NURS 6025 Cultivating Healthful Environments
Cultivating healthful work environment is an expectation for most organizations. Most human institutions develop code of ethics and professional conduct guidelines to maintain mutual respect, and cordial relationship among workers. However, sometimes people behave differently towards the set guidelines aimed at maintaining healthy work atmosphere. Incivility is mostly common in many organizations and professional bodies including, nursing practice. The prevalence of incivility in the work place negatively affects the nurse and her ability to deliver safe care to patients. Incivility causes nurses to become “stressed” or burn-out”, in their professional and personal lives (Ahn, & Choi, 2019. P.1 ). This paper will discuss, the issue of incivility, its importance to nursing, a story about incivility in the clinical setting, creating a healthful environment, practice application of incivility, and conclusion. NURS 6025 Cultivating Healthful Environments
ISSUE OF INCIVILITY
Incivility, as defined by the Merriam Webster dictionary , is “the state of being rude or discourteous”. People can be rude or show disrespectful attitude toward others in both private or public places depending on their mood and situation at hand. Most people see incivility as a form of bullying and attempt to stop it in any way they can. According to Glasper (2018. P. 1), incivility occurs in the nursing profession as well, where other nurses exhibit “behaviors that are designed to harm or infringe on acceptable workplace ethics and mutual respect”. Such behaviors make it almost impossible for the bullied nurse to work peacefully at work and sometimes, she takes the stressful situation at work to the house. This affects the well being of the nurse, thus putting patient health and life in an unsafe hand.
IMPORTANCE OF INCIVILITY TO NURSING
Nursing as described by a fellow nurse is the world’s caring profession but unfortunately the existence of incivility in the clinical field causes nurses to deliver care in an abusive environment. The importance of incivility to nursing cannot be ignored and outlined below are some of this importance. Firstly, incivility in the work place affects individual nurses physically, mentally, emotionally, and psychologically as the nurse may begin to doubt her competency and efficiency in practice. The “perpetrator may repeatedly belittle, ignore, criticize and verbally abuse” (Meires, 2018 ) the victimized nurse. Secondly, incivility affects microsystem work environment negatively. Microsystem level nurses are the direct care givers of patients and these nurses interact with patients and their families frequently. Existence of incivility for microsystem level nurses may include “false rumors, assuming credit for work done by someone else, and yelling” (Villers, 2017. P.18). Bullying negatively affects microsystem work environment through impaired communication between nurses, poor care delivery, stressed and burned out nurses, as well as poor cognitive performance by nurses. Lastly, bullying or incivility affects the caring focus of nurses, patient safety becomes , medication error may become prevalent, and team work becomes non-existent (Smith Phillips, Isaac MacKusick, & Whichello, 2018). NURS 6025 Cultivating Healthful Environments
STORYTELLING
I worked as the Skilled unit clinical manager for about a five months but resigned due to uncivil behavior from staff. Apparently, the unit had been without a permanent clinical manager for years until I took the position. When I started, nurses and other auxiliary staff one the unit expressed happiness for having a young, intelligent and vibrant RN as their lead. However, the nurses warned me about the MDS (Minimum Data Set) coordinator who was once the clinical manager. Second day on the unit, the MDS Coordinator started asking me about the number of years I have worked as nurse, long term care experience and a few other details about my professional and personal life. I answered her questions out of professionalism, and courtesy. Two weeks in office and the MDS Coordinator starts claiming my work in clinical meetings, questioning my clinical decisions, and directions for the unit in front of staff. Soon, the unit staff joined in and I felt belittled, uncomfortable and bullied at work. I called a meeting between myself, the MDS coordinator and the DON (Director of Nursing) to address her attitude towards me. for help but she informed her of how she had gone through the same treatment. After, the conversation, she stopped bullying me for a while and began again. Once again, I talked to the DON but this time, she told me that the MDS coordinator and staff do not mean any harm but want to know how strong I was. Over, the next couple of months, I felt drained, confused and began losing my focus as each day came with accusations, gossips and drama. The nursing staff took advantage of this and call outs became rampant, call lights were left unattended to, residents’ ADL care were not appropriately taken care of and family members started complaining. I could not take it anymore and finally resigned with incivility and bullying as my reason. In the scenario above, I felt vulnerable and drained emotionally, physically and psychologically. Patients and their family members felt the existence of chaos in the unit and staff exhibited unprofessional behavior. High turnover is present in this facility especially within the first ninety days after hire.. NURS 6025 Cultivating Healthful Environments
CREATING A HEALTHFUL ENVIRONMENT
Creating awareness about the negative effects of incivility or bullying is a very important strategy in creating a healthful work environment for nurses. When clinical managers and nurse executives are informed about instances of incivility and bullying in a facility, it is expected that they step in, address the issues and ensure orderliness. Nurse managers can educate and direct the perpetrators to organizational policies on incivility and expectations on work place ethics and mutual respect (Villers,2017) Also, creating a civil work environment with emphasis on nursing integrity is very necessary. Professional nursing institutions can address civility in facility sponsored workshops and orientation programs to educate and reinforce the tradition of civility in the work place (Lynette, Echevarria, Sun, & Ryan 2016). Lastly, effective communication is very important in ensuring team work and healthful work environment. When nurse practice open communication, quality care delivery becomes the focus in the work place. Therefore, most nurses become confident in addressing personal and professional issues that hinder growth and transparency in the work place ((Phillips, Stalter, Winegardner, Wiggs, & Jauch, 2018).
PRACTICE APPLICATION
Family Nurse Practitioner (FNP) is my specialty track of choice and there are about three strategies, that I plan to implement in my practice to encourage healthful work environment. Firstly, skilled communication is a strategy that I want to use in my practice with both patients and staff. Skilled communication involves open face to face interactions with co-workers that is filled with positive energy. Skilled communication uses objective criticism and professional etiquette aimed at ensuring free flow of information in a mutual manner (Kupperschmidt, Kientz, Ward, Reinholz , 2010). Secondly, team work is another important strategy that I hope to use in my FNP practice. Working as a team, does not mean that all team mates will always agree but rather, team members will have civilized diversity in care delivery. I will communicate professional expectations clearly to staff, encourage staff involvement in decision making and ensure transparency in care delivery in order to maintain healthy work environment (Clark, 2017). NURS 6025 Cultivating Healthful Environments
CONCLUSION
Incivility in the work place negatively affect nurses, patients, work environment and the nursing profession in general. Incivility and bullying are used interchangeably due to their association to violence and disruption of safe working environment. Incivility as a topic is very important to nursing because its presence causes emotional, psychological and physical strain on the nurse which creates and unsafe patient care. Strategies to create a healthful environment includes creating awareness about incivility and ways to address uncivil behaviors. Also, creating a civil work environment and open communication are all strategies that can help provide a healthful work environment. I am enrolled in the FNP specialty track and I plan to use skilled communication and team work as my contribution towards a healthful work environment in my practice area. Completing this assignment, has been both educative and eye-opening experience for me. I have reflected on how incivility has negatively affected me and other nurses personally and professionally. I have realized that help is always available and that I need to speak up and approach the bully or a superior for help. I have been able to identify realistic strategies that I can use as an FNP to contribute to healthful and civil work environment for me and other team mates.NURS 6025 Cultivating Healthful Environments