Conflict in a surgical center is like death and taxes: There's no escaping it. People are going to be irked, ticked and peeved - whether it's intense surgeons, overworked nurses or anxious patients. But instead of bracing for the next outburst, look at conflict as the positive outcome of people working together, a chance to think in new ways and to identify processes that need improvement. To truly turn a negative into a positive, retrain the way your staff perceives conflict and view it as an opportunity for personal growth.

Pushing the wrong buttons
To confront and resolve conflicts, you must first recognize the three common triggers of discord in the surgical environment.

• Ignored needs. Conflicts arise when needs are ignored, even if those needs appear to be minor issues. Surgeons are often locked into routines, have zero tolerance for lateness and mistakes and expect everything to be just so when they enter the OR. Is his favorite music on the stereo? Are the supplies in place? If not, his needs aren't being met. But what about the OR team who has the room readied and can't start the case on time because the surgeon is late and won't answer his cell? In that instance the surgeon is ignoring the needs of the nurses, techs and patient. The atmosphere sizzles with so many needy people. Stress presents itself at every turn.
• Misperceptions. Any random event can be interpreted and perceived by individuals in completely opposite ways. A straightforward response to a billing question can be seen as rude and indifferent. Body language and tone of voice often skew perceptions of situations. Stereotyping coworkers, patients and physicians is a basic ingredient for conflict. Remarks like "you know how doctors are" or the sarcastic "another brilliant idea brought to us by administration" reveal an innate attitude that drives barriers between factions of your team. And what about e-mail messages? Recipients often project whatever mood they feel onto the words on the screen, adding emotions or meaning to the words that are completely unrelated to what the sender intended.
• Emotion. Emotions may not be the root cause of a conflict, but they can exacerbate workplace conflicts. People who dedicate their lives to serving others tend to be emotionally driven. When conflict erupts and it's tightly wrapped in personal emotion, resolution is only possible if you strip away that emotion and address the real issue. In other words, react to the proposition, not the personality.

Conflicts of interest
So how do we react positively to personal attacks and seek honest, lasting conflict resolution? The first step is to recognize that many times the conflict, especially when it involves patients and physicians, is a negative reaction to a situation and not a personal attack. If you or your staff can ignore the angry words and look at the breakdown in the process that caused the hurt feelings, then those involved will be far more effective in handling the immediate situation. The ability to refocus helps control emotions, allowing for resolution of the problem.

Easier said than done? Perhaps. But retraining a line of thinking is possible. Tell your staff to literally repeat this mantra when confronted by an angry surgeon, co-worker or patient: "They are angry at the situation and not me personally." Like the smoker who snaps his wrist with a rubber band to squelch the urge to light up, the mantra helps staff react to conflict with cool logic instead of impractical emotion.

The next step to positive conflict resolution is to listen to the angry individual. Really listen and don't interrupt. They may be saying "you" when they're really referring to the schedule delay that caused their frustration. It's also important to clarify perceptions and get to the true reasons behind a negative issue. Ask, "What can I do right now to fix the problem?" or comment, "Help me to better understand what you're saying." Take the time to summarize and confirm your understanding. This is the most important step because without out clarifying, misperceptions will form and the conflict will remain unresolved.

Finally, apologize. Apologize because conflicts in a surgical facility are a professional issue and not a personal one. Apologizing is not admitting guilt, it's not a sign of weakness and it's definitely not placing blame; it shows empathy. Angry people are often expressing frustration that they had expectations that were not met and simply want someone to recognize that frustration. An apology does just that.

Live and learn
Focus on the future and don't rehash past conflicts. The goal of conflict resolution is to preserve relationships among staff and patients and to positively build on the negative issues. Once you've dissected the underlying cause of conflict, share the information and lessons learned to help prevent similar incidents. Try to incorporate the lessons into your staff's daily routine, perhaps using the conflict's resolution as the basis for future quality improvement efforts. Conflicts are inevitable, but they present opportunities to create a better team and work environment.