Examination of Incivility in Nursing
The prevalence of incivility in the health care arena is of growing concern (Peters, 2015). According to Blake (2016), the last two decades have seen a rise in the incidence of incivility in the work place. The presence of incivility in the workplace has been associated with poor self-esteem, increased staff turn-over, and ultimately inferior patient outcomes (McNamara, 2012). Multiple national organizations have called for strategies to be utilized to decrease incivility and promote a healthy work environment (Blake, 2016). The purpose of this paper is to discuss the issue of incivility and its effect on nursing, demonstration of incivility through storytelling, strategies for the creation of a healthy
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Acts of incivility can include discourteous or disdainful speech, public censure, character assassination, or lack of inclusion in patient care decisions (Lachman, 2014). Incivility, both lateral and hierarchal, has been found to occur at all levels of health care including academia and direct health care settings (Lachman, 2014). The prevalence of incivility in the health care work place is a disturbing problem. According to Nikstaitis and Simko (2014) 85% percent of nursing personnel report having experienced incivility in the workplace. Additionally, 39.6% state they intend to leave their place of work due to lateral violence (Nikstaitis & Simko, 2014). Incivility leads to an unhealthy work environment in which decreased morale and high nurse turn-over result in poor patient care and outcomes (McNamara, 2012). Lachman (2015) states that in addition to the effect on staff and patients, the cost of incivility is felt by the employer in cost of new staff training and in decreased insurance reimbursement due to poor patient outcomes and …show more content…
References
Blake, N. (2016, October-December). Building respect and reducing incivility in the workplace: Professional standards and reccomendations to improve the work environment for nurses. AACN Advanced Critical Care, 27(4), 368-371. https://doi.org/10.4037/aacnacc2016291
Eques, A. L., & Leinung, E. Z. (2013, July-September). The bully within and without: Strategies to address horizonal violence in nursing. Nursing Forum, 48(3), 185-190. https://doi.org/10.1111/nuf.12028
Lachman, V. D. (2014, January-February). Ethical issues in the disruptive behaviors of incivility, bullying, and horizontal/lateral violence. MEDSURG Nursing, 23(1), 56-58, 60. Retrieved from
Horizontal violence is a form of workplace relational aggression, an experience that is rampant in the nursing profession (McKenna, Smith, Poole, & Coverdale, 2003). The expression, horizontal violence, is used to describe cruel behaviors between colleagues of comparable status, such as registered nurses, in the workplace. Research has shown a variety of destructive peer-to-peer behaviors that are detrimental to the profession and healthcare systems (Farrell, 2001). Nevertheless, little research has been done on “eating their young,” horizontal violence arising between those with unequal power, such as registered nurses and students (Thomas & Burk, 2009).
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
Incivility is prevalent in the healthcare setting and is a broad term used to describe any negative discourteous manner all the way up to more serious bullying and violent behaviors. If these behaviors go unregulated, then there is the likelihood that low-intensity negative attitudes can turn into aggressive behaviors (Laschinger, Wong, Cummings, & Grau, 2014, p. 6). Consequently, there are serious repercussions which affect the persons involved, directly and indirectly, the work environment within the healthcare organization, and the nursing profession. These repercussions can range from poor work performance to staff retention issues. Therefore, this paper will address the issue of incivility, how it
Myers, et al. , (2016) performed their study as through collaboration with a New York State wide study to explore nuurses’ experience with lateral violence. Myers, et al. , (2016) offered both online and paper surveys for nurses comfort. The study revealed that lateral violence is seen throughout all roles of nurses from staa nurses to leadership roles.
Horizontal violence is an action that has been reported and documented in nursing and other healthcare professions for many years. This type of behavior between nurses has provided very discouraging and truly serious outcomes for nursing professionals and unfortunately for their patients as well. Horizontal violence is “hostile, aggressive, and harmful behavior by a nurse or group of nurses via attitudes, actions words, and/or behaviors.”(Becher, J. & Visovsky, C (2012)). This can be done either overt or covert. Overt, done openly, is when the victim is experiencing name calling, bickering between colleagues, fault finding, c...
Wilson, B. L., Diedrich, A., Phelps, C. L., & Choi, M. (2011). Bullies at work the impact of horizontal hostility in the hospital setting and intent to leave. The Journal of Nursing Admistration, 41, 453-457. doi:10.1097/NNA.0b013e3182346e90
Nurses are caring by nature. Nurses care for family members while at home, community members who may be neighbors, church members or friends from school and sports with children in common; however, nurses are known to display uncaring attitudes towards each other. When nurses are discourteous and disrespectful towards one another this may be known as workplace incivility. Incivility is defined by Merriam-Webster as, “the quality of state of being uncivil and a rude or discourteous act” (n.d.). Alexander (2017) related incivility to the events of the 2016 United States election as “rude and impolite behaviors that may be manifested when people feel fear or mistrust” (p. 79). Healthcare is subject to the same negative influence through communication between healthcare providers, educators and patients.
Nurses as caring professionals, it is surprising that incivility such as bullying exists in nursing workplace. Workplace bullying is a major occupational health concern among nurses worldwide, and it has increased health care cost due to high turnover (Stagg & Sheridan, 2010). Research shows that 20-25% of nurses suffer from bullying behaviour in the workplace (Wilson, 2016). The prevalence of bullying has many negative consequences such as negative health outcome of the nurse victims, the organizational performance, and the adverse patient outcomes (Wilson, 2016). Hence, combating the issue of bullying in nursing is of heightened importance (Ganz, et al., 2015). Nurse leaders can play an important role in maintaining the positive workplace environment, and prevent the bullying (College of Nurses Ontario, 2017). In this paper, I will explain about workplace bullying in nursing, and how the transformational leadership style can be used to create a positive work environment. For this, I
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.
Therefore, this position statement is relevant because these abuses can be seen in day-to-day healthcare environment. The effects of violence in nursing can be harmful to the proper function within a workplace. It can be damaging to the nursing profession and patient care. According to (Johnston et al., 2010, p.36), workplace violence is “spreading like a ‘superbug.’” Studies have shown, that lateral violence, nurse-on-nurse, has been one of the highest incidence of violence within the workplace. Also, statistics have shown that lateral violence has one of the most emotional impacts on an individual. This will be further discussed below. For these reasons, it is important for healthcare workers to validate the detrimental effects violence can have in the workplace, and be prepared to combat and prevent workplace violence.
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
Professionalism in the workplace in many professions can be simplified into general categories such as neat appearance, interaction with clients, punctuality, general subject knowledge, and likability. In nursing, professionalism encompasses a much more broad and inclusive set of criteria than any other profession. Nurses specifically are held to a higher standard in nearly every part of their job. Nurses are not only expected to uphold what it seen as professional in the aforementioned categories, but they are also expected to promote health, wellbeing, and advocate for patients, but also continually provide the highest standard of care, demonstrate exemplary subject and procedural knowledge, and abide by the Code of ethics set forth by the American Nurses Association. This Code of Ethics includes the complex moral and ethical principles of autonomy, beneficence, nonmaleficence, fidelity, honesty, and integrity.
Bullying can be an issue in schools, or the workplace, and it is very unfortunate this continues to occur. Bullying that occurs in the workplace is known as lateral violence, or workplace violence and is defined as “nurses overtly or covertly directing their dissatisfaction inward towards each other, themselves and towards those who are less powerful and influential than themselves” (Koh, 2016 p. 214). Lateral violence is a universal issue not just in nursing, but in all professions, however it goes underreported (Koh, 2016). Whatever the reasoning, it is essential to understand and address it because lateral violence can negatively impact the patients, staff, and organization. I reviewed an article written by Wee Meng Steven Koh, which investigated
Conflict comprises substantive, procedural, and psychological dimensions that participants in conflict respond to on the basis of their perceptions of a particular situation. This perception that filled with thoughts and emotions that guide the individual to a solution. Therefore, understanding the type of conflict and the way he or she responds to conflict is important in identifying effective strategies to manage conflict in the healthcare environment. Conflict management styles are used depend on the situation and parties. The nurse leader need to be purposeful and thoughtful when engaging in conflict resolution as the quality of communication and teamwork among healthcare providers has been directly linked to the safety of patient care. A nurse leader can strategically enhance patient safety through effective conflict management. The first strategy is engage in dialogue, where the nurse leader and nurse engage in dialogue that address conflict and conflict management behavior as a first step in creating a healthy work environment. The lack of communication and avoidance of the conflict prevents the root of the problem from being properly addressed and resolved, thus the conflict situation remains. Non punitive debriefing with staff about the management of a conflict issue provides reflective learning and removes frustration, which can lead to trust, openness, and effective conflict resolution in the future. Therefore, I will use this strategy to resolve the co-worker conflict in my workplace. The next strategy is engage in coaching, in which the nurse leader will minimize the conflict by educating nurses to learn how to effectively resolve conflict themselves. The third strategy is identify potential conflicts. Conflicts are normal and are usually predictable. Procedures and processes to identify potential common conflicts will be developed to