De victime à survivant—Partie 1 : stratégies à l’intention des cliniciens pour se protéger et protéger collègues et patients des comportements perturbateurs en salle d’opération
DOI :
https://doi.org/10.5737/ornac14515Mots-clés :
intimidation, incivilité, travail d’équipe, appréciation cognitive, communication cliniqueRésumé
Les comportements perturbateurs en salle d’opération ont des effets envahissants et causent du tort aux cliniciens, aux patients et aux établissements. Les cliniciens qui y sont exposés participent sans le vouloir à un conflit interpersonnel. Si les recherches antérieures étaient axées sur les antécédents et les conséquences du comportement perturbateur, le présent article adopte plutôt le point de vue de la résolution de conflit pour 1) outiller les cliniciens afin que leur bien-être ne souffre pas du comportement perturbateur et 2) décrire les réactions possibles pour éviter l’escalade et ne pas renforcer le comportement problématique.
La réponse des cliniciens commence par une appréciation cognitive permettant de déterminer l’effet psychologique du comportement perturbateur. Cette analyse peut être affinée à l’aide de techniques de connaissance de la situation, de restructuration cognitive et d’enracinement. À long terme, les cliniciens peuvent avoir recours à des mécanismes d’adaptation sains, caractérisés par un état d’esprit de « survie », et ainsi éviter les stratégies mésadaptées, qui provoquent un état d’esprit nuisible de « victime ». Les cliniciens doivent rester conscients du rôle qu’ils jouent dans les conflits. Les réactions malicieuses ou manipulatrices font des cliniciens des complices ou des agresseurs à leur tour s’ils exercent des représailles, tandis que le recours exagéré à des réponses passives les relègue au rang de spectateurs qui ne s’opposent pas au comportement. Les cliniciens doivent plutôt réagir avec assurance, ce qui les transforme alors en défenseurs, mais pour ce faire, il leur faut rediriger l’attention, éviter l’escalade soudaine, utiliser des outils de communication structurée, établir des limites claires et mettre en pratique ces habiletés lors d’exercices de simulation. Par ces interventions à petite échelle, les cliniciens peuvent encourager une culture de respect au bloc opératoire et préserver leur bien-être.
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