Incivility in the operating room: A French anesthesia survey

Incivilities in healthcare, especially in operating rooms, can cause emotional exhaustion, burnout, and reduced job satisfaction. Verbal and physical aggression, harassment, and sexual misconduct are common in surgical environments, negatively impacting healthcare workers and patient safety. This study assessed the prevalence of incivility in anesthesia teams in France and its impact.

A survey collecting demographic data and experiences of incivility was distributed to 4232 French Society of Anesthesia and Intensive Care (SFAR) members in 2022. The final sample (n = 873) showed a distribution of gender and professional roles broadly comparable to the overall SFAR membership. An adapted Maslach Burnout Inventory (MBI) was used to measure emotional exhaustion, depersonalization (interpreted here as loss of empathy), and personal accomplishment.

Out of 989 responses, 873 were included (20,6 % of SFAR members), with the following gender distribution: 48 % male and 52 % female. A total of 83 % reported experiencing incivility, and over 60 % witnessed it regularly. The overall effect of incivility was low for emotional exhaustion and loss of empathy. Women reported significantly more verbal aggression, sexual harassment, and deviant behaviors. Emotional exhaustion was higher in women and nurse anesthetists, while anesthesiologists reported greater loss of personal accomplishment. No significant differences in depersonalization or loss of empathy were found.

Incivility is widespread in operating rooms toward anesthesia teams, with notable emotional impacts, especially on women and nurse anesthetists. Despite this, empathy for patients remains largely preserved. Addressing gender and hierarchical dynamics is essential for improve workplace culture and support staff well-being.