MADELINE
After completing the work environment assessment and the Healthy Workplace Itinerary, I determined that my workplace is moderately healthy. Based on this, I would say that my workplace is also moderately civil. Incivility in the workplace can negatively impact employees’ mental health, productivity, and job satisfaction (Griffin & Clark, 2014). An example of incivility in a workplace would be bullying by coworkers, management, or in the case of nurses, by physicians. Incivility is very common in healthcare and has developed the saying “nurses eat their young” (Clark et. al., 2011). These examples are some of the reasons that I found my workplace moderately civil and not a completely healthy workplace. In my hospital, it is well known that there are some physicians that are rude and can be demeaning to nurses which was a major set back when scoring my workplace. Luckily, I feel that among nurses on my unit, there is not the “eat your young” mentality and our unit is a good place for new nurses to learn. Something that I did not realize until doing research on this topic is that eye-rolling is a major indicator of incivility. Eye-rolling is a passive aggressive behavior that has been recently added to signs of workplace violence and therefore incivility (Bar-David, 2018). More studies have been done involving these smaller signs of workplace violence because up until recently, only major indicators of workplace violence have been studied. What I found interesting about incivility is that it has been shown to cause people to intentionally decrease work ethic due to embarrassment or risk of negative reactions from coworkers again (Bar-David, 2018). A time that I can remember very vividly that I now know is a form of incivility is when a surgeon openly yelled at a nurse in the middle of the nurse’s station. I remember watching the young nurse as it happened, and she was very scared and did not know what to say to defend herself in this situation. Which I might add, the situation had nothing to do with her, the incident had occurred on the previous shift. I do not recall anyone stepping in and standing up for the nurse in this situation. I also did not hear about if anything was said to this surgeon after the incident. Looking back, this was a sign of how unhealthy our work environment had been in the past. Now, after many management changes, we are now in a situation where I feel that myself as well as many of my coworkers, would not let that happen the same way again.
Bar-David, S. (2018). What’s in an eye roll? It is time we explore the role of workplace incivility in healthcare. Israel Journal of Health Policy Research, 7(15). https://doi.org/10.1186/s13584-018-0209-0
Clark, C., Olender, L., Cardoni, C., & Kenski, D. (2011). Fostering civility in nursing education and practice: Nurse leader perspectives. The Journal of Nursing Administration, 41(7/8), 324-330. doi: 10.1097/NNA.0b013e31822509c4.
Griffin, M., & Clark, C.M. (2014). Revisiting cognitive rehearsal as an intervention against incivility and lateral violence in nursing: 10 years later. Journal of Continuing Education in Nursing, 45(12), 535-542.
joan
It is very important to work in a healthy stress-free work environment, most especially in the healthcare sector. The job of healthcare workers is to keep people healthy and that can be effectively done when the environment of the healthcare institution is healthy. To make changes to create the best possible environment for healthcare workers and patients can only be transformed by a collaborative effort between the staff members, team leaders, multidisciplinary levels, and administration (Broome & Marshall, 2021).
A healthy work environment is that environment where all staff exhibit behaviors and practices that are mission-driven, there is a high level of team civility, strong leadership both formal and informal, and conversations about mutual respect at all organizational levels (Clark, 2015). Before healthcare environments can be transformed, it is important to assess if the workplace is healthy or not, and what areas need improvements. I completed the Clark Healthy Workplace Inventory to determine the civility of my workplace environment. The results of the inventory tool determined that I had a barely-healthy workplace, with my score being 59, which is right on the cusp of being mildly healthy. I work on a busy medical/surgical/psychiatric floor at a level-one trauma center in MD. We recently started utilizing a new hall-bed program.
The pilot is that the emergency department (ED) can send patients who are waiting for a clean and ready bed, with the purpose being to decompress the ED. The only criteria that patients must have to be in a hall-bed is a COVID negative test. The issue is the ED sends us patients who are not appropriate for being in a hall bed. In my opinion, patients who are a high fall risk, patients with dementia, incontinence, handicap, or more critically ill patients who do not need to be in a hall-bed for privacy and safety purposes. This new pilot program has caused a lot of incivility between our unit, the ED, and our patient logistics team. Profane words have been used as well as passive-aggressive and overly assertive behaviors during the process. There haven’t been any meetings with leadership team to discuss our thoughts about it but surely when that time comes, I would expect our leadership to take our concerns to the administration in charge of this decompression program. The administration has a hard difficulty seeing our angles, but I plan on being as assertive and polite as I can with my concerns so leadership will take them seriously. Using cognitive rehearsal is a great way to prepare me, for discussion with peers, other disciplines, and leadership. Taking part in educational instruction, coming up with several phrases to use during disagreements, and having practice sessions can help prepare me before having a conversation about the incivility between departments regarding the hall-bed predicament (Griffin & Clark, 2014).
References
Broome, M., & Marshall, E. S. (2021). Transformational leadership in nursing: From expert clinician to influential leader (3rd ed.). New York, NY: Springer.
Clark, C.M. (2015). Conversations to inspire and promote a more civil workplace. American Nurse Today, 10 (11). 18-23. https://www.myamericannurse.com/wpcontent/uploads/2015/11/ant11-CE-Civility-1023.pdf.
Griffin, M., & Clark, C. M. (2014). Revisiting cognitive rehearsal as an intervention against incivility and lateral violence in nursing: 10 years later. The Journal of Continuing Education in Nursing, 45(12), 535–542. https://doi.org/10.3928/00220124-20141122-02.