This surgeon of Russian origin is working in a very rural farming community in the US. His OR team reported issues regarding his treatment of them during times of stress. He was reported as being disrespectful by “speaking in a condescending tone of voice, stomping his feet and grabbing the arms or hands of nurses.” Interestingly, most of the OR staff did not believe he was knowingly being rude. Human Resources initiated a six-month coaching program in conjunction with a Performance Improvement Plan. The coaching included a cultural assessment to gain awareness and insights on the cultural differences between his native country and the US. At the program’s conclusion, the OR nurses reported a vast improvement in his “communication skills.” According the to Chief OR Nurse, “his approach with the OR team is calmer because he is communicating more like we do.”