According to Merriam-Webster, Incivility is the act of being uncivil, rude or discourteous to others, which has become an increased problem in the recent years in the nursing community. Any act of violence whether verbal or physical toward another nurse or coworker is considered to be an act of incivility. Granted this type of behavior is not always meant to cause harm, but if it entails violations of social standards and practices it is considered an act of incivility. Incivility can be apparent in several different styles within the workplace; such as interpersonal, cyber sources and indirectly.
Incivility, when it’s considered interpersonal it’s when one individual is directly uncivil toward another individual (nurse vs nurse). For example; one nurse bullying another nurse because she prefers to work on one unit vs another unit, so she mentally attacks the other nurses so they will choose not to work that unit leaving it free for her to work. Cyber-incivility is when someone uses a source of electronic devices to personally attack another individual, by expressing uncivil behavior by means of emails, texts, and/ or social media. Lastly, we have indirect methods. Indirect methods of incivility is when the act or behavior does not impact a specific individual but rather a violation of the standards of practice or respect for others. For example at the end of the shift a nurse refuses to clean her cart and restock it before leaving. Instead she curses and slams things’ making the others nurses and residents feel uneasy and unsafe.
Have you ever heard the saying “Nurses eat their young”. When I think of this saying I imagine a nurse, bullying and intimidating another nurse, being rude, showing how much more knowledgeable she is than the next nurse. I’ve seen this behavior in school, clinical and the work setting a type of abusive treatment of new nurses. It’s a type of behavior that experienced nurse’s show towards new nurses. I had a coworker tell me when I first became a new nurse; “they are going to make you get your education and understanding of this facility out the mud” she was talking about the nurses that had been there for a while. She said “they are not going to help you, they are not going to give you no assistance.” She explained to me that was the way they treated all new nurses and not to let it get to me. She was right! However, I didn’t let it get to me. I made sure if I didn’t know something or if I had a question I utilized all my resources before asking the next nurse. Even if I had to go up to the DON’s office to get clarification I would rather do that before giving another nurse the pleasure of cutting me down or making me feel less competent. At times this did affect patient care. If I was able to go to the next nurse and get assistance it would have increased overall patient care. But because the mean-girl attitude of the experienced nurses made me uncomfortable, they were truly be my last resource. I’ve seen other nurses experience hostile treatment as well. I’ve seen a senior nurses on the floor lie about work another nurse performed and did not perform, she refused to help her when the new nurse asked for assistance, and corrected her unavoidable mistakes loudly and in public area. By the time she left, I could see she felt targeted. Like she had a mark on her back, once she became the target of bullying she was never the same nurse as she had started, happy go lucky and excited about work. I could see that situation had changed her and her work ethic.
Evidence has proven that incivility in the workforce impacts a nurses’ ability to use high levels of clinical judgement. Not only does it affect a nurse’s clinical judgment, it also can affect and will affect patient safety and the outcomes of overall patient care. Placing a nurse under stressful conditions making it difficult to focus and provide the best possible care to the patient. Often when individuals are in situations like this at work rather than reporting the situations to a supervisor or a manger, they often just quit. When a nurse just up and quits this puts many resident at risk for safety risk. Studies have revealed that all forms of disrupting and uncivil behavior, whether physicians or coworker’s, have similar impact on a patients safety outcome. It’s said that even seemingly inoffensive behavior directly affects a nurse’s clinical judgement. It decreases the overall care and quality that’s being provided to the patients. A negative interpersonal interaction amongst staff ultimately affects the patient. According to American Association of Critical-Care Nurses (AACN, 2006) 24.1% of responding nurses reported being verbally abused by a nurse coworker or a nurse manager.
In the nursing profession, incivility is a breach of professional code of conducts. The actions entailed in incivility, such as intimidating and disruptive behaviors also result in other negative implications like medical errors and decreased patient satisfaction. The nursing main aim of idealism and professionalism in healthcare settings can be damaged by consistent incivility actions through individuals who create a hostile work environment for others (Lachman, 2014).
In response to like situations, the Joint Commission issued a sentinel alert and in 2010 implemented new standards that require health care organizations to have mechanisms in place to deal with uncivil and disrespectful behavior. The AACN, also established standards for professional and comfortable work environments, proving and assuring to making this issue a top priority. Many regulations included in the process consist of skilled communication, effective teamwork, decision making skills, and the ability to recognize issues, maintain appropriate staffing and proper leadership. When a company’s foundations are built on these standards and guidelines, incivility becomes less of a risk for everyone. Strong leadership and communication skills are critical aspects to preventing disruptive and violent behavior among nursing staff. It also helps when companies offer counseling services, education programs, while implementing proper methods to ensure employees understand and has the knowledge to handle disruptive and bullying behaviors they encounter while at work. Having a place to turn to for assistance or guidance plays an important role with coping, stress management and conflict resolution. Educational programs and seminars offered to upper management staff is also beneficial, as they get equipped with the knowledge and tools that allow them to better assist staff members when dealing with incivility. Nurses should not fear retaliation, criticism, or retribution from coworkers or supervisors for reporting such behaviors or incivility. When there is an Open-Door policy between management and staff this will improve trust and help support resolution in incivility situations. Educate leaders on how to act as role models.
In Conclusion, if we educate upper management, place policy and programs into effect, have an open-door policy, address issues as they arise with a zero tolerance policy, I feel this will help minimize reoccurring problems. Ensuring that nurses work in a friendly and conducive working environment in order to provide effective and efficient nursing. Not allowing others to exert other burdens on nurses from issues like incivility. Incivility in the workplace has destructive effects on the nurses, patients as well as the company. It is important to understand the leadership style that is practiced because this to could be an issue causing incivility amongst the staff. Incivility is a problem in all professions; however, it doesn’t belong in the nursing field. Nursing is a culture founded on caring for others, showing compassion and being supportive.