By Rose O. Sherman, EdD, RN, NEA-BC, FAAN
Reducing negativity and incivility in their cultures is a major challenge for virtually every leader I have interviewed during the past three months. Not surprisingly, the incivility and discord that we see in society have seeped into our healthcare environments. Nurses are stressed on so many levels that many have very short emotional fuses. Situations that could have been easily managed a year ago by a nurse leader can now easily ignite into major dramas. For leaders, the staffing shortages are complicating an already difficult situation. Some admit that they overlook behaviors because the fight is too much, and they don’t have the energy or emotional bandwidth to deal with it.
In a 2015 New York Times op-ed, Christine Porath observed that “How we treat one another at work matters. Insensitive interactions have a way of whittling away at people’s health, performance, and souls.” Cultures where there is tolerance for incivility can feel very psychologically unsafe for staff. Worse yet, this incivility can quickly lead to situations where bullying is tolerated and even normalized. One leader recently asked a webinar about the differences between staff who lack civility and those who bully. It is a good question because although leaders need to confront both types of behavior, they are different.
The American Nurse Association has defined incivility as rude and discourteous behavior that may or may not have negative intent behind the behavior. These can be longstanding behaviors that staff may lack self-awareness about. Nurse leaders need to call out incivility that often manifests itself as abrasive, intimidating, or condescending statements. These behaviors are generally not targeted to any specific individual which is what makes incivility different than bullying.
By contrast, the bully intends to cause harm with targeted behaviors that are often premeditated. Renee Thompson, an expert on bullying in nursing, identifies three key components to bullying:
- A target – The bully chooses a target, a nurse or group of nurses such as new graduates on the unit.
- Harmful behavior – The bully intends to inflict harm through criticism, sabotage, or setting a nurse up for failure. Intent to harm is the difference between constructive feedback and bullying.
- Repeated behavior – The harmful behavior must be repeated over time.
Both incivility and bullying are very damaging in organizations. Incivility needs to be confronted by raising awareness and setting behavioral standards for team relationships. Some nurses will need to be coached to raise their awareness about how others perceive their behaviors. Bullying requires even more aggressive action by the leader. A culture of zero-tolerance for bullying is the most effective leadership strategy to prevent its occurrence. Staff needs education about the behaviors that constitute bullying to help break the silence.
General David Morrison wisely reminded us that “the standard we walk by is the standard we accept.” This is important for leaders to understand. When we don’t confront incivility and bullying, deviant behaviors can become normalized in the culture and become the way we treat each other. Once there is a normalization of deviance, resetting the culture is challenging, so leaders need to act now.
© emergingrnleader.com 2021
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