Taking care of the surgical team. A content analysis of surgical team members’ interviews on coping strategies and emotions during tense situations

Tense situations – ranging from small remarks to open conflicts - in the operating room (OR) have recently drawn growing attention in the medical field, for their high frequency, and potential negative impact on teamwork and patient safety. Previous studies focused mainly on their effects on team dynamics and performance, and relied on general perceptions of OR team members. However, less attention has been paid to the emotional experiences of surgical team members during specific tense situations and to the coping strategies they adopt in response to them. This study aims to provide a more granular understanding of what triggers a tense situation in the OR – both from the perspectives of initiators and potential victims, how tension is expressed, which emotions are experienced, and the coping strategies of the surgical team members. We conducted a thematic analysis on 40 explorative situational interviews. The sample consisted of 13 OR nurses, 21 surgeons, 6 anesthetists. The results include a synthesis of both covert and overt, problem-focused and emotion-focused coping strategies, which not only support individual well-being and enhance team functioning but also help prevent escalation and effects on patient safety. The study relies on self-reported data, which may be impacted by social desirability bias. The study did not fully investigate gender differences in expression and management of tensions in OR teams, nor differences related to specific professional roles, level of experience, or cultural background. Despite its limitations, it makes a valuable contribution to the literature by identifying coping strategies employed by OR teams to cope with tensions, and discuss their efficacy in preventing conflict escalation, maintain work satisfaction and protect patient safety. These findings may inform the development of formal training programs designed to equip OR teams with effective tools for managing critical tense situations in the OR.