Delivery of efficient and proficient services for nurses working in the emergency room has become an uphill task due to workplace incivility. Pundits in the healthcare industry define incivility as a low-intensity deviant uncouth, disruptive, offensive, or intimidating behavior directed towards another person. Such acts often interfere with the work environment as it causes both physiological and psychological distress to the affected parties (Kisner, 2018). Findings from various research studies have established that incivility has been rampant and pervasive in the workplace. Detailed research evidence shows that nurses in the emergency room experience incivility from both their co-workers and supervisors. Incivility behaviors are either covert or overt. Examples of such actions include giving the silent treatment, public rebukes, the use of demeaning language, withholding of compliments, interrupting others, among others (Nikstaitis, & Simko, 2014). Unchecked incivility results in the unhealthy working environment, thus barring nurses from discharging their duties professionally. Whether supervisors or co-workers do it with or without conscious intent, incivility lowers the emotional psyche of other workers. It is a form of psychological harassment which violates the moral and social fabrics of mutual respect.
My experience with Incivility
Lack of awareness in identifying, understanding, and addressing workplace incivility has led the behavior to become a silent epidemic in organizations (Abdollahzadeh et al., 2017). Majority of nurses experience incivility but are not courageous enough to speak up because they either fear to lose their jobs or retribution from colleagues. I once was a victim of incivility while working for a grocery store owner in my hometown. My boss was hard to please and a terrifying person. No matter how well I served customers, he often found an excuse to chastise my work. He often openly yelled to any employee who displeased him. I am aware of the slogan ‘the boss is always right.’ But a wise boss appreciates his/her staff for the little effort they contribute in the business to boost their morale. The working conditions became unbearable, was dissatisfied in the job, and experienced job stress. I eventually quit the job despite having no other source of income.
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The impact of my boss’ behaviors affected not only me but also some other three employees who were working in the same store. Failure on the part of the boss to address the micro-aggressions of the uncivil acts negatively impacted professional relationships in the job, work productivity, customer service, and everyday interactions. Individually, failure to address the act created a communication barrier between my boss and me, lack of respect, and lost confidence in his leadership. Research evidence from various nursing scholarly articles indicates that incivility creates a toxic work environment (Hoffman, & Chunta, 2015).
In nursing, incivility acts such as making rude remarks, bullying, rudeness, higher burnout rates, and withholding vital patient information affects not only patient safety but also care outcomes. Incivility threatens a patient’s safety as it results in negative interactions between nurses and doctors (Hoffman, & Chunta, 2015). The long-term resultant negative effect is ineffective communication in matters concerning patient needs. The process of care delivery suffers, and a likelihood of adverse patient outcomes increases. Research findings published in the Journal of Korean Academy of Nursing Administration show that incivility among nurses increases patient adverse events. It also decreases the quality of care offered by nurses.
A separate survey conducted by the American Association of Critical-Care Nurses (AACN) revealed that twenty-four percent of nurses reported experiencing public humiliation when managers raise their voice. The use of abusive language by managers and supervisors attacks the sense of self-worth and makes nurses feel small (Abdollahzadeh et al., 2017). Nurses who are victims of such humiliation end up being disrespected by fellow nurses. Mounting evidence suggests that unprofessional relationships in the work environment may arise among nurses, which in turn impacts patient’s outcome and safety. Both targets and witnesses of incivility may end up experiencing adverse behavioral and psychological effects. Nursing is a profession characterized by delicate responsibilities that require proper skills and knowledge to accomplish. Resultant disruptive actions of incivility can make nurses perform medical errors, which in turn reduces patient satisfaction and threatens life.
Importance of Incivility in Nursing
Understanding the issue of incivility in nursing is of critical importance to nursing because the behavior is not only costly but results in detrimental effects to health care organizations. Nurses who are victims of incivility end up putting less effort in their work and turn, produce, and deliver low-quality care to patients. Studies show that job stress, which results from incivility cost corporations in the United States of America three hundred billion dollars annually (Nikstaitis, & Simko, 2014). Such money could have been invested in healthcare research and improving care delivery rather than in addressing the effects of a preventable issue. For a nurse to deliver quality care, he/she should be in be emotionally stable and have a healthy peace of mind to administer medicine skillfully to patients. It is therefore vital to address incivility because it makes nurses to become stressed, unhappy, emotionally unstable, damage relationships, and erodes self-esteem. Eventually, the work environment ends up becoming contaminated, and nurses may act unprofessionally, thereby endangering the lives of patients.
Strategies for Creating a Healthful Environment
Strategic initiatives used in tackling incivility in the healthcare industry should be incorporated together with equal employment opportunity mandates to avoid confusing workers in the nursing profession (Kisner, 2018). Nurse Managers and employers can encourage civility in the workplace by modeling good behavior. Modeling of good behavior will only be possible when managers and supervisors are in the front-line of policing themselves and exhibit the behavior they want to see in every employee. Nurse Managers should ensure that the organizational missions, vision, and policies are aligned with the culture of mutual respect and understanding (Abdollahzadeh et al., 2017).
The second strategy that health care organizations should employ involves the hiring and training people for civility. Building a culture of civility based on mutual respect will be possible if the organization hires potential employees who exhibit signs of good manners (Hoffman, & Chunta, 2015). Such a strategy will shield against the hiring of toxic employees with negative behaviors who may badly treat co-workers and subordinates. Civility training in employee development, on the other hand, will reinforce positive behavior throughout their employment tenure. The last strategy involves avoiding making excuses and holding every employee accountable all day, every day (Kisner, 2018). The organization should address any issue involving disrespectful behavior as soon as employees bring it to their attention.
Conclusion
My future career aspirations have always been to become a distinguished women’s health nurse practitioner (WHCNP). A WHCNP’s responsibility is to ensure that women have access to continuing and comprehensive health care throughout their lives. Civility will become my priority for all my patients, even when working in a stressful environment. Some of the ways of contributing a healthy work environment include providing education and counseling programs to all junior nurses working under me. Counseling programs help in stress management and provide mechanisms to cope with disruptive behaviors in the workplace. Another viable option includes creating a zero-tolerance policy for violence in the workplace while following the regulations given by the American Association of Critical-Care Nurses (AACN)
References
Abdollahzadeh, F., Asghari, E., Ebrahimi, H., Rahmani, A., & Vahidi, M. (2017). How to prevent workplace incivility?: Nurses’ perspective. Iranian journal of nursing and midwifery research , 22 (2), 157.
Hoffman, R. L., & Chunta, K. (2015). Workplace incivility: promoting zero tolerance in nursing. Journal of radiology nursing , 34 (4), 222-227.
Kisner, T. (2018). Workplace incivility: How do you address it?. Nursing2019 , 48 (6), 36-40.
Nikstaitis, T., & Simko, L. C. (2014). Incivility among intensive care nurses: The effects of an educational intervention. Dimensions of critical care nursing , 33 (5), 293-301.
