1. Debra Scott, MSN, RN, FRE Executive Director Nevada State Board of Nursing

2. Learning Objectives Define incivility and civility Define workplace conflict Explore strategies to enhance civility and encourage a healthy and productive work atmosphere

3. Incivility vs. Civility Incivility: “rude or disrespectful behavior that demonstrates a lack of regard for others.” (Rau-Foster M. Workplace civility and staff retention. Nephrol Nurs J. 2004;31(6):702) Civility: authentic respect for others that requires time, presence, the will to engage in genuine discourse and intention to seek common ground. (Clark, 2010)

4. What is the result of letting incivility run rampant? Workplace bullying…on a continuum from open physical assault or violence, threatening behaviors, verbal abuse to more subtle, even masked behaviors such as backbiting, blaming, disparaging, and exclusionary treatment meant to do harm to another or others

5. Characteristics of Incivility and Bullying Intentional Occurs over a prolonged period of time Real or imagined imbalance of power Depends on the culture of the workplace

6. Incidence Worker surveys: o 4/5 state that a lack of respect and courtesy is a serious problem o 3/5 state that “it’s getting worse” o 25% of companies report bullying is present in their work environments

7. Nursing 97% of nurses report verbal abuse 1/3 express intent to leave positions due to bullying Over half say that bullying comes from colleagues, not supervisors 80% of nurses report that they have experienced at some time in their career 50% of nurses are victims of disruptive behavior and 90% have witnessed it (Brunt, 2011; Hutchinson, Jackson & Vickers, 2010;Clark & Olender, 2011)

8. The Culture Not just simple conflict Gradually evolves Persistent Systematic Toxic work environment: Victims, Victimizers, and witnesses Stress

9. The Victim New to profession New to position, newly assigned New to the system Could be above average, talented, energetic (+ attention from the boss)

10. The Perpetrator o Underlying low self-esteem o Sense of powerlessness o Fear of change o Has been the victim in the past

11. Common Forms: May be Covert or Overt Nonverbal innuendos Verbal affronts Undermining activities Withholding information Sabotage Infighting Failing to respect privacy Scapegoating Shunning Alliances and cliques that foster incivility

12. What can it do? Impacts productivity Increased turnover Decrease job satisfaction People just don’t want to come to work— increased “sick” time Agency becomes paralyzed

13. Leadership’s Responsibility Awareness Zero tolerance Exemplary communication Responsiveness Visibility and presence Role-modeling, mentoring, coaching Support Create a culture of regard Offering esteem and recognition of the significance Valuing individual’s unique contributions Empowering employees Facilitation of goal attainment

14. Fostering Civility in the Work Environment o Teamwork and collaboration o Educational/professional development in communication o Conflict management o Examine root causes for conflict o Acknowledgements for advancements and efforts o Providing for a culture of safety

15. Actions to Take o Educate all team members o Hold team members accountable o Develop/implement policies and procedures o Develop a process for addressing disruptive behaviors o Then—be consistent and persistent—provide the tools for sustaining a healthy and productive workplace

16. Leadership’s Ultimate Responsibility Successful leaders need to remember that establishing the right environment isn’t part of the job. It is the job.” (Doucette JN. Create a great work culture. American Nurse Today. 2009;4(6):13-14)

17. Questions?

18. References Candela, Lori, RN, EdD, FNP-BC, CNE, (2012) Nurse to Nurse Conflict in the Workplace & Culture Safety. PowerPoint Presentation. Cheung-Larivee, Karen, (2013) How rude! Workplace incivility hurts bottom line. Retrieved from http://www.fiercehealthcare.com/story/how-rude-workplace-incivility-hurts-bottom-line/2013-01-31 Olender-Russo, Lynda, PhD(c), MA, NEA-BC, RN. (2009) Reversing the bullying culture in nursing. Modern Medicine. Retrieved from http://license.icopyright.net/3.7503?icx_id=617102