Incivility in Nursing: Creating a Healthy Work Environment

This essay discusses the issue of incivility in the nursing profession and proposes strategies for creating a healthy work environment. It explores the prevalence of incivility, its impact on nurses' mental health, and the need for effective measures to address the problem.

Running head: NURSING ASSIGNMENT
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Name of the Student:
Name of the University:
Author Note:

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Introduction:
Incivility can be defined as a form of rude or unsociable behaviour. It can be defined
as a condition where an employee experiences an impolite behaviour or an offensive
comment (Muliara et al., 2017). In recent times, incivility and bullying have emerged out to
be complicated issues in nursing. A number of evidences state that incivility is on the rise
within healthcare organizations and are eliciting a negative implication on the care
professionals as well as the patients (Minton et al., 2018; Laschinger et al., 2013). This essay
would talk about the instance of incivility within the nursing profession and formulate a plan
for the creation of a healthy work environment.
Issue of incivility:
According to Rad and Moonaghi (2016), instances of incivility, bullying and violence
have become common in the nursing profession globally. According to a research study
conducted by Bambi et al. (2018), it has been estimated that approximately 67.5% to 90.4%
of the Nurses experience one episode of workplace incivility in their professional career.
Also, the research study indicated that the prevalence percentage of Lateral Violence varied
in between 1% to 87.4% and that of bullying ranged in between 2.4% to 81% (Bambi et al.,
2018). The National Institute of Occupational Safety has subdivided violence experienced by
Nurses under four categories that include, Criminal Intent where in there is no clear
relationship between the victim and the perpetrator and the violence is committed with a
criminal intent (ANA, 2019). The second category forms the most common type of violence
that Nurses experience within healthcare setting and it involves the clients (ANA, 2019). The
crime involves the client or a family member of a client assaulting the nurse within the
healthcare setting. The third category comprises the ‘worker-on-worker violence’ which is
also known as bullying and is practiced by the fellow colleagues (ANA, 2019). The fourth

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category includes a special case of ‘Personal Relationship’ where the offender targets and
assaults the victim on account of a previous personal grudge within the healthcare setting
(ANA, 2019). It should be critically noted in this context that the categories of violence
discussed above are not merely restricted to physical violence but also include instances of
psychological, emotional and verbal abuse. Research studies have indicated that the impact of
incivility on the nursing profession leads to above 25% of the nurses burnout globally
(Oyeleye et al., 2013; Wing et al., 2015). In addition to this, it should also be noted that
workplace incivility leads to poor mental health and job satisfaction level in Nurses (Oyeleye
et al., 2013). Where there is an ever increasing demand of Nursing professionals to address
the problem of nursing shortage globally, incivility seems to aggravate the issue by
exponentially increasing the percentage of Nurses burnout. Therefore, it is extremely
important to focus on the issue of incivility and adapt effective measures to control the
problem.
Practical Scenario:
I have personally experienced multiple incidences of incivility during my previous
clinical placement. My direct supervisor was RN X who was supposed to be my mentor and
was expected to assist me. RN X often made sexist remark that was directed to me. He would
often joke inappropriately about my physical appearance and on multiple occasions touched
me inappropriately. He would make me wait even after my shift hours and tie me up with
unnecessary trivial tidings and would utilise the opportunity to request for a physical contact.
He would even send me inappropriate texts and videos on social media and indicated sexual
gestures at me. I had been vulnerable at that stage because this happened during my first
clinical placement. I had never been exposed to a similar kind of incidence before and I was
deeply shaken with the experience. I felt too scared and insecure to report as I did not wish to
be terminated because of my behaviour and RN X seemed to have a respectable image within

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the hospital. I struggled and managed to survive for a month and ultimately resigned on not
being able to tackle the harassment anymore.
Healthy Environment Creation:
It is important to respond to the experiences of the care professionals who have
witnessed workplace incivility and design an appropriate plan so as to prevent the recurrence
of such incidents. The three strategies as evaluated from the research studies, that can be
undertaken for the creation of a healthy workplace environment would include, documenting,
reporting and effective communication (Rad et al., 2018). Awareness workshops and
informative seminars on workplace incivility can help in educating Nurses about the different
forms of workplace violence. Further, it could also help in making the Fresh GNs realise that
any form of workplace bullying or aggression caused by patients is treated equivalent to zero
tolerance. Further, Nursing professionals would be encouraged to reflect upon their
experiences and document every minute incident which offended them. This would largely
serve as evidence and it could involve things such as screenshots of abusive or inappropriate
mails, voice recordings, video recordings or pictures. The second strategy would involve
mandatory reporting of every harassment incident to the higher authorities with the
documentation record details. The third strategy would include promotion of effective
communication with the mandatory installation of counselling cells where Nurses could share
their concern with a counsellor and seek assistance. The main agenda would be not to miss
out on reporting cases of incivility and misconduct.
Application to practice:
My speciality role as an APN includes specialisation in Nursing Informatics. The two
strategies that would be undertaken by me for the cultivation of healthy work environment
would include, practicing effective communication with other care professionals and building

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a sound therapeutic relationship with the clients to avoid instances of incivility. The second
strategy would include, documentation and reporting of inappropriate episodes of bullying or
aggression exhibited by customers.
Conclusion:
Therefore, to conclude it can be mentioned that workplace incivility has emerged out
to be a major concern in the nursing profession that is leading to Nurses burnout and poor
mental health. Imparting education about types of workplace violence, promoting awareness
about documentation and mandatory reporting and installation of counselling cells to render
effective communication can help in tackling the problem. Also, as a APN specialising in
Nursing Informatics I would contribute to the cultivation of a healthy environment by
establishing an effective therapeutic relationship with the client and communication with
allied professionals as well as by documenting and reporting instances of misconduct.
Therefore, I believe by adapting the proposed strategies I would be able to overcome
situations that had tormented me in the past.

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References:
ANA (2019). Violence, Incivility, & Bullying | American Nurses Association. [online] ANA.
Available at:
https://www.nursingworld.org/practice-policy/work-environment/violence-incivility-
bullying/ [Accessed 22 Feb. 2019]. Retrieved From:
https://www.nursingworld.org/practice-policy/work-environment/violence-incivility-
bullying/
Bambi, S., Foà, C., De Felippis, C., Lucchini, A., Guazzini, A., & Rasero, L. (2018).
Workplace incivility, lateral violence and bullying among nurses. A review about
their prevalence and related factors. Acta Bio Medica Atenei Parmensis, 89(6-S), 51-
79. DOI: 10.23750/abm.v89i6-S.7461
Laschinger, H. K., Wong, C., Regan, S., Young-Ritchie, C., & Bushell, P. (2013). Workplace
incivility and new graduate nurses’ mental health: the protective role of
resiliency. Journal of Nursing Administration, 43(7/8), 415-421. DOI:
10.1097/NNA.0b013e31829d61c6
Minton, C., Birks, M., Cant, R., & Budden, L. M. (2018). New Zealand nursing students’
experience of bullying/harassment while on clinical placement: A cross-sectional
survey. Collegian, 25(6), 583-589. DOI: https://doi.org/10.1016/j.colegn.2018.06.003
Muliira, J. K., Natarajan, J., & Van Der Colff, J. (2017). Nursing faculty academic incivility:
perceptions of nursing students and faculty. BMC medical education, 17(1), 253.
DOI: 10.1186/s12909-017-1096-8
Rad, M., & Moonaghi, H. K. (2016). Strategies for managing nursing students’ incivility as
experienced by nursing educators: a qualitative study. Journal of caring
sciences, 5(1), 23. DOI: 10.15171/jcs.2016.003

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Wing, T., Regan, S., & Spence Laschinger, H. K. (2015). The influence of empowerment and
incivility on the mental health of new graduate nurses. Journal of nursing
management, 23(5), 632-643. DOI: https://doi.org/10.1111/jonm.12190
Oyeleye, O., Hanson, P., O’connor, N., & Dunn, D. (2013). Relationship of workplace
incivility, stress, and burnout on nurses’ turnover intentions and psychological
empowerment. Journal of Nursing Administration, 43(10), 536-542. DOI:
10.1097/NNA.0b013e3182a3e8c9