The working environment is important for any occupation, but in nursing it becomes crucial. The matter is that nurses closely interact with patients and unfavorable work environment can cause undesirable outcomes. For example, scholars prove that workplace incivility is related to stress and burnout and the complex of these factors has to impact on nurses’ turnover intentions (Oyeleye, Hanson, O’Connor, & Dunn, 2013). Moreover, incivility, or workplace mistreatment, can influence nurse-assessed patient outcomes and even increase patient safety risk (Laschinger, 2014). Thus, there is a necessity to develop strategies that can be applied for creation of a healthful environment in healthcare facilities. The current paper analyzes the concept of incivility, focuses on the significance of incivility in nursing, suggests a practice-related incivility scenario, provides strategies for healthful environment creation and identifies how these strategies can be used in practice.
The Issue of Incivility
At present, researchers determine such types of workplace violence as incivility or bullying (Laschinger, 2014). They do not look serious but can have detrimental effects on activity. While workplace bullying is explained as “repeated and prolonged exposure to predominantly psychological mistreatment, directed at a target which is typically teased, badgered and insulted,” incivility “refers to low-intensity rude or disrespectful behaviors with an ambiguous intent to harm others and differs from bullying in terms of degree, duration, and intentionality” (Laschinger, 2014, p. 284). Within a workplace, incivility is defined as “‘ low-intensity deviant behavior with ambiguous intent to harm the target and violates workplace norms for mutual respect” (Oyeleye et al., 2013, p. 537). D’ambra and Andrews (2013) in their study about the interconnection of incivility and retention explain incivility as rude, discourteous and disrespectful behavior towards other individuals. On the whole, these definitions have much in common, and it can be concluded that there is no ambiguity in its definition.
Importance of Incivility to Nursing
Workplace incivility is frequently studied in the context of the nursing profession. It is considered to be one of the multiple turnover predictors. D’ambra and Andrews (2013) state that “incivility in the workplace decreases job satisfaction and organizational commitment while increasing stated intent to leave” (p. 735). Moreover, the authors investigate the impact of incivility on retention and new graduate nurses concluding that incivility is an issue which should be addressed during graduate nurse transition programs together with interventions aimed at the increase of satisfaction and retention rates (D’ambra & Andrews, 2013).
According to Oyeleye et al. (2013), workplace incivility has the impact on work environments. A hospital unit, which is a specific microsystem, has its work climate that is expected to reduce stress and prevent burnout. However, incivility negatively influences this microsystem interfering with the positive environment and increasing stress and burnout rates (Oyeleye et al., 2013). Finally, incivility has an impact on nursing profession on the whole and its primary goal, which is patient safety, in particular. Thus, Laschinger (2014) in his investigation of bullying and incivility from medical staff came to a conclusion that these factors are related to nurse-assessed adverse events and patient quality of care.
Incivility Scenario
Although healthcare facilities attempt to avoid incivility cases, they are still frequent. One of the scenarios in which incivility is evident is as follows. A young nurse came to a cardiac unit of a hospital after college. She was appointed to work with an experienced nurse who was supposed to train a graduate and control her activity. Nevertheless, a more experienced nurse did not want to waste time and did not explain the necessary manipulations properly. As a result, a graduate nurse could not gain self-confidence and work slower than other nurses who made some other staff members mock her. As a result, the work environment lost its positive character.
Strategies for Healthful Environment
It is evident that incivility in the workplace should be prevented. To achieve this goal, it is necessary to develop strategies that will empower the creation of a healthful environment. One of the strategies that will contribute to healthful environment comprises targeted retention programs and policies “that will be sensitive to the needs and interests of nurses at high risk for leaving their organizations is imperative for nurse executives” (Oyeleye et al., 2013, p. 536). This strategy includes interventions that are supposed to reduce burnout and manage workplace stress. Moreover, it presupposes psychological empowerment which provides adaptive modes stimulating civil behavior.
Another strategy is workplace empowerment. It is primarily aimed at graduate nurses who start their career. D’ambra and Andrews (2013) believe that empowerment and a healthy work environment positively influence new graduate transition. According to the researchers, workplace empowerment comprises equal access to “opportunities, information, support, resources and relationships” for both experienced and novice staff members (D’ambra & Andrews, 2013, p. 739).
Finally, Twigg and McCullough (2014) suggest collaborative nurse-physician relationships as a strategy to create healthful work environment. Collegial relationships include better professional communication, encouragement of continuous education, and respect and trust among the colleagues. It is likely not only to create positive practice environment but also improve patient outcomes.
Practical Application
My selected specialty track is a family nurse practitioner. Within my specialty track, I can apply the following strategies that can contribute to the cultivation of a healthful work environment. First of all, I believe that skilled communication, which is defined as one of the standards contributing to a healthy work environment, can be an effective strategy (Morton, 2015). It presupposes written, spoke, and non-verbal communication between nurses. Communication is a part of nursing education and should be further trained during professional activity because effective information exchange is crucial both for the work environment and patient outcomes. Another strategy which I can apply in my practice is effective decision making (Morton, 2015). As a part of the staff, I am responsible for my decisions which should be based on my knowledge, skills, and policy of the healthcare facility. Effective decisions contribute to the improvement of performance thus creating a more positive working environment.
Conclusion
On the whole, workplace incivility is an issue which is frequently neglected by nurses and by managers. However, considering its possible negative consequences, incivility should be among the primary concerns of healthcare facilities. Thus, attention to incivility can help to reduce workplace stress and stimulate employee retention. Moreover, it stimulates the development of healthful working environments. As a family nurse practitioner, I can contribute to cultivating healthful environments in my future professional practice. For example, I can apply communication strategies to keep in touch with colleagues or train effective decision-making skills to guarantee my efficient, practical activity and contribute to the healthful work environment. Also, I believe that workplace empowerment is helpful because it presupposes equal access to different facilities and opportunities thus increasing nurse work satisfaction and, as a result, contributing to the healthful work environment.
References
D’ambra, A., & Andrews, D. (2013). Incivility, retention and new graduate nurses: An integrated review of the literature. Journal of Nursing Management, 22(6), 735-742.
Laschinger, H. (2014). Impact of workplace mistreatment on patient safety risk and nurse-assessed patient outcomes. JONA: The Journal of Nursing Administration, 44(5), 284-290.
Morton, P. (2015). Creating and sustaining healthy work environments. Journal of Professional Nursing, 31(3), 165-167.
Oyeleye, O., Hanson, P., O’Connor, N., & Dunn, D. (2013). Relationship of workplace incivility, stress, and burnout on nurses’ turnover intentions and psychological empowerment. JONA: The Journal of Nursing Administration, 43(10), 536-542.
Twigg, D., & McCullough, K. (2014). Nurse retention: A review of strategies to create and enhance positive practice environments in clinical settings. International Journal of Nursing Studies, 51(1), 85-92.