Caregiving and treatment for any individual patient will involve several professionals, nurses and otherwise who have to work together and sometimes contemporaneously. Euphemistically, it can be considered as several drivers handling a singular car, each having a different obligation yet having to work under absolute harmony for the car to run. No matter how qualified and proficient the team is, the patient stands to suffer unless they can manage to work in harmony and oneness (Clark, 2010). Among the basic elements of harmony among professionals is civility. It is for this reason that civility is definitively taught during nursing lessons and also meant to be adhered to by nursing practitioners. Further, the Advanced Nursing Practitioner (APN) carries among the myriad administrative duties the obligation to ensure that civility ensues amongst healthcare professionals. Indeed, civility is to be considered as an integral factor within professionalism in the practice of nursing.
Definition and Explanation
In the article by Lower (2017), critical care nursing expert Judith Lower, defines civility as conduct that exhibits respect to another person and also contributes towards mutual respect. Therefore, acting with incivility means acting in a manner unlikely to be interpreted as respect for others and in a manner that does not draw respect towards the self. This is drawn from a twofold obligation to the nursing officer. First, the nursing officer has an obligation not only to respect colleagues but also act in a manner that reflects the same. Secondly, the nursing officer has to act in a manner that attracts respect from colleagues (Clark, 2010). From the foregoing, incivility may, therefore, be both an act and/or an omission which either do not adhere to the definition of civility given above or goes contrary to it.
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Possible Consequences of Incivility
When no civility is exhibited, professionals in a nursing setting will be rude towards one another, get in each other’s way, lack respect for each other’s decisions and conduct but most importantly, fail to share crucial information (Lower, 2017). Referring to the earlier euphemism of driving the car, each and every party in the system may do the right thing but unless this right thing is done in harmony, they might either be ineffective or counterproductive. Further, when veteran professional or senior ones lack civility towards juniors akin to burying, they may cause the juniors to either make crucial errors due to lack of proper concentration denying the juniors an opportunity to thrive and grow within the profession (Clark, 2017) . In the final analysis, the patients and professionals stand to suffer and lose respectively if civility is not adhered to.
Incivility Scenario
One of the most important elements of proper caregiving is the handing over phase where one nurse hands over the care of a patient to another at the end of the shift. During this handing over, it is fundamental for all particulars kindred to a patient to be comprehensively communicated actively and/or passively to the nursing officer taking over at the change of shift or transfer of a patient. Janet, a nurse with a professional experience of eleven years as well as three college degrees was taking over care of Jacob, a cancer patient, from Alice. Alice was a qualified and dedicated nurse but had only been practicing for eight months. Jacob was her first terminal patient and Alice was moved greatly by his plight. Janet happened to catch Alice leaving Jacob’s room with a tear in her eyes and roundly rebuked her using very harsh language. So affected was Alice that she forgot the fact that she was indeed looking for Janet to explain to her an error that she had made in administering Jacob’s complex medication, which Alice needed help in solving. The error, therefore, went unresolved causing Jacob’s situation, which was already dire to exacerbate causing him great agony for the few months he remained alive. On the other hand, the combination of guilt from her error and outburst from the senior that she admired and looked up to affected Alice that she resigned from work and is considering a change of profession. The incivility of a senior practitioner caused both a patient and a junior inordinate suffering.
Three Strategies for Creating a Healthful Environment
Among the civility strategies for the creation of a healthful environment includes considerate conduct, effective communication, and team collaborations. Considerate conduct can be defined as acting reasonably under every circumstance towards all colleagues (Lim & Bernstein, 2014) . In simpler terms, reasonable conduct can be considered as placing one in the shoes of the recipient of their actions be they word or deed. Effective communication entails not only saying the right thing but also saying it in the right way. Even the right thing said in the wrong way can cause friction, yet even the hardest conversation can with effort be undertaken in a civil manner. Finally, team collaboration means each member doing their part in the right manner while allowing and enabling the other team members to also do their respective parts (Lim & Bernstein, 2014) .
Applicable Healthful Environment Strategies as an Executive Nursing Officer
My anticipated Masters-prepared advanced practice nurse specialty is an executive. This mainly focuses on administration, which includes not only nursing officers but also other officers that are kindred to the running of a healthcare institution. One of the major strategies for the creation of the healthful environment is proper coordination. It is always difficult for members of different professions to work together, more so when there is no clear chain of command or seniority concept between them (Clark, 2017) . Among the support staff, nursing officers and medical officers, there are respective chains of commands and concepts of seniority. However, this does not apply in a room where a support staff supervisor, APN, and physician find themselves working together. Coordination in these scenarios not only means setting rules of engagement but also encouraging mutual respect among the different professionals. The second important executive strategy is ensuring the absolute adherence to all laws, ethical provisions, rules, and regulations without any or any allowance for the cutting of corners (Massachusetts Action Coalition, 2016) . Incivility can be active but more often than not happens passively when a near innocent mistake leads to untoward ramifications that involve colleagues. Indeed, in the now highly integrated format adopted by healthcare institutions, a worker can exhibit incivility to another worker without even meeting them. Doing the right thing, in the right way and at all times is integral to the establishment of a healthful working environment (Massachusetts Action Coalition, 2016) .
When handling a patient, effectiveness cannot be achieved unless all the parties involved effectively play their respective roles. In some cases, it is the professionals themselves who hinder one another from achieving optimum effectiveness through incivility. Therefore, even if a certain individual is extremely effective, there will still be an overall failure unless the effectiveness is replicated by all the other participating professionals. This creates a secondary obligation for each and every professional to act in a manner likely to enhance harmony between all members of a team. This will be achieved if all the said members act with civility towards one another. Effective communication, considerate conduct, and team collaborations are fundamental to this. Further, leadership must also ensure that there is proper coordination between teams that work together as well as adherence to all requisite provisions by all members. This will enhance civility which will, in turn, result in a healthful environment in the healthcare institution.
References
Clark, C. (2010, March 22). Why civility matters. Retrieved July 15, 2017, from http://www.reflectionsonnursingleadership.org/features/more-features/Vol36_1_why-civility-matters
Clark, C. (2017). Creating & sustaining civility in nursing education . Indianapolis: Sigma Theta Tau
Lim, F. A., & Bernstein, I. (2014, April). Civility and workplace bullying: Resonance of Nightingale's persona and current best practices. Nursing Forum, 49 (2), 124-129.
Lower, J. (2017, June 08). Civility starts with you. American Nurse Today . 7(5). Retrieved July 15, 2017, from https://www.americannursetoday.com/civility-starts-with-you/
Massachusetts Action Coalition (2016). The Massachusetts nursing core competencies: A toolkit for implementation in education and practice settings . Retrieved from http://www.mass.edu/nahi/documents/Toolkit-First%20Edition-May%202014-r1.pdf
