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Nursing, Pages: 2, Peer Responses

Interprof Module 4 Discussion

Interprof Module 4 Discussion

Post 1 Response

Hello, thank you for your post. Your detailed discussion on workplace civility and incivility, complemented by the use of the Clark Healthy Workplace Inventory, provides insight into your workplace environment from many different angles. I appreciate that you center the respectful and professional behaviors that make up job satisfaction, productivity, and retention.
I agree that policies on things that create civility are simply not enough. Organizations should therefore be very proactive in ascertaining the health of their work environment. Although the CHW certainly represents a good instrument to do this, it provides this in terms of the overall measure of workplace civility. But I’d like to stretch that a bit further: continuous training and education set the postcode for a culture of civility. As Porath and Pearson (2013), put it, continuous training might be able to grant the employees the skills for conflict management and institute a proper way of communicating with each other to foster a more respectful and civil work environment.

Your interaction with the mental health worker is a very common phenomenon in healthcare settings where hierarchical tension may result in incivility. Admirably, you approached the situation intending to hold a civil conversation and bring in a house supervisor to bring about a resolution. This parallels advice from Broome and Marshall (2021), in which transformational leadership is encouraged to approach conflict swiftly and keep open lines of communication.
Another area that would raise your workplace environment to the next level is regular feedback mechanisms. Positive and constructive regular feedback would enable them to pick up on potential problems before they grow into major conflicts. But more than this, it demonstrates a culture of continuous improvement and mutual respect. As cited by Clark et al. (2016), feedback mechanisms play an important role in ensuring a healthy working environment by giving voice to employees to contribute to organizational improvement.

Furthermore, the issue that must be addressed is professional growth and development resources. Tuition reimbursement has been drastically decreased, and there is a prohibition against precepting NP students, an attitude Killer and possibly an obstacle to professional development. Professional development opportunities have to remain at the forefront because they will continue to develop a motivated skilled workforce. Professional development can also create an atmosphere of loyalty and commitment that will sustain employees in their work.
In summary, while your workplace has some reasonable levels of civility, there is much room for improvement. Ongoing training, regular feedback mechanisms, and professional growth opportunities are essential in creating a more empathetic and supportive workplace environment. Your insights and experiences provide rich ground for further discussion along these lines, and I would like to strongly advocate exploring such strategies in detail as a way to improve workplace civility and overall organizational health.

References

Broome, M., & Marshall, E. S. (2021). Transformational leadership in nursing: From expert clinician to influential leader. Springer.

Clark, C. M., Sattler, V. P., & Barbosa-Leiker, C. (2016). Development and testing of the healthy work environment inventory: A reliable tool for assessing work environment health and satisfaction. Journal of Nursing Education, 55(10), 555–562.
Porath, C. L., & Pearson, C. M. (2013). The price of incivility. Harvard Business Review, 91(1-2), 115-121.

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Question 

Interprof Module 4 Discussion

BY DAY 6 OF WEEK 7

  • Respond to at least two of your colleagues on two different days by sharing ideas for how shortcomings discovered in their evaluations and/or their examples of incivility could have been managed more effectively.

Resources:

Interprof Module 4 Discussion

Interprof Module 4 Discussion

POST 1

Workplace civility defined as the professional and respectful behavior towards other colleagues and peers at work is the foundation of an organization’s health (Xue, 2023). It is adhering to social norms by recognizing and respecting the dignity of others (Xue, 2023) and so it impacts all aspects of an organization as it affects job satisfaction, productivity, retention, and overall, the working environment and culture. Conversely, Schilpzand et al. (2016) asserts that incivility is the neglecting of mutual respect that leads to conflict and tension. Furthermore, it can be incivility can be as covert as standing idly by and not lending a helping hand to a staff member in a situation. It is ironic that incivility affects even the profession of nursing which is based on the ideals of caring as it was estimated that in the past 12 months 85% of nurses experienced incivility (Lewis & Malecha, 2011). Thus, organizations merely instituting policies designed to promote civility is not enough, they need to be proactive in assessing the organization’s health by using tools such as the Clark Health Workplace (CHW). The CHW is a 20-item psychometrical tool to measure work environment health that should be completed by all team members or individuals to gauge areas of weakness and strength (Clark et al., 2016).

After completing the Work Environment Assessment, the results showed a mildly healthy work environment with a 70 overall score. Although the results are subjective and overall results may vary individually, I feel it was accurate. Additionally, I will not go over all the 20-item psychometrics but will touch upon the highlights of strengths and weaknesses that I thought would be noteworthy. Due to my working environment being a 40-bed in-patient lock down psychiatric unit, it requires teamwork and collaboration which is evident by having scored a “5” of completely true. This team has been working for years and knows each other’s roles, strengths and weaknesses that we collectively and collaboratively work in unison as a team. Other areas that marked high with “5” were being treated fairly and respectfully as well as workload being reasonable and manageable. There is a healthy culture of civility in which each staff member is treated with respect and workload is distributed according to acuity. Conversely other areas of weaknesses or needed improvement are sufficient resources for professional growth and development which scored a “2” or somewhat true. The example that comes to mind regarding a lack of resources for professional development is that tuition reimbursement was slashed from $5K annually to $2K for those pursuing a bachelor’s or master’s degree. Additionally, the organization recently implemented a policy that prohibited the precepting of NP students even if one is an employee. Overall, I agree with the results of the assessment and believe that it is a mildly healthy working environment that treats each other with civility.

For the most part, there is civility in the workplace, yet we are dealing with the unpredictability of the human element and so surely there will be instances of incivility. One of my strengths from the StrengthsFinder Assessment was Harmony in which I value getting along in all aspects of my life personally, professionally, or academically. This strength of Harmony is reflected in having a trusting, respectful relationship with others. Yet, a situation of incivility that comes to mind transpired a few years ago, when I was working as a charge and the mental health worker was being uncivil noted by being rude and not respecting my position as the charge who is responsible for steering the ship. This created some tension and conflict and so I wanted to speak with the staff members about the situation but did not want to have any accusations so escalated to the chain of command to the house supervisors. In the presence of the house supervisor, we had a civil conversation in which each party was able to speak during their turn and offer their side of the perspective. Ultimately it was found to be a miscommunication in which both parties apologized and there were no other instances of incivility.

In conclusion, the Clarks Healthy Workplace Inventory is a tool that should be utilized in all workplaces to assess the civility or lack thereof which serves foundation of the organization’s health (Xue, 2023). After assessment, then diagnosis serves as a vital aspect of healthcare that serves as the first critical step forwards in addressing specific issues of which the other steps are development, implementation, evaluation, and dissemination. In my workplace being mildly health with a score of 70 made me angst as it is a slippery slope that can quickly go down further as there is no guarantee that incivility issues will improve without the aforementioned developments and protocols. Lastly, as this is our last discussion post, it has been a pleasure in the exchange of ideas through this course which will equip us to be leaders to make impacting changes in the present and the future.

References:

Clark, C. M., Sattler, V. P., & Barbosa-Leiker, C. (2016). Development and testing of the healthy work environment inventory: A reliable tool for assessing work environment health and satisfaction. Journal of Nursing Education, 55(10), 555–562. https://doi.org/10.3928/01484834-20160914-03Links to an external site.

Lewis, P. S., & Malecha, A. (2011). The impact of workplace incivility on the work environment, manager skill, and productivity. The Journal of Nursing Administration, 41(1), 41–47. 10.1097/NNA.0b013e3182002a4c PMID: 21157243

Schilpzand, P., De Pater, I. E., & Erez, A. (2016). Workplace incivility: A review of the literature and agenda for future research. Journal of Organizational Behavior, 37(1), S57–S88. https://doi.org/10.1002/job.1976Links to an external site.

Xue, P. (2023). Advancing workplace civility: A systematic review and meta-analysis of definitions, measurements, and associated factors. Frontiers in Psychology, 14(1277188). https://doi.org/10.3389/fpsyg.2023.1277188Links to an external site.

POST 2

Incivility is an issue plaguing many nurses. This is an issue often with novice nurses but can happen to any nurse. Incivility is defined as, “negative behaviors with low-intensity and unclear intention that damage the targeted person” (Atashzadeh et al., 2021). Some examples of incivility include verbal abuse, nonverbal abuse, sexual harassment, and passive aggressive behavior (Ataszadeh et al., 2021). After completing the Clark Healthy Workplace Inventory, I found that my organization scored a 49. This is considered an very unhealthy score and action must be taken to help improve these scores and decrease the incivility that occurs within the organization.

Some areas that my organization struggles, contributing to the low score include; level of trust among leadership and other members of the work place, respectful communication, valuing employees, including employees in decision making, reasonable workloads, and overall employee outlook on the organization. All of which contribute to incivility and dissatisfaction among employees. Establishing respect within the organization has the potential to benefit the organization as whole, “respectful behaviors in the nursing workplace improve the image of nursing, reduce multigenerational conflicts among nurses, increase the quality of work-life in nurses, reduce human error through information sharing in their workplace, and finally increase the quality of patient care” (Nouri et al., 2021).

Often times throughout my career I have faced incivility. As a new graduate, I was often faced with incivility at the beginning of my career. Many times seasoned nurses forget what it is like to practice as a new graduate and to be faced with new situations. Nursing school can only prepare nurses for the situations that students are faced with while in school and inevitably new nurses will face situations that they have not experienced prior. A study has shown cognitive rehearsal as “an evidence-based method for educating NLRNs to clearly communicate a rehearsed response to uncivil behaviors” (McDermott et al., 2021). Implementing this technique in the new graduate residency program would help combat the incivility that occurs towards these nurses.

Another situation I have been faced with incivility is working as a travel nurse. Often times as a travel nurse I am faced with unfair and unsafe workloads. For example, recently I was told after my shift started that my assignment is being changed because the current nurse is unable to handle the patient. I already had a full assignment and was forced to give up my easiest patient to accommodate the new assignment. Travel nurses are often placed in areas with “high turnover rates; lack of support staff; unsafe ratios; and heavy workloads” (Abraham, 2020). The same study shares an example of incivility, “She ended up feeling as though she was drowning and unable to care for her patients safely while the other staff nurses were sitting at their computers shopping online or reading books” (Abraham, 2020). It is important when faced with this unsafe situation to reach out to management to correct the issue. Although travel nurses are there to help with staffing, they are still nurses and can only safely provide care with appropriate staffing and adequate resources.

Reference

Abraham, S. (2020). The Lived Experiences and the Factors Affecting Assimilation of Travel Nurses into the Culture of Assigned Nursing Unit. Retrieved from https://www.researchgate.net/profile/Samuel-Abraham4/publication/345891825_The_Lived_Experiences_and_the_Factors_Affecting_Assimilation_of_Travel_Nurses_into_the_Culture_of_Assigned_Nursing_Unit/links/5fb09519a6fdcc9ae0552b70/The-Lived-Experiences-and-the-Factors-Affecting-Assimilation-of-Travel-Nurses-into-the-Culture-of-Assigned-Nursing-Unit.pdfLinks to an external site.

Atashzadeh Shoorideh, F., Moosavi, S., & Balouchi, A. (2021). Incivility toward nurses: a systematic review and meta-analysis. Journal of medical ethics and history of medicine, 14, 15. https://doi.org/10.18502/Links to an external site.

Nouri, A., Sanagoo, A., Jouybari, L., & Taleghani, F. (2021). Contextual Barriers of Respectful Workplace in Nursing: A Focused Ethnography. Iranian journal of nursing and midwifery research, 26(4), 349–354. https://doi.org/10.4103/

McDermott, C., Bernard, N., & Hathaway, W. (2021). Taking a stand against workplace incivility Links to an external site.. Journal of Continuing Education in Nursing, 52(5), 232–239.