Straight Out of the OR

Welcome to the OR Manager Conference Blog featuring news and updates from around the OR!


Work is stressful. We can all agree on that. Add in a non-stop day of life-threatening circumstances followed by high pressure situations and being positive is nearly impossible.

The OR Manager Conference welcomes in Keynote Speaker, Jody Urquhart, to teach us how we can maintain a positive environment for both ourselves and our team. But before Jody takes the stage in Las Vegas, we wanted to better understand what makes our workplace environment so critical and learn her secret to remaining positive, even in the worst of times. 

OR Manager: Why is a fun work environment with strong morale so important?

Jody Urquhart: When people are having fun while working the time tends to fly right by. Fun workplaces are more productive, purposeful and engaging. Laughing alone has a lot of health benefits that directly and immediately combat stress.

OR Manager: How would you advise a perioperative team to maintain a positive perspective during stress? How can they best deal with difficult people?

Jody Urquhart: Staying positive is challenging when more and more stress is constantly flung in your direction. It can pile up and overwhelm someone. I share with audiences that we need to keep balancing positive thoughts (and other techniques) to keep stress at bay. Your attitude really matters. One of the things that directly counters stress is to take on the perspective that you take yourself lightly through stress, so as not to take it too personally and let it overwhelm you.

Difficult people are difficult because they are getting something out of it. Understanding what someone is getting out of their difficult behavior will help them to understand it and stop difficult people in their tracks.

OR Manager: What is the most important message OR Manager Conference attendees can take away from your presentation?

Jody Urquhart: As leaders we have the opportunity to create and influence culture. I would like to share with the audience three specific culture types and how they either build or break down morale and productivity.  OR Managers will have a better feel of their culture and how to improve it, in a fun way!

OR Manager: How can an OR manager improve workplace satisfaction and productivity?

Jody Urquhart: The name of the game today is to do more work with fewer resources. OR managers may notice morale is sinking and people feeling drained. We will look at how to impact that culture. Boosting morale takes time but is worth the effort!

OR Manager: How can a perioperative manager inspire him/herself while engaging others?

Jody Urquhart: As leaders if we aren’t engaged,  our team won’t be either. OR managers need to keep their own fires of inspiration lit, so they can inspire others. We will explore how keeping a sense of humor can help ward off stress and keep OR managers uplifted and engaged.


Jody will be joining the OR Manager Conference on Friday, September 23rd and you can register to hear what will be a motivating and enlightening presentation, here.



Nurse practitioners are forced to endure a lot. We see patients come through our doors with a wide array of injuries and conditions, often in a tremendous amount of pain. The nurses of the Vietnam War bore witness to some of the most violent and horrific atrocities in one of history’s  deadliest wars. These leaders stoically performed their duties on enemy territory, risking their own lives in the process. It’s this sense of duty and loyalty to their profession, patients, and their country that intrigued Dr. Elizabeth Norman and inspired her to find the nurse veterans of the Vietnam War to share their story and draw on lessons of their strength to inspire us in our daily practice.

We caught up with Dr. Norman to ask a few questions about her latest book,  We Band of Angels and Women at War: The Story of Fifty Military Nurses Who Served in Vietnam 1965-1973 and to learn more about what inspires her each day:


OR Manager: What inspired you to write We Band of Angels and Women at War: The Story of Fifty Military Nurses Who Served in Vietnam 1965-1973?

Dr. Norman: I wrote Women at War because Vietnam War was part of my youth and once I learned that no one had spoken with female nurses about their experience (this was in 1982), I wanted to make sure we recorded their stories. Too much nursing history, too much history involving women is lost. I was also interested in the intersection between nursing, which is focused on saving lives, with war, which is focused on killing. In Vietnam, women were very much in the minority and I was interested in how women adapt and survive in a man’s world.

I wrote We Band of Angels because I was interested to learn how nurses, women, without any training or preparation, survived as POWs.

OR Manager: Of the surviving nurses you were able to meet in person, whose story has most influenced your career and why?

Dr. Norman: Hard question to answer, probably Helen Cassiani “Cassie” Nestor.  She lived near me and I saw her often. Two things she taught me about my career (and often life too): not to sweat the small stuff and to never forget the responsibility you have to others whether they be patients, colleagues, friends or students.  On 9/11 when I returned to northern New Jersey, I learned I could not make outgoing phone calls. I wanted to notify my family that I was okay.  About 5 minutes after walking in the door, Cassie called me. “How you doing kid?  What do you need?” I asked her to call my family and gave her their phone numbers. She called every one of them. I always thought that was a good example of her and the other Angels’ humanity and reliability.

OR Manager: What is the most valuable lesson OR managers today can learn from the wartime heroes you’ve written about?

Dr. Norman: A retired Air Force general, who served in Vietnam, once told me a valuable lesson about leadership: “Work yourself hard but more importantly take care of your staff.”  She felt that when the staff realized that she had their backs, she noticed that their morale stayed up and productivity was good.

OR Manager: What training and/or traits should a perioperative manager have in order to lead a productive team?

Dr. Norman: Managers must have a fundamental knowledge about the surgeries going on in their OR so they know what can happen and plan accordingly. Flexibility is key because if something can break, it most likely will; and if something can go wrong, it often does. Thinking quickly and objectively and being able to adapt is important. The ability to communicate with your team is paramount.

OR Manager: Do nurse leaders today face similar challenges/adversities as those from the past?

Dr. Norman: I wish I could answer this question that times have changed, which they have, but some challenges are the same–trying to adapt to diminishing resources, dealing with time and the volume of surgeries. There remains pressure to keep staff turnover down and to keep the ORs working efficiently. Fortunately these situations occur in an environment where the manager and staff’s lives are not in danger and everyone gets to go home after work.


Dr. Norman will be joining the OR Manager Conference on Thursday, September 22 for her afternoon keynote presentation: Heroism on the Front Lines: Achieving Greatness and Conquering Adversity.

Join Dr. Norman and the other keynote speakers this September at Caesars Palace to learn more about the heroism of these wartime nurses and how we can use their actions to motivate us each day.




Keynote Speaker, Rose Sherman, EdD, RN, NEA-BC, FAAN, sat down with OR Manager to share her thoughts on the future of the OR and how each one of us can help shape that future.

OR Manager: What trends within the past few years have you observed that have had the biggest influence on the way operating rooms are managed?

I am not a perioperative nurse leader so I am looking at this question as an outsider who is knowledgeable about what is happening in the healthcare environment.  I think operating rooms have been subject to the same forces as other areas in healthcare.  Health care organizations in general are becoming larger – partially because of the need for economies of scale but also to serve a wider patient base.  As an outcome of this, most perioperative leaders now probably work within health systems that are focusing on standardizing processes.  This means that there probably is more systems oversight in almost every area from staffing to throughput to purchasing.

At the same time, there have been radical changes in reimbursement with an eye toward value versus volume.  Health Systems have become Accountable Care Organizations in some cases – in others, they will be the insurer themselves.  Ultimately, we will see much more in the way of “population health” where organizations assume responsibility for a population of patients.  With these types of changes, operating rooms move from a revenue generator to a cost center.  There will be much more assessment about the value of doing certain types of surgical procedures, purchasing of technology and development of health system centers of excellence for certain procedures.

Another interesting dynamic is that it is now more common that physicians are employees of the health system or at the least in tight contractual arrangements.  This is a shift from the “surgeon as a hospital customer”.  They too are now subject to the same type of productivity standards that nursing has dealt with for many decades.  The good news here is that this dynamic can lead to a much more collaborative relationship between physicians and nurses where interprofessional respect can truly be an expectation.

The challenge for perioperative nurse leaders is that the change is happening so quickly that things can seem very chaotic to staff.

OR Manager: Besides patient safety, what should be the top priorities for OR managers who are trying to demonstrate quality of service?

Patient safety is a big concern but so is the patient experience.

25% of the Medicare incentive pay which for 2017 (remember everything is retrospective so we need to work on this today) will be 2.0% of total Medicare Reimbursement for a facility is based on the Patient Experience scores so a focus in this area is extremely important for perioperative leaders.  The specific HCAHPS questions that are part of this include:  1) communication with nurses  2) communication with physicians  3) responsiveness of staff  4) pain management 5) communication about medications  6) cleanliness and quietness  7) discharge information  8) overall rating of the hospital.   Having excellent scores could translate into considerable additional reimbursement. 

OR Manager: What are some strategies they can use to give their staffs a sense of their own value?

I think that helping to frame the changes for staff in a way that they can understand is an important first step.  Everyone’s contribution really matters in a value-based environment.  My experience is that even leaders struggle to understand the changes in reimbursement so you can imagine what it is like for staff.  I was in an OR lounge recently with a group of staff and was struck by the number of dashboards that surrounded us in that room.  We need to remember that as leaders – it is important to use caring-based nursing leadership practices that enable staff to see their value and contribution.  Yes – healthcare is a business but ultimately it is about relationships and we have to keep that front and center.

OR Manager: What are some of the biggest challenges ahead in perioperative services, and how do you think they can be managed?

Aside from the reimbursement issues that we have discussed, the biggest issue moving forward for perioperative nursing is and will continue to be the recruitment/development of both staff and leaders.  Perioperative nursing is ground zero for our current nursing shortage as hospitals struggle to replace their aging nursing workforce who are now moving into retirement.  But the real challenge moving forward is that the shortage will not just be in Perioperative nursing –  workforce data is being revised because of the growing demand for nurses in so many new emerging areas.  The Department of Labor now reports that we could have up to 1.2 million vacancies emerge between now and 2020.

As someone who studies leadership – I am concerned about having nurse leaders in perioperative environments who can navigate all that is being asked of them.  This could be very challenging moving forward.


Attend Rose Sherman’s keynote presentation at the OR Manager Conference in Las Vegas on September 22nd by registering here. Don’t forget that the OR Manager Conference also offers group rates with the VIP Code: Group.


Keynote Presentation Sponsored by:

Halyard Heath





Five tips for Conquering the Joint Commission Survey

Mary Diamond
 Senior Director, Nursing
TriCity Medical Center
OR Manager Conference Planning Committee Member

Consistent success preparing for the Joint Commission Survey requires an enterprise-wide cultural adoption of the safety, quality control and patient care standards that are accessed during the evaluation process. This is not an overnight transition, preparedness must come from the top with consistent training and education from the most fundamental aspects of maintaining an effective OR to high level managerial techniques.

Here are five ways that I like to keep my team and facility prepared for the Joint Commission Survey:

1. Regularly (weekly or at least twice monthly) perform Survey Readiness rounds, with emphasis on Environment of Care and Infection Control.

2. Keep department/service specific files ( staff education, staff communication, sterilization, HLD, risk assesments and the like) up-to-date, organized, well labeled and accessible.

3. Create and maintain an “Evidence Book” – listing all relevant Standards and CoP’s, and all policies, procedures  or forms which demonstrate compliance.   Remember to update this book anytime you update a policy or form.

4. No weak links in the chain. The old adage “You’re only as strong as your weakest link” has a lot of truth to it. No matter the level, your entire staff should be prepared for the JCS so arm each of them with the knowledge they need to remain prepared.

Ask a colleague to act as your Surveyor and round-in your department…not with you or your leaders, but with staff. Preferably your newest staff person.  You’ll learn a lot about where your training gaps are!

5. Use your peers. Network with colleagues, both locally and nationally, to learn their tips and tricks, and to share your own! Connect with them on LinkedIn. Attend conferences, like the OR Manager Conference, with questions already prepared and with your successes written out. Benchmark facilities of different sizes to see how you stack up. Researching this data is as easy as asking a question.


At the OR Manager Conference this September, the Planning Committee placed an emphasis on providing you with workshops and breakout sessions completely focused on developing actionable take home tools that you can take back to your facility.

Learn more about the Conference Program and build your own scheduled!

Join us in Las Vegas and see how you stack up!





Combating Passion Fatigue with Keynote Speaker, Marcus Engel

OR Manager recently caught up with Keynote Speaker, Marcus Engel, M.S. CSP, Author of The Other End of the Stethoscope, to get his thoughts on his upcoming Keynote Presentation at the 2016 OR Manager Conference.

Here is what he had to say:


OR Manager: How did you decide to become a speaker and writer, and how has your career evolved?

Marcus: When I first began speaking at age 23, I only wanted to help save lives by encouraging students to make intelligent choices, especially concerning substance abuse and impaired driving. As things progressed and I started to share more stories of hospitalization and recovery, healthcare professionals, specifically nurses, kept commenting how much they learned about patient perception. These days, I want to provide insight and strategies for excellent patient care while honoring the professions that, quite literally, saved my life.


OR Manager: What is the I’m Here Movement and what does it mean to you?

Marcus: Business wise, the I’m Here Movement is a 501C3, non for profit that reminds individuals the power of simple human presence. When Jennifer held my hand throughout the worst night of my life and said, “I’m here”, that comfort was the best (and only) thing she could do for me. We can all relate, in some way, to vulnerability, fear, anxiety and pain and (hopefully) we’ve also received the comfort that human presence brings. I simply remind healthcare professionals how such a small act can mean the world to patients.


OR Manager: What question do you hear the most from healthcare leaders and what is your answer?

Marcus: Those who go into healthcare have a natural heart for helping. Fortunately, the question I hear most these days is this: “Marcus, we have really awesome people and we give really great care, but we always want to be better. How can we do this?” My answer is to return to the foundation of caregiving: presence. What will help those on the front line be more present for patients? Systemic change? Cultural change? ? Better training? More teamwork? Each healthcare environment is unique and each patient is unique, but patients all have one thing in common: vulnerability. Remembering this and remembering to provide presence for patients is a return to the foundation of caregiving.


OR Manager: If you were an OR director, what would you do to make more compassionate care a priority?

Marcus: I would remind and encourage those on the front line to remember that patients are afraid and vulnerable and how providing simple human presence is the cornerstone from which compassion radiates.


OR Manager: If you could leave OR Manager Conference attendees with one key takeaway from your session, what would that be?

Marcus: To remember that we’re all human. With all the flaws and scars and ego and fears that we all have. The more we can be present for our patients, our co-workers, our family members, etc., the more likely we are to fully realize all aspects of the human experience. And to remember that the OR is their place of employment for 40 hours per week (usually more!), but coming into the hospital is a terrifying experience for most patients like me. Remembering those fears of patients and being present combine to help make the patient experience much, much better.


As the opening keynote, Marcus will be kicking off the Conference portion of the OR Manager Conference on Wednesday, September 21, 2016. We are extremely excited to have him on board at the 2016 OR Manager Conference. You can learn even more about his keynote presentation here. And if you’re ready to see Marcus in person you can register for the OR Manager Conference here.

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