Presentation on theme: "INCIVILITY IN THE WORKPLACE"— Presentation transcript:
1INCIVILITY IN THE WORKPLACE Patricia Obulaney, MSN, RN, ANP-C
2Define workplace incivility in nursing profession- in both clinical and academic settings. Describe civil and uncivil behaviors.List strategies and interventions to create a civil environmentObjectives
3Is Incivility A Real problem? Incivility has increased in the workplaceOccurs between manager and employee or employee to employeeAlso seen in higher education settings: between or among disciplines in higher education, faculty to faculty, faculty to student, and student to student.Is Incivility A Real problem?
4Dr. Cindy Clark, faculty at Boise State University- consultant to nursing for workplace or learning institutions to foster an environment of civility.Clark (2009, 2012): Rude or disruptive behaviors which often result in psychological or physiological distress for people involved-and if left unaddressed, may progress to threatening situations or result in temporary or permanent injury or illness.Incivility in Nursing
5Uncivil Behaviors Definitions of workplace uncivil behaviors: Low-intensity, deviant behavior with ambiguous intent to harm the targetRude and discourteous behaviorsLack of regard for othersCauses atmosphere of conflict,disrespect, and STRESSWorkplace uncivil behaviors:Low-intensity, deviant behavior with ambiguous intent to harm the targetRude and discourteous behaviorsLack of regard for othersCauses atmosphere of conflict,disrespect, and STRESSHere’s the best: some people don’t even know they are bullying. They just think they are “faster, smarter, or better skilled” than their workplace peers. They have an exaggerated sense of self-worth and importance. Some folks don’t realize excluding others from their elite circle of friends or their unwelcoming attitude to another is actually a form of bullying.
6Those of us who are over 40 can remember when you would become upset by occasional, rude behavior and it was unexpected and almost a rare occurrence. Over the past ten years, we have seen an increase in rude behavior-on the highway, in super markets, in a classroom setting and on our TVs (reality shows where they vote individuals out of their “world” or little inner circle) and in movies. More recently, the “mean girls” behavior has become more commonplace. People are texting, face-booking and ing nasty things to others or about others on this public forum. It’s kind of gossip on steroids! It has become quite problematic in businesses, schools, and now even in the patient care setting. We are on a decline and few experts see a quick resolve for this rising issue.Uncivil Behavior
7Uncivil Behaviors Insulting comments Denigration of the target's work Spreading false rumorsSocial isolationBad mannersMean girls mentalityDevelop feelings ofunfairness and anger;can lead to hostility &violenceSome examples of uncivil behaviorUncivil Behaviors
8Clark’s Continuum of Incivility Begins with low risk or disruptive behaviors (eye- rolling, sarcastic comments, which eventually progresses to bullying & racial/ethnic slurs)Progresses to high risk or threatening behaviors (intimidation, physical violence, even tragedy)Clark’s Continuum of Incivility
10Lateral violence Nonverbal innuendo (eyebrow raising, make faces) Undermining activities (not be available)Verbal affront (snide remarks, abrupt responses)Withhold informationSabotage (set up negative situation)Back stabbing (complain about individual to others)Failure to respect privacyBroken confidenceGriffin, 2004Lateral violence
11Incivility in the U.S. American acts of goodwill are declining Repeated public opinion polls indicate concern of Americans over the attrition of civilityKRC Research survey (2011) of Americans: 86% report being victims of incivility when driving and 72% while shoppingSix in 10 Americans surveyed admit they have acted in an uncivil mannerIncivility in the U.S.
12In movies, television shows Via phone (texting & speaking) Where is Incivility?In the WorkplaceIn our SchoolsOn our RoadsIn PoliticsOn the WebIn movies, television showsVia phone (texting & speaking)Our highways and parking lots have been slowly increasing with people exhibiting rude behaviors. It is now uncommon for someone to let another person go before them…when it was a common occurrence when I was a child.Some of the workplace conflicts have also been attributed to people losing basic communication skills due to electronic communications, abbreviated conversations on texts. Frustrations at home (finances, children, relationships, chronic illnesses) carry over to the workplace, roadways, shopping centers.
13Causes of Incivility Forni (2008) feels individuals are Vulnerable StressedUnhappyRushedForni eloquently stated, "Incivility often occurs when people are stressed, unhappy, and rushed. When these coincide, anything can happen. Incivility erodes self-esteem, damages relationships, increases stress, contaminates the work environment, and may escalate into violence. Some stressors include lack of control, long work hours, heavy workloads, poor reward system, inadequate structure of communication flow within the institution-be it a hospital, medical office, same day surgery center. Lastly, in a compassion industry such as healthcare, compassion burnout is a problem.EMOTIONAL EXHAUSTION opens the door to depersonalization at the workplace-start giving impersonal responses, and become unaffected with a flattened affect…or become a short fuse under the pressure.Causes of Incivility
14Instigators of Workplace Incivility Mismatched Team MembersLow Employee MoraleWorkplace StressBad Employees/ Rude Behavior-Kate McFarlin (2012)Age, skill level, personalities can cause conflict. Managers’ attitudes also contributeLow morale d/t feeling unappreciated, unfair treatment (real or perceived), being treated as incompetent by a peer or managerWorkplace stress: 12 hour shifts are being studied & evidence is leaning towards long shifts as contributing,. ALSO poor time management skills, lack of teamwork, high acuity patient loadsPoor behavior-young adults may not be learning coping skills or are not being taught how to cope in workplace.Kate McFarland wrote a piece in Chronicle aboutInstigators of Workplace Incivility
15Causes of employee conflict Poor communicationDifferent valuesDifference in personalitiesCompetitionVaried educational backgroundsCauses of employee conflict
16Negative work environment which can cause medical mistakes Medical complicationsViolence in workplaceEven deathIncivility Breeds
17What is the Impact? Lower job satisfaction Feelings of self-doubt, low self-esteemAbsenteeism, tardiness,Unfavorable perception of work environmentGreater intent to leave jobDecreased communication, teamwork, collaborationDeterioration of moraleAnxiety, helplessness, dejection and emotional painWhat is the Impact?
18Impact of Uncivil Behavior RNs working day shifts experienced higher levels of verbal abuse than those working evening and weekend shifts.Staffing shortfalls also were correlated with higher levels of abuse.Intent to leave a job highly correlated with the levels of abuse new RNs experiencedRNs who reported no verbal abuse were least likely to plan to leave in the next three years.Those who experienced moderate to high levels of abuse were most likely to say they intended to leave their positions in the next 12 months, but planned to stay in nursing.(Budin, Brewer, Chao, & Kovner, 2013)Impact of Uncivil Behavior
19Studies have shown students and graduate nurses are the most common victims of uncivil behaviors! Namie, 2005Years ago, nurses were battling the problem of rude, disrespectful physicians. Now some of these same nurses are treating students and new graduates in a similar manner. I guess nurses still “eat their young”. Unfortunately, this cycle of abuse is a sad fact.The Unfortunate Truth
20What Does Civility Look Like?? Stage an interaction to exhibit poor behaviorWhat Does Civility Look Like??
21What is Civility?? “An authentic respect for others that requires time, presence, willingness to engage in genuinediscourse, and intention to seek common groundthat governs both speech and behavior towardothers” Clark, 2011What is Civility??
22What can we do? Healthcare leaders should act as role models Promote and uphold an atmosphere of respectCreate an example of harmony and collaboration for staffFoster healthy communicationIntervene when witnessing bullying behaviorsNurse Practitioners and Physician Assistants are healthcare leaders & role models and should conduct themselves in that manner. Healthcare leaders should act as role modelsPromote and uphold an atmosphere of respect. Create an example of harmony and collaboration for staff. Intervene when witnessing bullying behaviors by asking one of the involved to help you in an area away from the person bullying or just stand beside the individual being bullied. It puts a damper on the situation.What can we do?
23If you are the recipient of confrontational encounter, take a breath, consider what just happened, take time to chill, and carefully develop your response. After careful reflection, you might choose not to respond at all.Dr. Clark recommends: before you act, ask yourself: "If I do not respond, what is the worst (or best) thing that can happen? If I do respond, what is the worst (or best) thing that can happen?"How to respond
24How to respond Admit that you are being treated poorly and take action It is easier to ignore the problem than to deal with the unprofessional behaviorCan be an emotional burdenShare your experience with a trusted colleague or two and solicit feedback on how they perceive the situation.Start a paper trail and document any encountersHow to respond
25Recommended strategies A strong sense of community in the workplace, which views each individual as a valuable member of the team, is the best weapon against bullying and uncivil behaviors.Dellasega, 2003Recommended strategies
26What to do Become cognizant of workplace bullying Recommend behavioral health services to victimsIncrease awareness of negative effect of incivility-loss of sleep, anxiety, eating disordersDevelop effective communication skillsBecome cognizant of workplace bullying-recognize it and acknowledge it.Recommend behavioral health services-being a victim of bullying is extremely overwhelming.What to do
27Formal Approaches to prevent incivility Incorporate stress reduction techniques.Initiate training regarding professional behaviors, effective communication, and team buildingDevelop policies to address uncivil behaviorsDocument unacceptable behavior towards the victimFormal Approaches to prevent incivility
29Be Part of the solution Show respect to all office/hospital staff Employ open and honest communicationKeep actions inclusive and collaborativeBe non-judgmental and honestAvoid gossipBe a team-builderFoster forgivenessBe Part of the solution
32Budin, W. , Brewer, C. S. , Chao, Y. Y. , and Kovner, C. (2013) Budin, W., Brewer, C.S., Chao, Y.Y., and Kovner, C. (2013). Verbal abuse from nurse colleagues and work environment of early career registered nurses. Journal of Nursing Scholarship. DOI: /jnu.12033Clark, Cynthia and Carnosso, Joan. (2008). Civility: A concept analysis. Journal of Theory Construction & Testing, 12(1),Dellasega, C. (2003). Girl Wars: 12 strategies that will end female bullying. Forest City, NC: Fireside.Forni PM. The Civility Solution. New York, NY: St. Martin's Press; 2008.Griffin, M. (2004). Teaching cognitive rehearsal as a shield for lateral violence: An intervention for newly licensed nurses. Journal of Continuing Education in Nursing. 35(6),McFarlin, K. (2013). What causes incivility in the workplace? Chron.com. Retrieved fromNamie, G. (2005). Workplace bullying: Hazard for healthcare professionals. Clinical New, 9(11),References