Incivility is a complex problem that has significant implications for patients, health care units, and nurses. The behavior hinders interpersonal relationships, destroys effective communication among nurses, and weakens the working relations. It poses a considerable challenge to the majority of nursing health care units since it is termed to be expensive and reduce the civility of nurses in their health organizations. The issue of incivility has undermined the expectations of patients, students in nursing and other professional healthcare personnel.
The Issue of Incivility
Incivility has been defined as “low-intensity deviant behavior with ambiguous intent to harm the target, in violation of workplace norms for mutual respect” (Vickous, 2015). Incivility is a term used to describe intimidating, disruptive, and behaviors that are undesirable i.e. mostly directed towards another person (Harris, 2015). The leadership of various organizations had ignored and tolerated this behavior for long, making incivility to appear as a conflicting issue creating an impact on the task force (Vickous, 2015).
The problem of incivility among nurses has been seen from physical and mental sides. This has made nursing fraternity to be highly responsible and accountable for the health of their workers. It has destroyed effective communication among nurses, caused patients not getting better health care and led to poor productivity of nurses. The impact of incivility on patient outcomes creates scenarios whereby nursing staff gets disrupted towards patient care, which raises patient safety issues. This results in an unhealthy working environment and causes costly situations towards the health organizations (Vickous, 2015).
Impact of Incivility on Nursing
Incivility violates and undermines the workplace expectations and the wellbeing of nursing employees. The majority of healthcare organizations have become a breeding ground of incivility because the leaders involved do not understand even its existence. The clash of professional cultures has also contributed to its rise. Incivility has had an enormous impact on nursing including lowering the morale of the nurses causing the low-quality production of their services. It has also led to absenteeism among nurses due to physical and mental damage, which also compromises the patients’ safety (Zhou, 2014).
Within the micro-system environments, the nurse and patient relationships always get frustrated, and this affects the health care system. It also impacts on the care team safety because quality concerns that affect the patients and health workers are under-reported. This creates a lot of harm and errors in health recommendation (The Joint Commission, 2016).
Health workers, nurses in particular, tolerate and ignore incivility due to the lack of knowledge. The act has affected the majority of nursing professions since it is the primary reason why nurses leave the job. It has contributed to poor health conditions among nurses and weak patient care system. The United States research showed that the average total amount the hospital spends on incivility was $94,156 annually. It includes treatment and indemnity of the hospital nurses who reported injuries caused by incivility (American Nurses Association, 2015).
The Scenario in a Work Setting
Considering the following scenario, two persons from personnel were caught in a quarrel by the management; one was senior to the other. The senior nurse was drunk, and he was directing his junior to a particular job but with harshness, shouting and being cruel to her. To make things even worse, the lady decided to walk away from her senior murmuring. The management did not take the matter seriously, and no apologies were requested from the offending partner. This shows how the administration tolerates that behavior showing the staff how some workers have more rights than others. Within the same profound organization, the lady was intimidated and stressed due to what happened to her. The disdain from her senior created the weak relationship, showing the lack of respect between the two and towards their working environment. It also led to poor communication between the colleagues.
Creating a Healthful Environment
Environmental safety is paramount in promoting the psychological and physical status of workers. The vulnerability of the health environment exists when the health care team does not feel safe, thus the existence of incivility is evident.
1. Civility is important in improving the working environment and promoting patients’ safety, and all behaviors that undermine the culture of health and safety are not tolerated. Therefore, health facilities and organizations should create a plan for developing and implementing policies that address work incivility, devising strict disciplinary actions and responding to those people who face the behavior of incivility (The Joint Commission, 2016).
2. The health work organization should redefine their roles by ensuring the creation of healthy working places is maintained and consistent with its functions to provide support programs. This requires the organizational cultural system changes including its practices. More healthy workplaces and jobs should be created to ensure it benefits the citizens, health workers, employers and all stakeholders involved in the health community (Pravamayee, 2014).
3. Health workers should be educated on their ethical professional conducts that are consistent with the organization’s practices. Every team should be held accountable for their actions (Association, 2015).
Practical Application in Health Care Policy
In consideration of cultivating a healthy working environment, I intend to apply the following strategies.
- Developing a plan action as the part of my academic research portfolio on procedures and processes that address incivility both in the nursing academic profession and within the health care departments. This includes developing guidelines and disciplinary measures and sharing with the organization in charge to ensure all individuals are amicably held accountable on their behaviors. I will also respond to families and patients who witnessed or became victims of incivility.
- With the help of the learning and healthcare institution, I will ensure that other members of the nursing profession adhere to the code of conduct on nursing profession by educating them on interpersonal relationships and good communication skills. In this regard, I will accept responsibilities of establishing and promoting healthy interpersonal-relationships with all the members of health care team.
Nursing education and its programs should be reviewed to be objective and rely not only on grade points criteria but effective assessment on student’s competencies. Besides, the nursing programs should be focusing on the ethical and moral proclivities of students who want to fit in nursing.
Nursing curricula and its content focus should not only base on didactic types of information such as pharmacology or nursing care with specific procedural skills, but also healthy working elements such as professional and effective communication skills, disaster and conflict resolutions, professional coordination of workers and managing crisis at different levels should be highly considered in nursing profession and integrated into the curricula (Luparell, 2011).
It is evident that incivility in nursing has significant implications for a more comprehensive scope implicating patients, nurses and healthcare institutions. All stakeholders in the nursing field should continue having discussions and conversations on how to address bullying and incivility in preparation of new nurses and within the nursing academia. The full complexity of incivility should be addressed to foster a healthy working environment as the main priority in nursing and the healthcare in general.
American Nurses Association. (2015). Incivility,bullying, and workplace violence.
Harris, C. T. (2015). Incivility in nursing. North Carolina Board of Nursing. Retrieved form https://www.ncbon.com/vdownloads/course-bulletin-offerings-articles/bulletin-article-fall-2011-incivility-in-nursing.pdf.
Luparell, S. (2011, April). Incivility in nursing: The conection bewteen academia and clinical settings. Retrieved from http://ccn.aacnjournals.org/content/31/2/92.
Pravamayee, S. (2014). Strategy to develop an effective workplace environment. International Journal of Language & Linguistics, 1-5.
The Joint Commission. (2016). Bullying has no place in health care – Issue 24.
Vickous, K. E. (2015, May). Perceptions of Incivility in nursing education: A survey of associate and baccalaureate program nursing students. Kenturcky.
Zhou, Z. (2014). Effects of workplace incivility on nurses’ emotions, well-being, and behaviors: A longitudinal study. University of South Florida.