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Effects of incivility in the nurse's culture
Preventing incivility in healthcare environments
Effects of incivility in the nurse's culture
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I found an interesting article out of the Critical Care Nurse journal titled, Incivility in Nursing: The Connection Between Academia and Clinical Settings by Susan Luparell (2011). Her writing discussed the issue of incivility among nursing students, educators, clinical instructors, and nursing faculty in clinical settings. She questioned the criteria allowing uncivil nurses to graduate and become practicing nurses (Luparell, 2011). Luparell (2011) stated, “One must wonder if it is professionally ethical to graduate students who, although by all accounts clinically proficient, have obvious and serious deficits in their ability to communicate clearly or in their ability to form professional, respectful, and collegial relationships” (p. 94). I agree with her because I have seen other students in my class who have treated others, including my nursing professors, and other students, rudely. Thus there should be criteria on civility when entering a nursing program. To me bullying and treating others disrespectfully, should not be tolerated in …show more content…
nursing school, or in practice in any facility. Nurses should work collaboratively with others on staff, and to our patients in a professional and respectful manner. Luparell (2011) also talked about how often incivility occurs with nurses in practice and how that has an impact on student nurses.
In the clinical setting student nurses are observing practicing nurses bullying and disrespecting coworkers, as if that is a normal occurrence (Luparell, 2011). This is unfortunate that it is happening, however despite observing such behaviors, I know incivility is not acceptable. Although, other nursing students may perceive this behavior as normal. Therefore changes in the work environment need to be addressed (Luparell, 2011). Professors too are experiencing incivility from the students, such as being yelled at, rude comments being made about them, threats, and even physical assaults (Luparell, 2011). Luparell (2011) mentioned the death of three nursing professors at the University of Arizona back in 2002 from a dissatisfied nursing student. For someone to be killed, there is clearly an issue
with incivility. With some experience as a student nurse and after reading this article, I gather incivility as an issue that needs more attention. Not only do the nursing personnel need to improve for better working relationships with their peers, but for their patients. Research has shown that with incivility among health care providers and poor communication skills, patient’s safety and medical outcomes are affected (Luparell, 2011). Personally that strikes me as the most concerning aspect of incivility in nursing. If one cannot improve for the sake of better relationships with one another, make changes for the better of our patients. As a student nurse I think I should focus on maintaining a professional behavior and respecting others as I have been doing.
Nurse horizontal violence towards new nurses and nursing students includes methodical, unwelcome or unprovoked behaviors with the intent to upset, control, humiliate, harm, or segregate (Hutchinson, Vickers, Jackson, & Wilkes, 2006). Horizontal violence can be furtive and shrewd (such as withholding information or spreading gossip) as well as obvious and direct, such as reproaching in front of other staff, false complaints, or threatening body language (Hutchinson et al., 2006). Other forms of the experience, described both in nursing and non-nursing literature, include bullying, mobbing, intimidation, and aggression (Farrell, 2001). Bullies form cliques and engage in repetit...
Khadjehturian, R. E. (2012). Stopping the Culture of Workplace Incivility in Nursing. Clinical Journal Of Oncology Nursing, 16(6), 638-639. doi:10.1188/12.CJON.638-639
An expert in the field, Dr. Cynthia Cark has created a comprehensive civility curriculum for new students entering the nursing field, which provides these students with core concepts including respect, professionalism, and ethical conduct (Nickitas, 2014, p. 308). Additionally, to prepare for the practice setting, they learn skills in the classroom and simulation labs on how to deal with incivility (Nickitas, 2014, p. 308). This form of education is beneficial, and healthcare organizations should continue with a similar educational program for its employees throughout their careers. Educational programs can help foster teamwork among co-workers and disciplines.
Incivility is an issue in nursing. Our profession is of caring and as nurses we do this without second thought. It’s a cruel act of a nurse’s character to treat colleagues the opposite of the values which form why nurses are nurses. An issue of incivility exists among nursing students. According to Karatas, Ozturk, and Bektas (2017), the issue of bullying in the academic setting is well known and frequent. As a family nurse practitioner (FNP) student it is important to be aware
It has various negative effects which are persistent in nature, and the individual victim realizes the behaviour as bullying (Wilson, 2016). Bullying is associated with physical and psychological problems among nurses leading to absenteeism, poor performance, low job satisfaction, and increased turnover (Ganz, et al., 2015). The issue of bullying among nurses further affects the entire health care team including patient outcomes and health care costs due to the declining level of nurses’ performance (Becher & Visovsky, 2012). Although bullying exists in the nursing work place, they are silent in nature, and goes undetected (Becher & Visovsky,2012). Hence, identifying and managing workplace bullying needs efforts of individual facing bullying and support of the
According to (Abdollahzadeh, 2016), the issue of incivility in nursing can be defined as “low intensity” deviant behavior with the intent to harm the target. Nurses are subjected to incivility at a higher rate than other job fields, and this concern is one that has an impact on the mental health and well-being of nurses and can lead to a reduction in job satisfaction and employee recruitment and retention
Workplace bullying is increasingly being recognised as a serious problem in society. Reports from the general media and professional press suggest that there is increasing evidence that the scale of bullying, harassment and violence amongst health care staff is widespread (UNISON, 2003). Chaboyer, Najman, and Dunn (2001) explain that although nursing in Australia is now considered a profession, the use of horizontal violence, bullying and aggression in nursing interactions has been identified as a serious problem. Levett-Jones (as cited in Clare, White, Edwards, & van Loon, 2002) explains that the recipients or victims of bullying within the nursing profession are often graduate nurses, with 25% of graduates reporting negative experiences. Bullying behaviour often renders the workplace a harmful, fearful and abusive environment and has a devastating effect on the nurse, healthcare team and patient. This essay will discuss the issue of bullying within the nursing profession, with a particular focus on the experiences of graduate nurses. The contributing historical, social, political and economic factors will be explored in order to better understand the origins of this trend. The subsequent impact of bullying on nursing practice will be analysed and recommendations for practice, supported by current literature, will be provided.
The Ethical Issues of Disruptive Behavior in Health Care Disruptive behaviors such as bullying, incivility, and horizontal/lateral violence are prevalent issues in the health care field. These behaviors not only create hostility among colleagues, but they also decrease safety and can increase the cost of patient care. The effect disruptive behavior has on patient care and team morale are reasons for action against this issue. Disrespectful behavior violates the code of ethics for nurses, which are ethical standards set by the American Nurses Association (ANA) (Lachman, 2014).
Nurses continually strive to bring holistic, efficient, and safe care to their patients. However, if the safety and well-being of the nurses are threatened or compromised, it is difficult for nurses to work effectively and efficiently. Therefore, the position of the American Nurses Association (ANA) advocate that every nursing professional have the right to work in a healthy work environment free of abusive behavior such as bullying, hostility, lateral abuse and violence, sexual harassment, intimidation, abuse of authority and position and reprisal for speaking out against abuses (American Nurses Association, 2012).
According to Blackstock, Harlos, and Hardy (2015) “Workplace bullying refers to repeated behaviors by organizational members that are offensive, often escalating in intensity with a perceived intent to harm” (p.1107). When nursing at any professional level you take an oath of doing no harm and agreeing to act accordingly to the facilities mission statement. According to the code of Ethics for Registered Nurses(2008), under the section Promoting Justice, this idea is clearly outlined in the statement “Nurses refrain from judging, labelling, demeaning, stigmatizing and humiliating behaviors toward persons receiving care, other health-care professionals and each other”(p.17). Another point reinforcing this is written under the heading of Being Accountable states “Nurses are honest and practice with integrity in all of their professional interactions”(p. 18). It is important that all nurses take their professional accountability seriously and follow the Code of Ethics. The nursing staff who witness the actions of the bully and do not report this are also failing in their own accountability towards peers and patients. Staff have a professional obligation to maintain a safe work environment for themselves, their co-workers and especially their patients. Reporting a co-worker or nurse can be stressful and overwhelming, increasing vulnerability to the bully’s further attention and becoming a target of their behavior. Research has determined that bullying impairs the victims’ physical and psychological well-being (Katrinli, Atabay, Gunay, & Cangarli 2010). The damage caused by bullying goes further than skin deep for it can have pervasive and ongoing impacts on staff relationships and patient trust in the safety of the medical system to ensure high quality compassionate
This is largely due to nurses leaving their jobs and/or medical incidents involving patients. A nurse working in an environment lacking civility can create stress and anxiety for the nurse. This, in turn, will lead to poor attitudes, decreased productivity, increased absences, and higher job turnover rates (Kerber, 2015). While working in uncivil environments is unhealthy for the healthcare professionals, it has also been shown to greatly affect patient care. A nurse working in a hostile environment can feel stress and overwhelmed, which can lead to an altered emotional state. Blevins (2015) reports in Impact of Incivility in Nursing that nurses working in this type of environment can “experience stress-related disorders and physical illness” which can decrease work attendance. A nurse or healthcare provider providing patient care in this emotional state can turn their negative feelings into uncivil behavior toward the patient or miss something critical to patient care, leading to patient harm or death. For example, if a nurse is upset about being disrespected from a fellow healthcare worker the nurse might turn her emotions on the patent by not asking the right assessment questions, or writing off a critical detail the patient is reporting. Incivility can also reach the patient level when a nurse is afraid to ask questions regarding patient care to the charge nurse as a result of recent bullying. The opposite is also true; If a patient is being discourteous to a nurse who is being civil and helping to the patient, it might make the nurse unconcerned about patient care satisfaction. This can spiral into an incivility cycle that is hard to
Unprofessional Conduct according to the Arkansas State Board of Nursing is detailed in ASBN Rules and Regulations, Chapter 7, Section XV, #6. The section states the following conduct are considered unprofessional. Failing to assess, evaluate, and intervene, Incorrect documentation, Missappropriation of residents property, Medication and Treatment errors, Performing or attempting to perform procedures that the nurse is untrained to do, Violating confidentiality. Neglect/Abuse or failure to report these incidents, Failing to report violations or attempted violations to the ASBN, Inappropriate delegation of duties, Failing to supervise, Practicing when unfit.
Nursing surrounds the concept of patient care physically, mentally and ethically. The therapeutic relationship that is created is built on the knowledge and skills of the nurse and relies on patient and nurse trusting one another. The use of nursing skills can ensure these boundaries are maintained, it allows for safe patient care. Professional boundaries are the line that nurses cannot cross, involving aspects such as patient confidentiality and privacy, ensuring legal aspects of nursing and the boundaries put in place are not breached. However, nurses accepting financial or personal gain from patient can also cross these professional boundaries. It is only through education in this area that the rights of patients can be preserved, as well as the nursing standards. Through education in areas such as confidentiality, boundaries can remain in tact and the patient care can remain within the zone of helpfulness.
Stokowski, L. (2010, September 30). A matter of respect and dignity: Bullying in the nursing profession. Medscape. Retrieved from http://www.medscape.com/viewarticle/729474
One of the nurses specifically revealed exactly whom I don’t want to bring to practice. Not only was their attitude challenging but I also felt that they had zero concern for our learning and success as nursing students. This was frustrating as it made me ask myself why they became nurses in the first place. It also made me question why the nurse acted in that way. Was it stress in the work place? Did they bring their personal life into practice that day? Were they their for the patient or job security? As frustrating as it was, I tried to tell myself in the moment that everyone has a story and because I did not ask the nurse directly why they dealt with the situation in that way, I cannot assume anything in regards to their actions or lack there