Session: Using 16th century Samurai code to help leaders succeed

Editor's Note

Lead your OR like a samurai—anchor the team in purpose, practice servant leadership, and model the behavior you expect. That was the through line of this session, led by Brian Dawson, MSN, RN-BC, CNOR, CAPT, NC, USN (Ret), president and CEO of BD Perioperative Healthcare Consulting. He argued that leaders, including perioperative leaders, can win hearts and minds in their teams by serving first, overcommunicating, and showing up where the work happens.

Servant leadership begins “from the inside out” and centers on purpose, Dawson said. Questions like ‘Why do we exist and why should anyone care’ should be posed to “ourselves and our teams” because, according to Simon Sinek’s Golden Circle framework, “people don’t buy into what you do, they buy into why you do it.” He tied that mindset to core servant leadership tenets popularized by Robert Greenleaf, including serving before leading, growing others, ethical power, and foresight through deep listening.

He framed the concept of servant leadership with one poignant tidbit: “People have asked me, ‘Brian, why are you promoting your best people out of the organization?’ and my answer is always the same: ‘Because, as a servant leader, it's my job to make sure that they succeed not just for me, but for themselves.” And high performers should be mentoring their peers, he added, so the right culture and best expectations are reinforced throughout the team, and “non-titled leaders” feel like they have a direct stake on outcomes.

Dawson also introduced attendees to the samurai code Bushido, which he said offers a practical template for OR culture: justice, courage, benevolence, respect, honesty, honor, and loyalty. Good leaders “do the right thing even at personal cost,” show moral bravery, and act with courtesy and truthfulness while upholding team and mission. Dawson linked those virtues to daily practices that resonate with perioperative teams. He said to clarify and champion the mission, then “over-communicate with intent” through regular group touchpoints and one-to-ones so staff know expectations and feel part of solutions.

Other key signs of good leadership are visible support and modeling. “There’s nothing that I’m going to ask our staff to do that I won’t do,” Dawson said before describing how he helped to turnover rooms in scrubs himself to reset expectations around delineated roles and shorten turnover time from 30 minutes to roughly 12 minutes—only possible with all hands helping. Another example he shared was partnering with a prominent surgeon to honor the red line and don proper attire, which helped to quickly shift culture around that safeguard because the surgeon—a visible influence—was brought into the process.

He advised zero tolerance for toxic behavior. Leaders should confront gossip and undermining traits directly, with HR and union collaboration as needed. He framed trust as the currency that allows correction when standards slip and advocacy when staff do the right thing. “Have your team’s back in public and coach in private,” he said. That is part of creating a family atmosphere. Dawson contrasted being a “great father” with learning to be an attentive dad, then applied that lesson at work: eat in the break room, ask team members about real life, and help solve practical problems when possible, he urged.

On adoption, he cautioned leaders to set written expectations with staff input and to plan for a runway. Culture change takes time, typically 6 to 12 months, and requires relentless visibility. “Be deliberate in how you lead, be visible, roll up your sleeves, and work side by side. By doing those things, there’s nothing that staff won’t do for you,” he concluded.