or devalue another peer (or group) that creates a risk to health and/or safety. Bullying can either be overt (name-calling, sarcasm, bickering, fault-finding, back-stabbing, criticism, intimidation, gossip, shouting, blaming, put-downs, raising eyebrows) or covert (unfair assignments, eye-rolling, ignoring, making faces behind someone's back, refusal to help, sighing, whining, sarcasm, refusal to work with someone, sabotage, isolation, exclusion or fabrication).

She challenged her audience to return to their facilities and institute a zero-tolerance policy for any communication that is unhealthy. When Ms. Bartholomew asked her audience members if they've ever heard a nurse talking negatively about another nurse, all 153 an-swered yes. To thrive, hostility needs secrecy, shame and a silent witness. "Don't let that silent witness be you," she said.