Cultivating Healthful Environments 1 Cultivating Healthful Environments Wei Cao Chamberlain College of Nursing NR500 Foundational Concepts and Applications 8/19/2020 Cultivating Healthful Environments Cultivating Healthful Environments Workplace incivility is very common among nursing staff in health care settings. Incivility is related to unwanted and repeated harmful actions directed to a person and causes different levels of distress to the victim (Buck-Hoope, 2018). Incivility often results in psychological or physiological distress for the people involved causing significant stress, anger, and anxiety to the affected person, which reduces their capacity to offer high-quality services and negatively impact patient outcomes (Al-Omari, 2015). Nurses must play a significant role in reducing incidences of incivility in their workplace and uphold a healthy work environment. This paper is comprised of the following sections: issue of incivility, importance to nursing, storytelling, creating a healthful environment, practice application, and conclusion. Issue of Incivility According to Buck-Hoope (2018), workplace incivility is defined as low-intensity conduct with a divergent, ambiguous intention to causes harm to the target, which violates the workplace norms for mutual respect. Incivility manifests in different ways in the nursing profession from actions such as sabotaging, sarcasm, and undermining. Other behaviors related to incivility include blaming, name-calling, rudeness, and false accusations (Buck-Hoope, 2018). The problem of incivility happens at all levels of the organization, from senior management to fellow nurses and support staff. Some overt actions that arise from incivility include intimidating coworkers or making demeaning comments to undermine the target. Incivility can also be covert and include activities such as failing to provide vital information or failing to intervene to uphold a safe working environment (ANA, 2015). Cultivating Healthful Environments Importance to Nursing Incivility often results in both physical and mental distress to nurses. It may lead to physical health problems such as headaches, migraines, stomach ulcers, and sleep disturbance. It can also cause distress and emotional harm to the victim, resulting in disruptive behaviors and reduced productivity at work (Buck-Hoope, 2018). Incivility impacts the microsystem work environment by adversely affecting teamwork, reducing the unit or department's productivity, and negatively affecting patient outcomes. According to Logan (2016), incivility causes a reduction in specialized team's focus that contributes to a lack of synergy when addressing patients' needs. The issue creates a decrease in combined actions and thoughts when faced with varying patients' problems. Incivility can also increase the hiring cost and training cost of the facility. The individuals facing the harassment also feel demotivated in their work and are likely to consider leaving such organizations (Zhang et al. 2018). The nursing profession has suffered negative impacts due to the high incidences of incivility. Research shows that exposure to incivility affects people in the nursing profession by exposing them to psychosocial problems (Spiri et al. 2017). The result is the declining performance of the workforce that reduces the quality of services offered to junior nurses in healthcare facilities. Incivility further promotes some sense of power distance in the nursing profession. The rivalry has the potential to causes the nursing profession unattractive to potential future nurses who feel threatened by their supervisors in healthcare facilities. Also, low nurse morale will harm the nursing profession (Spiri et al. 2017). Cultivating Healthful Environments Storytelling Marie is a senior white nurse who has been working in the operating room for 20 years. One day, she was assigned to train a new African nurse Alima. Alima came to the United States two years ago. During the procedure, Alima asked Marie a question about blood transfusion, after asking Alima repeating the same question twice, Marie still didn't understand what she said. Marie got very impatient and yelled at Alima. In front of everyone in the procedure room, Marie told Alima that her African accent is too heavy to understand. She suggested that Alima should go back to Africa to serve better for the patient. Alima's face got flushed suddenly, and she didn't say a word until the end of the procedure. Marie’s incivility behavior humiliated the new nurse Alima. Alima may suffer from stress, anxiety, and anger after this incident. Marie’s incivility behavior also harmed Alima's selfconfidence and self-esteem. To avoid more humiliation, Alima may never have the courage to ask more questions during the whole training process, which would significantly impact her learning progress. Marie set a lousy example of teamwork between coworkers and brought down the morale in the working environment. Marie’s uncivil behavior created an unpleasant work environment by embarrassing everyone, including the doctors and the other coworkers. Working in an unfriendly environment can contribute to low productivity. Unmanaged stress could further lead to the team's poor performance and high levels of staff turnover in the department. Creating a Healthful Environment Staff education is crucial for creating a healthy work environment. We should educate nurses to recognize uncivil behaviors and develop practical negotiation skills during conflicts. Training through role-playing, evidence-based scripts, and cognitive reprisal help improve the Cultivating Healthful Environments approach to handle disrespectful encounters (Clark, 2019). The education should also aim to ensure the nurses get a chance to face professional counselors to help them boost their emotional intelligence. Another strategy for creating a healthy environment is to develop ethical guidelines and enforce the guidelines in the facility. The International Code of Ethics of Nurses provides that nurses have the responsibility of respecting and promoting the dignity of others (Clark, 2019). During training, all nurses must get exposed to the code of ethics to ensure that their verbal or physical behavior does not go against any moral requirement. The training further provides that the nurses understand the zero-tolerance policy that prevents lateral violence and any form of bullying in the workplace. Exposure to the ANA regulation also adds to nurses' obligation to promote an ethical environment free from incivility (Clark, 2019). To create a civil work environment, we can also develop protocols and policies for the situation when incivility behavior happens in the workplace. We should warn nurses that engage in bullying and incivility according to the protocols. The protocols ensure nurses uphold ethical standards and decency that replicates civility behavior and molds a united workforce that focuses on their patients' welfare (Rad & Moonaghi, 2016). Practice Application As a nurse educator, I will implement two strategies in the advanced practice role to cultivate a healthy work environment. One approach is to develop ethical codes that guide the relationship between nurses in the workplace. It is critical to ensure that nurses and other practitioners working in the healthcare setting uphold the value of teamwork. The ethic guideline can provide a framework that ensures that the nurses remain committed to their profession's ethical Cultivating Healthful Environments expectations. It will ensure that nurses understand that one way to register higher performance is through the respect of their colleagues. The ethical guideline will teach nurses that the bullying behaviors towards their colleagues or other stakeholders will result in demotivation and poor working relationships (Rad & Moonaghi, 2016). The second strategy I will employ as a nurse educator to cultivate a healthy work environment is making protocols that warn nurses that engage in bullying and incivility behavior in the workplace. Combinations of indirect and direct warning support administrators to enable all nurses to understand inappropriate behavior and avoid them in the future (Rad & Moonaghi, 2016). The protocols will further allow nurses to understand the possibility of facing disciplinary actions due to incidences of incivility behavior. Combining the strategies will support teamwork among nurses who embrace respect and discourage inappropriate behavior. Conclusion Incivility is a low-intensity or uncivil behavior with the intent to harm the target. Uncivil behaviors can make recipients upset and feel humiliated, vulnerable, or threatened, which can create stress and undermine their self-confidence. The impact of incivility in nursing includes reduced productivity of the victims, causing nurses physical and mental stress, and negatively impacts patient care outcomes. Incivility can significantly impact individuals, organizations, and the nursing profession as a whole. There are different strategies to create a healthy working environment; these include nurse education about uncivil behaviors and the skills to overcome incivility, enforcement of the ethic code and guidelines, and development of protocols. As a nurse educator, I will use two strategies to cultivate a healthy work environment. I will focus on education about the work ethic codes and the guidelines. Also, I will help my department to Cultivating Healthful Environments develop protocols to handle the situation when incivility happens. This assignment has helped me understand how incivility in the nursing profession can affect nurses' effectiveness and motivation. I have realized that I have a role to play in enhancing civility in the nursing profession and building teamwork that embraces respect and avoids bullying behavior. In my future practice, as a nurse educator, I should take care of myself and make sure I am physically and mentally prepared for competent practice; I will guide nurses and colleagues on the need to uphold emotional intelligence when dealing with incivility to avoid being bullied. I will also commit myself to be a role model of enhancing civility behaviors and promoting cultures of civility. Cultivating Healthful Environments References American Nurses Association (2015). Incivility, bullying, and workplace violence [Position Statement].http://www.nursingworld.org/MainMenuCategories/WorkplaceSafety/Healthy -Nurse/bullyingworkplaceviolence/Incivility-Bullying-and-Workplace-Violence.html Buck-Hoope, T. (2018). Bullies in White: The Reality of Incivility in Nursing. International Journal of Studies in Nursing, 3(1), 78-81. Clark, C. M. (2019). Fostering a Culture of Civility and Respect in Nursing. Journal of Nursing Regulation, 10(1), 44-52. Logan, T. R. (2016). Influence Of Teamwork Behaviors On Workplace Incivility As It Applies To Nurses. Creighton Journal of Interdisciplinary Leadership, 2(1), 47- 53. 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), 23–32. Spiri, C., Brantley, M. & Mcguire, J. (2017). Incivility in the Workplace: A study of nursing staff in the Military Health System. Journal of Nursing Education and Practice, 7(3), 40 - 46. Zhang, S., Ma, C., Meng, D. et al. (2018). Impact of Workplace Incivility In Hospitals On The WorkAbility, Career Expectations, And Job Performance Of Chinese Nurses: A CrossSectional Survey. The British Medical Journal, 8(1), 1-9.