February 29, 2024/Nursing/Clinical Nursing

Speaking Up in the Perioperative Setting (Podcast)

Advocating for patient safety is imperative in fast-paced surgical settings

Nurses were voted the most trusted profession for the 22nd consecutive year in Gallup’s 2023 Honesty and Ethics poll. Part of the public’s trust hinges on nurses speaking up and advocating in the patient’s best interests.


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An early episode of Cleveland Clinic’s Nurse Essentials podcast shared advice on how to speak up in difficult situations. We revisit the important topic, focusing on perioperative nursing, in the latest Nurse Essentials podcast.

“The operating room can be a very intimidating environment,” says Dena Salamon, MSN, RN, perioperative nursing director for the main pavilion operating rooms at Cleveland Clinic main campus. “[But] it doesn’t matter what role you’re in – surgeon, anesthesia – everybody has the same right to speak up… . If you see something, say something.”

Salamon shares insight on:

  • Educating new perioperative nurses on how and when to stop the line
  • Techniques to use when speaking up in a clinical setting or as a nurse leader
  • Understanding when and how to share concerns in a fast-paced OR
  • The ARCC tool: Ask a question, make a Request, voice a Concern, use Chain of command
  • Being humble enough to listen to and accept feedback when someone speaks up to you

Click the podcast player above to listen to the episode now, or read on for a short edited excerpt. Check out more Nurse Essentials episodes at my.clevelandclinic.org/podcasts/nurse-essentials or wherever you get your podcasts.


Podcast excerpt

Podcast host Carol Pehotsky, DNP, RN, NEA-BC: What techniques did you use to speak up when you were in clinical care?

Salamon: I love to be in clinical care. It's like my Zen. It's my favorite place to be. It's relaxing. Repetition – the more you're in there, the more familiar your face is. And the more you're in there, the more practice you get, the more you see things, the more you're able to understand and know what's going on. And the more practice you get, the more you know, so they begin to trust you – the surgeons lean on you. They understand that you might know your table because that's your space.

You know, the surgeons operating rely on you to keep your space. To know what's on your space, to keep it clean, to make sure that you know what's going on over here, while they're operating over there. They start to form a bond and a trust in you. And they value your opinion.

So, it's just a familiar face. It's getting in there. It's asking questions. At the end of the day, we're in a teaching hospital. Yeah, you might get an angry surgeon here or there, but we all get angry once in a while – especially sometimes when the patients are really sick.


Pehotsky: It's a high stakes environment.

Salamon: It's a very high stakes environment, but they love to teach. We're in a place that’s a very educational environment. So, you learn when and where to ask the questions. You kind of gauge and you kind of learn the room. But at the end of the day, they love to talk and they love to teach. So, you're learning. Every day is a learning experience, and I don't think there's one day that I come in here that I don't learn something.

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