If OR etiquette represents a code of conduct—respect, communication, shared mental model, and teamwork—then manners represent the behaviors that embody this code of behavior. These seem like simple rules that should have been learned at an early age, but a few pointers will go a long way toward integrating junior residents and students into the OR team.
1. Be polite.
2. Be respectful.
3. Be humble.
4. Learn everyone’s name.
5. Offer help without being asked.
6. Ask for help when needed.
7. Thank your colleagues.
8. Keep the patient at the center of all you do.
Rude, disruptive, or disrespectful behavior is not tolerated. Do not yell or make sarcastic comments. Do not make jokes with sexual or racial themes. Do not gossip or denigrate others. Many surgeons enjoy listening to music in the operating room, but in choosing a playlist, be aware that some music may have offensive lyrics that should not be played in the workplace. It is most polite to ask before playing music and to check in with music preferences, as not everyone in the OR may appreciate loud death metal. Music should be turned off during critical times such as the initial time-out. Surgeons use social media like many others, but the OR is not the place to check Facebook or Instagram. When posting to social media, be professional—anything posted to the Internet can be screen captured and spread, no matter what privacy settings you may have turned on. A recent study of publicly accessible Facebook posts showed 14.1% of surgery residents had posted potentially unprofessional content, and 12.2% had clearly unprofessional content, with violations of patient privacy being one of the most common problems, along with description of binge drinking and racially or sexually offensive material. Specific to the OR, be aware that social media postings with potentially identified patient information are absolutely forbidden. This does not need to include a name of a patient to be identifiable information—a few details of a particularly unique case and a timestamped posting can be enough to cause trouble.