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Emerging Nurse Leader

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Promoting Civility

September 8, 2016 by rose

An eye for an eye makes the whole world blind”.  Mahatma Gandhi

If you watch the nightly news and/or observe what goes on in our political environments today, you may sometimes wonder if we live in a civilized society.  There is a rash of discourteous, disrespectful and rude behavior that is strangely tolerated, and even accepted as a new norm.  Bullying others now seems to be OK.  With increasing pressure to get their work done, some staff may feel that there is no time to be polite, to say please or thank you or to think about how their behavior is affecting others on the team.  Even patients today feel more comfortable telling staff that they will punch them in the face if they don’t have their needs met.  The issue of incivility has become an important topic of concern in all workplaces, but especially healthcare where it has the potential to impact patient safety.  The interesting problem with incivility is that if it is not dealt with, it can exponentially increase over time and become an accepted part of a work culture.

What is Civility?

Civility in the workplace can be defined as behaviors that show respect toward another person, makes them feel valued, and contributes to mutual respect, effective communication and team collaboration.  Conversely, workplace incivility can be defined as “low-intensity deviant behavior with ambiguous intent to harm the target, in violation of workplace norms for mutual respect; uncivil behaviors are characteristically rude and discourteous, displaying a lack of regard for others  In a Civility in America 2016 poll, nearly all Americans, 95 percent, say civility is a problem, with three-quarters (74 percent) saying civility has declined in the past few years. 70 percent also say that incivility in this country has risen to “crisis” levels, up from 65 percent in 2014.

The Costs of Incivility

Disrespectful and uncivil behaviors drain productivity and negatively influence staff satisfaction and patient outcomes.  Incivility has been found to contribute to the following:

  • Staff Sick Leave Use
  • Loss of Productivity
  • Staff Turnover
  • Staff Disengagement
  • Medical Errors

With our changing US healthcare reimbursement structures now tied to patient satisfaction with care, incivility in clinical environments may also have a significant negative impact on the economic bottom line of organizations.

Reducing Incivility in the Work Environment

One interesting find in the Civility in America poll described above is that US Workers surveyed felt that the leadership in the country and in their organizations were accountable for the growth in workplace incivility.  Many leaders might disagree with this finding, but it is true that leaders are highly influential in establishing work cultures that either tolerate or don’t tolerate incivility.  Ski Lower in an article in the American Nurse Today provides some good strategies that leaders can use to promote civility in their environments.

  1. Examine your own behavior and how you contribute to civility or incivility.
  2. Take a temperature check in your unit to see how staff treat one another.
  3. Don’t listen to or tolerate rumors and gossip.
  4. Encourage staff not to jump to conclusions about the intent or motives of other staff, patients or families.
  5. Stop the blame game and encourage a solutions orientation to problems.
  6. Encourage acts of kindness among staff.
  7. Go out of your way to say thank you and promote this behavior in staff.
  8. Look for common ground in dealing with conflict.
  9. Encourage the practice of forgiveness.
  10. Make it safe for staff to ask questions and discuss problems.

Anne Frank once wisely observed that, “How wonderful it is that nobody need wait a single moment before starting to improve the world.”   This is good advice for nurse leaders to consider.  Small changes in behavior to promote civility can produce powerful results.

Lower, J. (2012).  Civility starts with you.  American Nurse Today. 7(5). 21-22.

Sutton, R.I. (2007).  The No-Asshole Rule: Building a Civilized Workplace and Surviving One that Isn’t.   New York: Business Plus.

© emergingrnleader.com 2016

Filed Under: The Future of Healthcare Tagged With: Bullying, incivility

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