Incivility means unacceptable and rude behavior within a workplace which results in psychological distress and becomes an obstacle for good work. It is a serious issue in the healthcare sphere affecting both the doctors’ welfare and the quality of provided services. It may seem strange that in such a profession, whose main purpose is caring for people, problems related to treating colleagues exist. It is reported that in the USA “24.1% of nurses stated they were verbally abused either by a nurse manager or nurse colleague” (Logan, 2016, p. 49). The American Nurses Association (ANA, n.d.) recommends creating and supporting a safe and respectful work environment, making the health the main priority. Nurses should feel secure at work, and not be afraid of exposing acts of improper treatment to the management. Without a doubt, it is easy to ignore the fact of this problem existence, but it requires close attention as incivility evokes many serious consequences, demanding working solutions to be found.
Impact of Incivility on Clinical Judgment Ability
The ability of showing good performance is directly influenced by the environment and organization at work. Creating a positive atmosphere is required for successful nursing practice. Meanwhile, workplace incivility is a huge problem in the healthcare sphere. There are many cases of inappropriate treatment, such as a surgeon reprimanding a nurse handing the wrong instrument, a social worker addressing a cleaner in a humiliating manner in front of a patient, and others. Such incidents often happen in situations where people have no time to think of their actions and words, and it is one of the biggest issues in medical care. It is established that those who encounter incivility at work experience a number of behavioral and psychological problems. Consequently, this distress affects their ability to effectively use clinical judgment.
Psychological stress which appears as the result of incivility leads to situations when nurses become less committed to their job and responsibilities. Besides, victims of incivility “are more likely to quit their job” (Logan, 2016, p. 49). It is a serious issue as healthcare often loses good professionals. Nurses who suffer from uncivil treatment develop low self-esteem which may later result in health problems such as sleep deprivation, headaches, depression, and mood swings. These issues immediately impact the clinical judgment of nurses, which is a major skill, helping to provide safe and effective care on the basis of scientific evidence. Incivility typically distracts a person, occupying their mind, and shifts the focus of attention. This situation often leads to serious medical errors and damage to the patients’ health, for example, the drugs usage without proper prescription, an absence of support when lifting a person, or an appointed procedure omission.
Moreover, in many cases, personnel, especially new nurses, may experience stress when facing a gap between their career expectations and real medical competences. As the result, they begin to show ambiguous behaviors, such as ignoring requests, being treated unfairly or confronted with rude language by colleagues. Workplace incivility affects the nurses’ attitudes, and decreases their self-confidence, making it difficult for them to objectively evaluate their own performance. In addition, the negative atmosphere at work can lead to a lack of motivation, and, therefore, to worse performance, as such employees stop trying to achieve their goals and provide lower quality care.
Incidents at Workplace Provoked by Incivility
Incivility among nurses affects not only the morale side but also a patient’s safety and medical outcomes. According to research, intimidation of nurses leads to medical errors in approximately 7% of cases (American Nurses Association [ANA], 2015). As the result, there is an increase of incidents happening to patients, such as falls or delayed medication administration. Moreover, incivility has a spiral effect arising more cases of even more aggressive behavior, and affecting the process of communication between the personnel, patients, and their families. Nurses who are treated inappropriately often begin being hostile to their patients and other colleagues. In most cases, even the behavior which seems to be harmless can decrease care quality and inflict physical or psychological damage to the patient’s health. For example, in a situation when a nurse is rude to the client, it can result in their state aggravation, as the person does not receive the support they require. Problems with attitude between colleagues may also result in hurting patients, as the employee, failing to converse with the team members, would not receive advice or help when needed. Thus, communication problems in healthcare are harmful at all the levels.
It is estimated that quality patient care depends on effective teamwork, which is regarded as “an essential part of healthcare’s organizational fabric for delivering quality care” (Logan, 2016, p. 48). In case of existing incivility, the team is always dissociated, which leads to lower performance of the personnel and to medical errors, which sometimes can result in serious consequences. Hospitals and organizations suffer from these situations as well, as they often ruin the reputation of the institute. Patients and their families who did not receive the care they were expected would hardly return back or recommend the organization to others. These are the basic principles upon which reputation is built. Moreover, the personnel being not content with their work conditions have more chances to make critical mistakes during medical procedures or mistreat their clients.
Initiatives for Decreasing Incivility
All over the world, experts are concerned with this problem of increased medical errors, lowered patients’ satisfaction and loss of qualified personnel. That is why a set of rules destined at encouraging civility was adopted by many organizations. First of all, it is necessary to “establish a strict zero-tolerance policy for violence” (Bradley University, n.d., para. 9). The ANA (2015) recommendations include collaboration, effective decision-making, skilled communication, meaningful recognition, and authentic leadership. These qualities are critical for preventing disruptive behavior among the personnel.
Other important rules include providing counseling programs which allow nurses feel confident and know that they will receive help in coping with inappropriate behaviors at work. Another good measure is creating a reporting system and monitoring the cases of incivility, as nurses should be able to protect themselves by reporting the violations without fearing criticism or retribution. The last important factor is teaching leaders to be models of appropriate behavior and, thus, setting a culture of respect in the organization. By following these principles, it is possible to solve the problem of incivility in healthcare.
Conclusion
In conclusion, incivility is one of the most serious problems in the medical sphere. It affects nurses’ performance and often leads to losing excellent workers, because many people do not cope with these problems and have to quit. Incivility results in psychological problems and may lead to a severe depression what, in its turn, results in increase of medical errors inflicting damage to patients. In order to solve the problem, certain recommendations which should be followed exist, including the creation of the leader image serving as an example of proper behavior. The main idea targeted at providing conditions necessary for a good performance at work is nurturing a harmonious environment in the organization. This can improve the efficiency and quality of nursing care, and the personnel may demonstrate positive behavior and achieve their career goals. It is an obligation for colleagues and supervisors to make this proper atmosphere in order to help nurses provide good care for their patients.
References
American Nurses Association (n.d.). Violence, incivility, & bullying. Web.
American Nurses Association (2015). Professional issues panel on incivility, bullying, and workplace violence. Web.
Bradley University (n.d). Fostering civility among nursing staff. Web.
Logan, T. R. (2016). Influence of teamwork behaviors on workplace incivility as it applies to nurses. Creighton Journal of Interdisciplinary Leadership, 2(1), 47–53. Web.