Cultivating Healthful Environments

Healthful Environments

       Cultivating Healthful Environments     Incivility in the workplace encompasses hostility, bullying and various forms of violence against coworkers and clients. According to Catalano (2015), more than 2 million workers encounter various forms of workplace incivility every year. Thousands of employees die annually due to causes associated with workplace incivility. The economic costs of workplace incivility exceed $4 billion annually in the United States. These costs are associated with increased employee absenteeism, diminished morale, productivity and job satisfaction, declined physical and mental health, and various legal issues. Incivility in healthcare settings has been growing problem. According to the United States Department of Labor (n.d.), the incidences of workplace violence in healthcare settings between 2002 and 2013 were more than four times the incidences reported in the private industry. Incivility in the healthcare environment not only entails hostility, bullying and violence among the healthcare providers but also against patients and their families. An analysis of the impact of incivility on nursing, common scenarios of incivility and the strategies for creating a healthful work environment is important to the delivery of safe and quality care.

Impact of Incivility on Nursing

            Incivility is an important issue in nursing because it inhibits interpersonal relations, teamwork and optimal provider’s health. These aspects are integral to the delivery of safe and quality care. Healthcare providers cannot work in isolation. The day-to-day delivery of care requires nurses to interact with different people in different contexts (Stein-Parburys, 2017). These people include work colleagues, patients and their families. During these interactions, the nurse gathers important data and information that guides the patient assessment and treatment actions. Patient-centered care cannot be attained in an environment characterized by incivility.

Nurses are members of interprofessional and nursing teams. Incivility leads to ineffective teamwork due to diminished communication, collaboration and coordination among the team members (Finkelman, 2017). The highly charged healthcare settings make conflicts a common issue for healthcare teams. Consistent professional conduct is critical to the effective resolution of conflicts and ongoing team effectiveness. The delivery of safe and quality nursing care requires optimal physical and mental health for the nurse. Incivility threatens the nurse’s health and ability to deliver quality care. The other impact of incivility is the violation of the standards of the nursing profession. The ANA Code of Ethics includes principles that dictate values, attitudes and behaviors that are consistent with professional conduct in the practice settings (Catalano, 2015). The code makes it clear that anyone who enters the nursing profession must practice with respect for the dignity, worth and the uniqueness of every person.

Incivility Scenario

            I have experienced incivility in my practice settings on several occasions. One of these events occurred during a staff meeting. The meeting was convened to discuss the recent changes in the procedures manual. When I asked why the changes had been made and whether they were within my scope of practice, the nurse manager sighed loudly and said that I was ignorant and arrogant to question her decision-making authority. She added that she would appreciate if I just focused on my work and let her do hers. The experience was humiliating. I began to resent the nurse manager and skipped or failed to participate in other staff meetings that she convened. Furthermore, I felt demoralized in the subsequent weeks and devised strategies to avoid one-on-one interactions with the nurse manager. My enthusiasm to report for my shifts was diminished as a felt that the manager did not value my work. The scenario led to a tensed and distrustful work environment. The nurses who had witnessed the scenario began showing less motivation to participate in staff meetings and discuss important issues with the nurse manager.

Healthful Work Environment

            The strategies that can help to create a healthful work environment include improving interpersonal knowledge and skills, familiarizing oneself with the organization’s incivility policy and performing one’s duties and responsibilities effectively and on time. First, poor interpersonal skills are a major cause of incivility in the workplace. These skills include communication, teamwork and conflict resolution. A person with effective verbal and non-verbal communication skills can communicate courtesy, respect, value and appreciation to colleagues and clients. These messages minimize incidences of humiliation, harassment and aggression. The individual can effectively deliver feedback to the instigator and get him or her to change the annoying behavior before the prevailing disagreements turn into aggression (Murray, 2017). For example, a nurse who is annoyed by the colleague’s failure to tidy the working table at the end of her shift should communicate the concerns to the colleague rather than becoming hostile or gossiping about it. Secondly, knowledge of the organization’s incivility policy guides the individual in changing his attitude and behavior accordingly, reporting the incivility incidence and seeking support. This knowledge promotes the overall decline in negative behaviors in the workplace (Finkelman, 2017). For example, a nurse manager who knows that organization’s policy prohibits disrespectful behavior towards the nursing assistants will desist from engaging in acts of incivility because she knows that the assistants are protected. Thirdly, performing one’s responsibilities prevents incivility by promoting the fair distribution of the workload, streamlining the care delivery process and enhancing the relationships among care teams (Asghari et al., 2017). For example, an anesthetist nurse who gets to the operating room on time and performs all the relevant tasks perfectly enables the surgeon to do his work with minimal constraints.

Conclusion

            Incivility in healthcare settings is a threat to the professional nursing practice and the delivery of safe and effective care. Behaviors such as teasing, humiliating and harassing coworkers and patients impede interpersonal relationships, teamwork and the provider’s wellbeing. The victim of workplace hostility or bullying may become stressed, frustrated, distracted and demoralized. These outcomes led to diminished productivity. Individual providers and healthcare organizations must take relevant measures to prevent incivility and its adverse impacts on employees and patients. These measures should include the improvement of interpersonal skills, studying the organization’s incivility policy and performing one’s duties responsibly. Incivility in palliative care settings is a serious threat to the management of the distressing experiences by the patient, his family and the care provider. Some of the ways that a palliative care nurse can promote a healthful environment are therapeutic communication to enhance the nurse-patient relationship, engaging the patient’s family in decision-making and the ongoing consultation within the palliative care team. This incivility paper has taught me that the nature of the healthcare environment makes healthcare provides more predisposed to incivility issues in comparison to the professionals in other industries. I have realized that incivility in healthcare settings is one of the major healthcare issues in the 21^st century. Additional research on the organizational factors that make incivility more prevalent in some work settings compared to other is crucial to the development of integrated strategies for creating healthful work environments.