Debra Scott, MSN, RN, FRE
Executive Director
Nevada State Board of Nursing
Learning Objectives
 Define incivility and civility
 Define workplace conflict
 Explore strategies to enhance civility and
encourage a healthy and productive work
atmosphere
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)
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
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
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
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)
The Culture
 Not just simple conflict
 Gradually evolves
 Persistent
 Systematic
 Toxic work environment: Victims, Victimizers, and
witnesses
 Stress
The Victim
 New to profession
 New to position, newly assigned
 New to the system
 Could be above average, talented, energetic (+ attention
from the boss)
The Perpetrator
o Underlying low self-esteem
o Sense of powerlessness
o Fear of change
o Has been the victim in the past
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
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
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
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
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
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)
Questions?
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