Impacts of Incivility in Nursing

Incivility in Nursing

 Incivility and How It Effects Nursing

 Nursing is a profession dedicated to helping others. Nurses work in many environments that can lead to situations where emotions boil over.  Significant job demands may lead to high levels of work-related stress that impedes effective teamwork. Some nurses may feel at the bottom of the team. They feel below doctors, administration and patients. With perceptions such as these, they can result in a sense of powerlessness and frustration. As a result of the powerlessness and frustration, nurses often are faced with incivility in the workplace.

What is Incivility  

  As defined by Merriam-Webster, incivility is the quality or state of being uncivil; a rude or discourteous act. (2019,) Incivility, bullying and violence in the workplace are issues in nursing. The American Nurses Association (ANA) defines bullying as “repeated, unwanted, harmful actions intended to humiliate offend and cause distress in the recipient. Incivility according to the American Nurses Association  (ANA), the one or more rude discourteous or disrespectful actions that may not have a negative intent behind them.”( 2015, ANA)

Issue of Incivility

 Work place incivility has become a pervasive problem in nursing. 24.1 % of nurses stated they were verbally abused either by a nurse manager or nurse colleague(  ). This type of abuse creates feelings of defenselessness in the victim and can demoralize dignity in the workplace.  Colleagues disagree with each other at times but it is important to maintain respect for each other. Experienced nurses can model how to confront others in a positive manner. Incivility can

be difficult to determine from the small subtle acts that many people experience. Little things such as showing up late to meetings, texting or checking emails, dismissing, ignoring co-worker concerns, thoughts or input are examples of more subtle types of incivility. The increase in workplace incivility is occurring at a time when the nursing profession is facing a growing shortage of nurses.

Importance to Nursing

 Workplace incivility has long-lasting effects on an organization. Workplace incivility, usually occurs under the radar, is thought to be benign and frequently is not apparent to the leaders of the organization. Incivility is on the rise in the nursing environment. This has caused the ANA to release a statement on incivility in the workplace. Many nurses have experienced or witnessed incivility in the workplace. Sustained incivility can be damaging to nurses’ dignity and induce psychological harm.  

   Incivility can negatively affect healthcare practice and patient outcomes. Incivility wreaks havoc on nurses’ relationships and workplace morale as well as patient safety. The Joint Commission takes the position that incivility is a safety issue and issued a standard on intimidating and disruptive behaviors at work (2015, Lachman). The Joint Commission concerns about increased medical errors, poor patient satisfaction, adverse outcomes, higher cost and loss of qualified staff. The best is to resolve the issue between the people exhibiting the behavior and the person effective by the behavior.  Behaviors are better changed when fixing the root of the problem. Explain to them how the behavior makes them feel. Take a time out and walk away from the situation. Bring the problem to a third party.

Scenario

Colleagues disagree with each other at times but it is important to maintain respect for each other. Experienced nurses can model how to confront others positively. Incivility can be difficult to determine from the small subtle acts that many people experience. Little things such as showing up late to meetings, texting or checking emails, dismissing, ignoring co-workers concerns, thoughts or input are examples of more subtle types of incivility.

 You are sitting with several other colleagues catching up on charting for the day. One of your colleagues starts gossiping and slamming another one of your colleagues.  These causes stress between the other employees sitting there. The others nurses don not know whether to add in or walk away. If someone is gossiping and slamming your colleagues do not join in or give approval by not saying anything. Have the courage to say I do not feel right, talking about this behind her/his back. Ask them if they have addressed these issues with the staff member involved in their gossip. It is important to hold each other accountable from our chosen behaviors.  Ask yourself how did the situation make you feel.

Nurses must rise the awareness and the awareness others about these behaviors. Recognize the behaviors that undermined a culture of safety when it occurs. Nurses must empower one another to address, confront, and move beyond the incivility.

Nurse Executive

 The nurse executive master’s program will teach me the ways to deal with incivility in nursing. Creating and maintaining a healthy work environment is part of the role of a nurse manager. As a nurse executive, I would want to create awareness to the situation. Having a no tolerance policy in the work place, is the first step. Staff needs to be aware that bullying and incivility will not be tolerated.  Creating an environment where colleagues are free to question each other and each other’s practice.

 A big part of incivility in nursing is other nurses comparing skills. Nurses will harass other nurses if they feel that they are not doing something right. This can even come out when they are talking to the patients. As a nurse executive, I would want to make sure that the staff feels comfortable asking for assistance when they are unsure about things that need to be completed. Setting up mentor program for new nurses, is a great way to make sure they have the skills needed to complete their job.  Allowing nurses to maintain clinical competence  and help others gain competence as means to becoming a secure member of the team competence affects team members’ trust and respect for one another.

Conclusion

  Disruptive behavior negatively affects patient outcomes, nursing practice, and a facility As bullying continues to increase a negative impact on staff retention and quality also increase. If incivility is not addressed then the organization can be put at risk for legal actions. Improving the environment in which nurses work may attract new students to nursing.  Dealing with the issue of incivility in nursing will improve the work environment which will in turn improve the quality and safety of patient care.

References 

• The Journal of Nursing Administration 41(1):41-47 Jan 2011 The impact of workplace incivility on work environment, manager skill, productivity
• Incivility in nursing North Carolinas Board of nursing.