The Joke That Isn’t Funny; Sexual Harassment in the Operating Department
Katy Jeffery – RODP, Divisional Manager Surgery
Sexual harassment (SH) perpetrated by colleagues isn’t just a personnel issue in the Operating Department (OD), it’s a fundamental threat to patient safety. This toxic behaviour creates a work environment riddled with fear and silence, where staff are afraid to report clinical errors, and mistakes are more likely to happen.
This isn’t about a few isolated incidents. Study after study confirms that healthcare professionals frequently experience or witness SH in this setting, with some research highlighting the OD as the most common location for it to occur. The harassment is varied, ranging from physical acts like unwanted touching and groping to verbal misconduct; sexist slurs, sexually explicit comments, and demeaning jokes disguised as banter.
The Operating Department Context
The very nature of the OD creates unique risks. Within a surgical culture steeped in hierarchy, staff work in close physical proximity for long hours, often unable to simply walk away from a perpetrator, especially when scrubbed in at the operating table. This confined space, combined with a perceived sense of privacy away from the public eye, can foster an environment where professional boundaries are blurred and inappropriate behaviour goes unchecked. The immediate, critical needs of the patient often take precedence, meaning harassment is ignored in the moment and potentially not addressed later.
Verbal SH is a common form of harassment in the OD, but why does this pervasive issue persist? Perhaps because inappropriate conduct is often cloaked in the acceptable language of banter: reciprocal, light-hearted exchange of teasing remarks or jocular mockery. This creates a harmful paradox; a culture that praises humour and camaraderie and simultaneously allows that same humour to be used to humiliate, negotiate power, and enforce compliance through fear. When this behaviour is accepted and even met with laughter from the wider team, it creates a permissive culture where victims feel isolated and perpetrators are emboldened.
Banter in the Operating Department
It is important to acknowledge that humour serves a vital function in our world. The Operating Department is an intense, high-stakes environment where teams deal with trauma, life-and-death decisions, and immense pressure. In this context, healthy banter is often the glue that holds the team together. It relieves stress, builds cohesion, and fosters the resilience needed to get through a difficult list. When respectful, this shared humour improves communication and helps us cope with the emotional weight of our work.
However, there is a distinct line between supportive humour and toxic behaviour. Every operating department has its own unique ‘micro-culture’, defined by the personalities, leadership, and history of that specific unit. While some departments foster a supportive environment where banter uplifts the team, others struggle with a culture where boundaries are blurred.
The impact of this culture is devastating. For individuals, it causes profound psychological distress, including anxiety, fear, and shame, leading to burnout and forcing talented professionals to leave their jobs or the surgical field entirely.
The consequences extend far beyond the individual. A workplace rife with harassment erodes trust, fractures team cohesion, and hinders communication. When staff are distressed, distracted, or afraid to speak up, the risk of error during critical procedures increases. SH, therefore, is not just a workforce issue; it is a direct threat to patient safety.
What Can We Do?
Addressing this deep-seated problem requires more than just policies and reporting mechanisms. It demands a fundamental cultural shift. We need targeted interventions that address the unique environment of the operating department. We must challenge the normalisation of harmful ‘banter’ and empower bystanders to call out misconduct safely. We must amplify the voices of all members of the OD team, especially underrepresented groups like Operating Department Practitioners (ODPs) and Healthcare Support Workers, whose voices are largely missing from research and representation.
Operating Department Practitioners
ODPs are essential to the theatre team. They provide skilled care and support throughout the entire patient journey, from anaesthetics to surgery to recovery. But despite their integral role, ODPs remain significantly underrepresented in healthcare research. This isn’t just an oversight; it’s a critical omission.
Why? Because ODPs represent a unique research population whose experiences can’t be replicated or captured by studying other roles.
ODPs navigate the complex hierarchy of the OD alongside doctors and nurses. Their perspective offers a key insight into how that hierarchy functions, or malfunctions. However, unlike many other professionals who rotate through different wards or clinical settings, ODPs are often exclusively based within the closed, high-pressure environment of the OD. This constancy means they possess deep, specific knowledge about the cultural dynamics, safety risks, and communication challenges inherent to that specific space but, despite growing diversity in ODP career progression, many will not have professional experience in other healthcare environments.
To truly understand patient safety, professional dynamics, and culture within the OD, we need to amplify the ODP voice. By continuing to share our stories and demand accountability, we can begin to dismantle the toxic culture of silence and create a truly safe environment for every member of the team.
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