Introduction
There are various problems facing the medical world today. One of the main challenges is nurses’ incivility, which is evident in different care delivery settings and affects the well-being of the caretakers and patients. The challenge of nurse incivility is mainly based on disrespect, negativity, and disruption by the nurses, which undermines the work environment (Eka & Chambers, 2019). There are various pieces of evidence of nurses’ incivility, which have been displayed in the media and those that patients experience every time. Some examples include hostility, rudeness, poor communication, withholding information, and belittling of patients. The evidence of incivility has affected nurses and other healthcare professionals, patients, as well as the families of the patients. These are often in terms of subtle remarks or even outright aggression. Incivility is a complex issue that results in a wide range of challenges to healthcare delivery (Eka & Chambers, 2019). For instance, when it happens between colleagues, it can result in decreased job satisfaction, high turnover, and burnout in the nurses. On the other hand, it can affect the delivery of patient care, causing medical errors and low satisfaction of patients, among other adverse outcomes. Therefore, it is essential to come up with ways of evaluating the causes of incivility, the consequences, and the strategies which can be used to address the issue.
With increased recognition of incivility as a problem in society today, it is essential to adopt ways of dealing with and eliminating the challenge. This may be in terms of regular reports of incivility by nurses. However, the subtle and ingrained nature of the problem makes it difficult to address the problem. Moreover, there needs to be more consensus in research on what constitutes incivility and some of the best ways of addressing the problem. As a result, this analysis seeks to evaluate the problems and understand the challenges related to incivility and some solutions for addressing the problem. This will be critical in contributing to developing evidence-based strategies and developing a more supportive work environment in healthcare settings. Dealing with this problem calls for the engagement of different stakeholders in various settings and supporting the process to achieve a positive outcome. Therefore, in this analysis, a review of the literature and identification of causes and consequences will be done to develop evidence-based strategies for dealing with the problem in healthcare settings.
Problem Statement
Background
Considering the demanding nature of the nursing profession, nurses often require high levels of professionalism. This can be achieved through teamwork, interpersonal communication, and emotional intelligence. Therefore, managing the complexity of the working environment is a vital role of a nurse in ensuring better patient outcomes (Maharaj et al., 2019). However, it is evident that while this is a critical consideration for nurses, they often experience some form of incivility from colleagues, patients, and organizations, which can result in significant consequences to the process of medical service delivery.
Problem Description
Incivility in nursing has been identified as a significant challenge that results in psychological and physiological distress to the people involved. It has been associated with impeding the development of a harmonious and cooperative working atmosphere. At the same time, researchers have noted that incivility undermines the safety culture and jeopardizes the welfare and goal attainment of patients, staff members, and other stakeholders in healthcare facilities. A study on nursing education and practice in 2016 indicated that more than 80% of nurses have either dealt with incivility or experienced some form of incivility in the workplace (Crawford et al., 2019). Also, data indicates that approximately 40% of nurses report incivility every week. It is important to note that there currently does not exist any federal statute that requires protection against incivility. Therefore, there is a critical need to enact legislation and regulation to protect healthcare workers, patients, and different stakeholders in care delivery from incivility in the workplace. Lack of protection against incivility has indicated that more than 87% of nurses have low job satisfaction, reduced retention, and a lack of commitment toward the delivery of services (Shoorideh et al., 2021). Therefore, it is evident that incivility is a critical problem in healthcare systems today, and there is a vital need to address the problem and ensure positive impacts in the long term.
Stakeholders Affected
The problem significantly affects nurses, patients, and healthcare organizations. This results in adverse consequences for these stakeholders affecting the primary goal of healthcare service delivery, ensuring quality patient care. For nurses, reduced job satisfaction and burnout or turnover are one of the challenges of incivility. Also, when incivility forces nurses to leave their jobs, it causes a shortage of nursing staff and reduces patient care. For patients, incivility causes reduced quality of care, mainly due to poor communication between the nurses and the patients, which can affect their safety outcomes (DeOca, 2021). For the healthcare organization, incivility causes reduced productivity, high costs, and a poor societal reputation. At the same time, an organization is forced to deal with low morale of employees, high turnover, and poor satisfaction of patients. Incivility causes adverse outcomes to healthcare delivery and the health sector’s overall goal of patient care.
Solutions to the Problem of Nurse Incivility
To identify the solutions to the problem of incivility, it is essential to note the costs that it has in society. A study carried out in 2017 indicated that more than 800 physicians in the USA reported experiencing offensive remarks about themselves, including comments about their race, gender, ethnicity, weight, and age. Studies further indicate how female physicians experience more bias than males. A 2015 study indicated that 48% of workers who had experienced or received incivility cut back their work efforts resulting in a 66% decrease in performance (Alberts, 2015). 80% of the time was lost while the workers were thinking about the incidents, and 12% left their job.
On the other hand, a study on the importance of civility noted that people who displayed civility in the workplace, such as through attentive listening, giving credit, and acknowledging others, were more satisfied in their jobs and were considered by others as competent and warm as leaders. Therefore, having a plan in place to deal with situations of incivility is very important for today’s healthcare delivery environment. This is mainly because it helps keep healthcare stakeholders safe both physically, emotionally, and spiritually. At the same time, it helps avoid these costs resulting from a lack of civility in healthcare.
- Changing Organization Culture
The organization’s culture plays a vital role in influencing the behavior of employees and dealing with incivility in the workplace. Therefore, changing the organization’s culture can help solve the problem. First, promoting a culture where employees respect each other allows the nurses to treat each other with kindness and professionalism and encourages compassion. Civility in the workplace is essential in setting the tone for the workers’ most acceptable behaviors and establishing the standards on how people should behave and interact with each other (Frisbee et al., 2019). Further, the organization managers need to work on educating, training, and leading their employees in a direction where they can respect each other, communicate and collaborate to solve problems. Also, leaders need to model positive behavior within the organization in such a way that they support the employees that experience incivility. Organizational culture is an important way of helping the employees be accountable for their actions and creating an environment where leaders can communicate in an individual behavior setting the consequences for the people that do not practice or meet the expectations.
- Regular education of nurses
This is another essential part of ensuring that nurses understand the impact of their behaviors on patient care, the satisfaction of their fellow employees, and overall organizational performance. Making nurses aware allows them to recognize how important it is to communicate respectably and work on addressing the problem of incivility. At the same time, regular education allows the employees to understand different strategies for adopting effective communication and conflict resolution. Employees are therefore more equipped in such a way that they can actively listen to the patients, remain assertive and respect each other during communication. At the same time, nurses with better education can handle difficult situations and communicate effectively with their colleagues. Regular education is a step toward creating a culture of respect within the organization. Education of nurses in the workplace helps them understand why communicating respectfully and positively interacting with each other is essential for the organization’s success.
Further regular education of nurses helps them to work collaboratively as a team, thus reducing incivility. Nurses are better equipped to work together in this case, allowing them to avoid conflict that can cause incivility. Education also helps provide the nurses with needed resources to support their incivility experiences.
- Developing and enforcing a code of conduct
A code of conduct in place for any nursing facility is critical for success and overall organizational performance. In this case, it can work as a strategy for minimizing the incivility of nurses. This is mainly because they clearly illustrate their expectations for each nurse in terms of communication and behavior with each other patient or any other person in the facility. With a clear code of conduct, the nurses can understand what incivility is and have an understanding of the guidelines for proper behaviors. Also, a code of conduct allows the employees to understand the consequences of violating the requirements, such as disciplinary action, retraining, and termination whenever necessary. When employees understand that they can face the consequences of their actions, it can deter them from engaging in uncivil behavior (Boo et al., 2022).
On the other hand, a code of conduct ensures consistency in enforcement where the nurses have a set of guidelines on what is applicable to all of them. This is critical in ensuring that all employees are not favored and that everyone is held to the same standard. This reduced favoritism and perception of unfairness when it came to enforcing the rules in the workplace. At the same time, the code of conduct acts as a way of clarifying the rights and responsibilities. This helps them understand their rights, such as respectful treatment. This helps solve the problem of miscommunication or misunderstanding that can cause incivility within the workplace.
- Providing support to victims of incivility
As a solution to the problem of incivility, providing support to victims is a meaningful way, especially in allowing the victims to have some validation and feel understood and heard. This way the organization will be able to address the negative emotional impacts incivility has on an individual. At the same time, supporting the victims allows them to have some coping strategies to manage the negative impacts resulting from incivility. This is important as it allows them to manage stress and anxiety and deal with negative emotions resulting from being a target of incivility. This allows the nurses and other people to be equipped with ways of handling future instances of the same, thus allowing them to avoid any instances of the same themselves (Layne et al., 2019).
On the other hand, medical facilities must establish some reporting mechanisms where victims can report cases and feel that the management or their colleagues are supporting them. Allowing the nurses to report is essential in minimizing incivility and helps contribute to the workplace’s culture of respect and collaboration. Another way of supporting victims is by training them, which allows them to understand different ways of handling incivility and working on effective communication strategies to prevent similar cases. Therefore, victims serve as ambassadors and are equipped with skills to deal with similar situations in the future by fostering better communication and positive behavior.
- Holding offenders accountable
It is important to note that accountability is the first step toward acceptance and dedication toward improvement. Therefore, ensuring that offenders are accountable within a nursing facility reduces incivility among nursing professionals. For instance, this helps ensure deterrence where individuals that engage in uncivil behaviors serve as an example to the rest of the employees that similar practices in the future will not likely be tolerated within the facility. As a result, the rest of the employees and stakeholders will likely refrain from engaging in similar behaviors if they avoid facing the consequences. At the same time, accountability helps prevent similar incidents as the offenders. Once they are punished, they are not likely to repeat the same behaviors in the future. At the same time, ensuring that the offenders are held accountable helps serve as a form of restitution to the victims (Alquwez, 2020). For organizations changing the culture, holding the offenders accountable is an important way of strengthening the culture and allowing the rest of the employees to take the changes seriously, thus boosting accountability and professionalism in work. This allows every employee to act acceptably and make decisions professionally without disrespecting anyone. In the long term, offenders can decide to change as they avoid being held accountable.
Effectiveness of These Solutions in Solving the Problem
Over the years, different strategies have been adopted to deal with the problem of incivility in nursing. However, many have indicated significant failures and lack of effectiveness when dealing with the problems in medical practices. For instance, some strategies have not been fully enforced, meaning the offenders are not held accountable for their behaviors. Therefore it has resulted in tolerated incivility in the workplace (Karaçay & Oflaz, 2022). On the other hand, nurses have not been sufficiently trained in identifying and dealing with this problem. The lack of proper training of employees means that employees lack the understanding of how to deal with different problems, and therefore they are highly likely to experience incivility. Most people fail to report incivility due to the fear of retaliation from the other employees or offenders themselves, which can adversely impact the employees’ employment productivity. Lack of support from the management and lack of resources aimed at ensuring that incivility is dealt with has contributed significantly to the failures of the strategies adopted in the past to deal with incivility. Poor leadership in nursing facilities and workplace environments has seen leaders fail to prioritize incivility, leading to people modeling or promoting behavior that negatively impacts the facility. In the long run, leaders fail to take a strong stance against incivility, which tends to indicate that it is not a vital issue that can be addressed due to promoting the behavior (Karaçay & Oflaz, 2022). These challenges indicate the need for a multifaceted strategy to solve the problem of incivility in nursing practice. Therefore, our recommendations above tend to help solve the problem by identifying the most effective ways of solving the problem in the long term.
Conclusion
In this analysis, we have evaluated the problem of incivility in nursing. This indicates a critical problem that affects major medical facilities in the healthcare facilities today. Incivility is evident through rudeness, hostility, poor communication, and withholding of information, among other strategies. This problem has been identified to affect more than 80% of medical workers and nurses. Therefore medical facilities and other healthcare organizations need to work on solving the problem in the long term. Some of the identified solutions in this analysis include changing the organization’s culture, regular training and education of nurses, enforcing a code of conduct, providing support to victims, and holding the offenders accountable. These strategies indicate a significant potential of fully solving the problem of incivility and, in the long run, ensuring that nurses harmoniously interact with each other, collaborating and working as teams in solving different problems. Despite the challenges faced when dealing with the problem of incivility the identified strategies are effective in ensuring success in the long term.
References
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