The Importance Of Incivility In Nursing

Everyone has to deal with conflict: both in the workplace and personal lives. Fresh nurses too have to witness this at their new work setting.

At the same time, workplace incivility happens between colleagues and between manager and subordinates, it is happening almost every day in healthcare settings such as in hospital and clinics where workers are directly uncivil to disrespect each other. For instance, when a nurse is deviant or does not follow the supervisor intensely because of differences in opinion or an act of retaliation when the manager is being rude, treating their staff with rough words, discourtesy, and lack respect to his staff, there are also times when the uncivil behavior is not intentional or

work relationships in nursing to find a solution. The result of that investigation stated that horizontal violence in nursing is commonplace and experienced by nursing students, nurses with limited experience, and seasoned nurses equally.

Key words and terminology in the article search included hostility, nursing turnover, nursing attrition, nurse aggression, bullying, and nurse hostility. Specific key words that were used to narrow down the search included incivility, nurse turnover, lateral violence (LV), horizontal violence (HV), disruptive behavior (DB), and horizontal hostility (HH). The publication date range was adjusted to 2012 through 2017. The following literature review probes into the research of incivility to explore the connection with nursing turnover and patient care.

Implementation of this intervention in other rural nursing settings may assist nurses in cultivating greater confidence in their ability to recognize and respond to workplace incivility (Armstrong,

Workplace violence commonly occurs between nurses, between nurses and patient, between nurses and families, or even between nurses and physician. Violence from relatives and friends of patients may occur as a result of frustration with a perceived lack of care or communication (Roche et.al. 2010). According to Woefle and McCaffrey there two consequences of violence (physical and psychological) for nurses and organization. Physical by the mean nurses can possibly experience weight loss, cardiac palpitation, stress, hypertension and irritable bowel syndrome. Psychological by the means of being mentally drain of nurses that can cause danger in giving a quality care.

Nurses have a professional responsibility to ensure that safe boundaries are kept in the relationship between patient and Nurse. It is these boundaries that provide the nursing profession with integrity, and according to Baca (2010, pp.195) it is essential these boundaries be maintained because of the difference in power between the nurse and patient. However, boundary violations can occur, when a nurse crosses from the zone of helpfulness to over involved, the ANMC (2011 pp.3) believes that when a violation occurs a nurse is behaving unprofessional manner and misusing their power in the patient nurse relationship. This misuse of power can be categorized into 3 types; boundary crossing, boundary violation and the extreme form of sexual misconduct. Often by mistake a nurse could cross the boundary without thought, a

Unfortunately, I have experienced and witnessed incivility in my past place of work. One experience that I can remember where I can say that I fell victim to incivility involved a situation with my center manager and me. A couple of months ago my family and I experienced a sudden and tragic death of one of my dearest cousins. When I found out about this devastating news I set up a meeting with my supervisor to inform her of this tragedy and the one day I will need off so I have time to attend her funeral and wake. Long story short she was not too thrilled for letting her know about the time off in such short notice. She failed to show any sympathy and denied me the time off a went on to tell me that if I call out and fail to fine coverage I would receive a point on my record. After hearing, this I was so outraged and confused, I couldn't understand how someone working in healthcare can lack so empathy and compassion for her employees. This situation caused me to have ill feeling toward my manager, which created a hostile environment; and it was at that point I began my search for a new facility to practice in.

Moreover, another type of violence which nurses experience is horizontal violence. Horizontal violence is described as “hostile, aggressive, and harmful behavior by a nurse or group of nurses toward a co-worker or group of nurses via attitudes, actions, words, and behaviors” (Becher & Visovsky, 2012, p. 210). Horizontal violence not only involves nurse-nurse violence but includes nurse-physician and nurse-supervisor violence. The perpetrator displays behaviors associated with horizontal violence which may include refusing to lend assistance, criticizing, intimidation, gossiping, name-calling, and ignoring (Becher & Visovsky, 2012). The American Nurses Association sets the expectations for nursing standards. According to the American Nurses

Nursing is a career that offers many benefits, but with it comes numerous controversies. A major controversy that is evident today is lateral violence in the workplace. Norris (2010) describes lateral violence as, “the act of threatening, humiliating, or actually inflicting physical, mental or emotional harm on a peer or group” (p. 1). This topic has become critical in the nursing field because it impacts a very large demographic. Lateral violence affects nurses, patients, and the healthcare system as a whole and there are many techniques being put in place to try and prevent its existence.

Horizontal violence is characterized by the presence of series of undermining incidents overtime, as opposed to one isolated conflict in the workplace (Jackson, Flirtko, & Edenborough, 2007). I believe that being a nurse is one of the most rewarding careers. At the same time it is very challenging work physically and emotionally. When faced with horizontal violence in a workplace; it makes it very difficult for the nurses to provide a focused patient care especially working under mostly male physicians and being looked down upon at times. Cherished nursing characteristics, such as sensitivity and caring are viewed as less important or even negative when compared to those of medical practitioners, who often are seen as the central culture in health care (Woelfle & McCaffrey).

The past decade accrediting and nursing professional bodies such as the Joint Commission and the American Nurses Association have been taking a closer look at the occurrence of incivility between coworkers in healthcare (Smith, Morin & Lake, 2018). In 2015 the American Nurses Association (ANA) came out with a position statement that addressed incivility within the nursing code of ethics. In this position statement the ANA (2015) proposes that nurses create a culture and environment of civility and kindness treating coworkers, colleagues, students with dignity and

My experience with nursing incivility began when I became a certified nursing assistant (CNA). I was hired at a local nursing home as a float CNA, but being that five out of the seven assignments on my unit has permanent CNAs, there were only two assignments I floated to.

If a nurse purposely does not relay information, the patient can develop a condition that could have been prevented (e.g. pressure ulcers, incontinence, nosocomial infections). Promoting and Implementing Civility in Nurses Promoting civility can be described as showing respect toward another person. However, the problem with bullying, is it cannot be reversed with one simple approach. Healthcare organizations need to be restructured to solve the problems that take place in their facilities (Granstra, 2015).

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).