Incivility in Nursing: Impact of Education and Communication
Incivility, also known as harassment or bullying, can include behaviors such as insults, derogatory language and disrespectful behavior. Studies have shown the decrease in efficiency in work spaces tainted with this problem, which affects health personnel, patients and the economy of the health facility equally. A survey conducted shows that 24.1% of working nurses have endured verbal abuse by a fellow staff member. Approximately 22% of the interviewed nurse confided that they were ill treated by their fellow co-workers (Ulrich et al, AACN, 2006).
Further studies reveal that incivility deeply affects the psychological well-being of health personnel, patients, faculty, students and work environment, resulting in conflicts and in the case of clinical nurses the abandonment of their job positions due to depression, anxiety and occupational stress (Simmons, 2008). In this academic dissertation, the implications of the resulting evidence in these investigations will be analyzed thoroughly, considering the context of behavioral conducts in the healthcare profession, study program, nursing practice and work space.
This research is to delve into the negative effects associated with incivility and bullying in nursing, discuss the issues associated with it and how to address them, and generate the proposal of an application strategy designed to diminish the uncivil behaviors in the nursing and healthcare workplace, as well as find ways to encourage healthy environments for patients and hospital staff alike.
Incivility at the workplace is defined as a deviant behavior of low intensity with the intention of harming another(s) in violation of the rules of mutual respect in the work space. The cost of incivility as a common phenomenon in an organization can be observed by the decrease in creativity and quality of work produced by employees, including the highly negative impact on interpersonal relationships with external persons, such as patients (Porath & Pearson, 2013).
What we are trying to achieve through this is to understand the correlation amidst incivility in nursing and the effects it has in patients, as well as provide skills and practices of registered nurses through their different specialties, addressing civility in academic and clinical environments to create healthy work spaces with no hindering or negative psychological effects.
In her research paper regarding incivility, Luparell recalls reports of nursing faculty “being yelled at by students, threatened with injury, stalked, or physically assaulted. And, many readers will recall the 2002 murders of 3 University of Arizona nursing professors at the hands of a disgruntled student” (Luparell, 2011, 92).
The writer further explains the effects of mistreatment, whereas the responses include depression, physical symptoms and a feeling of being judged. In the academic world, incivility hinders student learning and achieves professional success (Luparell, 2011). In the workplace, lack of citizenship interferes with safety, quality of care and in turn, these issues lead to high staff turnover.
The main question to be answered is whether a harmonious and stable climate in healthcare and nursing can be established with formation and high communication skills.It is crucial to identify effective communication strategies in order to create an understanding in the facilities of a hospital or health care center. This investigation poses concerns about ethical dilemmas, types of responses to hostile actions or behaviors and ways to achieve dialogue in the professional nursing and healthcare work environment.
Scope of Behavior Conducts in Healthcare Environments
Incivility can be cataloged by acts of bad education, lack of respect among people, lack of courtesy in interpersonal relationships, poor decorum, insolence, derogatory or savage behavior, improper communication habits, rudeness, vulgarity or obscenity in language. Statistics are alarming when a look is taken at the impact that incivility can have on a work space. According to a survey conducted by Porath & Pearson (2013) in the United States, they found that incivility at work caused that:
• 48% of employees will intentionally decrease their effort at work.
• 47% of employees intentionally decreased the time they spent at work.
• 80% lost work time thinking about the incident.
• 63% of employees lost their time evading the offender.
• 78% of employees said that their commitment to the organization decreased.
• 12% of employees will leave their job because of uncivil treatment.
• 25% of employees admit to unleashing their frustration with external customers.
In short, the lack of respect reduces the participation and commitment of workers, reduces concentration and productivity, affects customers and, ultimately, deteriorates the image of the company. That is, all these actions lead to the cost of a hospital or establishment related to the health area being harmed in an economic way.
Methods of Promoting Civility in the Nursing Environment
The main issue at hand is the fact that incivility in nursing is a well-know concept, a habit that has become part of the culture. Uncivil behaviors of all kind and coarseness in general are often seen and experienced. Aggressiveness and discourteous attitudes are looked down in the academy but are commonplace nonetheless.
It is an accepted fact that nursing school is no longer that place that was once considered safe or intellectually challenging. Reflecting on the violent conducts in nursing schools, subsequent rude attitudes in hospitals and care centers and the need to achieve favorable working conditions in both, leads to the conclusion that it is in everyone’s interest to know what the health care institutions can do to prevent or minimize violent behavior, in this time when conflicts seems to be an inherent part of contemporary society.
· Luparell, 2011, explains that “many nursing programs rely on objective criteria such as grade point average in prerequisite courses for acceptance into their programs. Little, if any, attempt is made to assess the effective competencies of student applicants. Nor do most programs assess applicants for their fit with nursing or for their moral and ethical proclivities. And, to complicate matters, the poorly behaving students are often quite competent at demonstrating empirical knowledge and mastering technical skills.” (Luparell, 2011, 91)
What can be done, then, to improve work conditions and correct incivility issues among the nursing staff? For starters, those in leadership positions should know that not everyone understands respect in the same way. It is a matter of perception and the rules may vary depending on the generation to which the nurse or worker belongs, their culture, even their gender.
The Joint Commission issued a warning to address the problem in 2010, calling for the implementation of regulatory guidelines and rules aimed at health care entities to create safety nets in dealings with incivility and coarse behaviors, which damage the culture of safety. Promoting consideration and courtesy within work structures is essential when laying the foundations of a good work culture and identity. Leaders and managers should start by themselves, being exemplary models, hiring people who have a similar attitude; encouraging, reinforcing and rewarding good behaviors and reporting aggressive actions, negative behaviors and conflicts between healthcare workers.
Team collaboration, appreciating your coworkers’ efforts, mutual respect, paying attention to details and sharing personal experiences are some of the steps that can be taken by any professional to promote and maintain civility in their workplace. Being disrespectful and uncivil especially in the workplace leads to the formation of union or groups among individuals, this brings down the overall productivity of the work-space. This not only negatively influences the staff morale but also affects their treatment towards the patients. It leads to staff taking unnecessary sick leaves, which burden the system, staff disengagement and in many cases medical errors. Healthcare institutions depend on the patient’s satisfaction with the care provided. Incivility among staff may affect this and hence have an impact on the economic status of the hospital.
Recent polls and survey showed that leadership among the unions in the work-space leads to incivility among staff. It is a known fact that leadership establishes a work culture and behavior among staff and may or may not promote incivility among the staff members. Leadership is necessary in a workplace to set examples and to conduct the duties in order. If this leadership is given to a person chosen unanimously then it will lead to lesser conflicts among staff. Ignoring rumors and mindless gossip is another efficient way to keep a healthy work environment. Communication is the key to resolving conflicts and staff must be counseled and encouraged to find a common ground between their differences rather than resorting to extreme measures.
Small changes in behavior and attitude made by a lot of people leads to a more dramatic change in a work-space. A happy work-space is always a more productive work-space.