How can interventions more directly address drivers of unprofessional behaviour between healthcare staff?

Unprofessional behaviours (UBs) between healthcare staff are widespread and have negative impacts on patient safety, staff well-being and organisational efficiency. However, knowledge of how to address UBs is lacking. Our recent realist review analysed 148 sources including 42 reports of interventions drawing on different behaviour change strategies and found that interventions insufficiently explain their rationale for using particular strategies. We also explored the drivers of UBs and how these may interact. In our analysis, we elucidated both common mechanisms underlying both how drivers increase UB and how strategies address UB, enabling the mapping of strategies against drivers they address. For example, social norm-setting strategies work by fostering a more professional social norm, which can help tackle the driver 'reduced social cohesion'. Our novel programme theory, presented here, provides an increased understanding of what strategies might be effective to adddress specific drivers of UB. This can inform logic model design for those seeking to develop interventions addressing UB in healthcare settings.

Effectiveness of cognitive rehearsal programs for the prevention of workplace bullying among hospital nurses: a systematic review and meta-analysis

BACKGROUND

To solve the problem of workplace bullying among nurses, it is necessary to review the effects of interventions and generalize the findings. We conducted a systematic literature review and meta-analysis to evaluate the effects of cognitive rehearsal programs on workplace bullying among hospital nurses.

METHODS

Data were collected from March 30 to April 11, 2021, and 11,048 journal articles published in South Korea and internationally were examined across eight databases. Nine articles were selected for inclusion in the systematic literature review; five of the nine studies were included in the meta-analysis. For randomized controlled trials, the risk of bias was evaluated, and for non-randomized controlled trials, the study quality was evaluated using the Risk of Bias for Non-randomized Studies version 2.0. Egger's regression test was performed to determine publication bias.

RESULTS

Of the nine articles selected for this study, two were randomized controlled trials and seven were non-randomized controlled trials. The I2 value was 18.9%, indicating non-significant heterogeneity. The overall effect size of the cognitive rehearsal programs was -0.40 (95% confidence interval: -0.604 to -0.196; Z = -3.85; p = .0001) in a random-effects model, indicating a large effect size with statistical significance.

CONCLUSIONS

Therefore, cognitive rehearsal programs that address workplace bullying among hospital nurses are effective. Health policymakers must implement cognitive rehearsal programs in a policy manner to address the problems of bullying in the workplace.

Using Cognitive Rehearsal to Address Faculty Incivility in Nursing Academe

BACKGROUND

Faculty-to-faculty incivility is a national and global problem. Recent studies examining faculty incivility in nursing academe found that respondents expressed emotional and physical distress stemming from workplace incivility, and most avoid dealing with the problem. A top strategy for improving workplace civility includes providing ongoing education to improve communication skills.

PROBLEM

Faculty and academic nurse leaders require evidence-based strategies to prevent and address the range of uncivil behaviors occurring in academic work environments.

APPROACH

Cognitive Rehearsal (CR) is a primary prevention and intervention communication strategy used to address incivility in health care and educational settings. Working with a skilled facilitator, participants practice addressing stressful situations in a non-threatening environment. This is the first known publication using CR to address faculty-to-faculty incivility.

CONCLUSIONS

The author uses real-life situations derived from faculty-to-faculty incivility research studies and in-person conversations to describe each step of the CR process.

Interventions for Preventing and Resolving Bullying in Nursing: A Scoping Review

Bullying in the workplace is a serious problem in nursing and has an impact on the well-being of teams, patients, and organisations. This study's aim is to map possible interventions designed to prevent or resolve bullying in nursing. A scoping review of primary research published in English and Italian between 2011 and 2021 was undertaken from four databases (Cochrane Collaboration, PubMed, CINAHL Complete, and PsycInfo). The data were analysed using Arksey and O'Malley's framework, and the Preferred Reporting Items for Systematic reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) Checklist was followed to report the study. Fourteen papers met the review eligibility criteria. The analysis revealed four main themes: educational interventions, cognitive rehearsal, team building, and nursing leaders' experiences. Interventions enabled nurses to recognise bullying and address it with assertive communication. Further research is needed to demonstrate these interventions' effectiveness and if they lead to a significant decrease in the short-/long-term frequency of these issues. This review increases the available knowledge and guides nurse leaders in choosing effective interventions. Eradicating this phenomenon from healthcare settings involves active engagement of nurses, regardless of their role, in addition to support from the nurse leaders, the organisations, and professional and health policies.

Developing and testing a prototype smartphone educational application to address incivility and bullying in nursing workplaces

BACKGROUND

Incivility and bullying in the nursing workplace may induce psychological trauma and increase staff turnover, however, the effects can be mitigated by cognitive rehearsal therapy. Smartphone education applications have emerged as an important educational tool in recent years. However, to date, no educational applications have been developed that combine cognitive rehearsal approaches with clinical situations. Therefore, in this study an education application (Easy Play Communication) was developed and tested to address incivility and bullying in the nursing workplace.

DESIGN/METHODS

This study design was employed in two phases. Phase 1 (February 2020-March 2021) combined analysis, design, development, implementation, and evaluation (ADDIE model) stages in the application development process. This phase involved conducting research into educational training and cognitive rehearsal literature, consultations with seven experts in related fields and administering a user needs questionnaire among 41 nurses. Phase 2 (April 2021-December 2021) was a pilot test phase, where 47 Mandarin and Taiwanese speaking nurses used the application to conduct cognitive rehearsal training. Changes in workplace incivility and bullying were tested using a pretest-posttest design. The posttest was conducted one week after the pretest.

RESULTS

Phase 1 showed user satisfaction with the app's accessibility (96.3 %), practicality (81.4 %), willingness to use (92.6 %), information content (88.9 %), information quality (88.9 %), and interface quality (88.9 %). Phase 2 showed that participants' perceived incivility in their interactions with other nurses, physicians, and patients and their family members decreased over the study period.

DISCUSSION/IMPLICATIONS

The findings indicate that smartphone applications combining theoretical knowledge with practical exercises can have a positive impact on nurses in the context of workplace incivility and bullying. We also demonstrated a development process that can be used to build applications for clinical nurses.

Interventions to address unprofessional behaviours between staff in acute care: what works for whom and why? A realist review

BACKGROUND

Unprofessional behaviour (UB) between staff encompasses various behaviours, including incivility, microaggressions, harassment, and bullying. UB is pervasive in acute healthcare settings and disproportionately impacts minoritised staff. UB has detrimental effects on staff wellbeing, patient safety and organisational resources. While interventions have been implemented to mitigate UB, there is limited understanding of how and why they may work and for whom.

METHODS

This study utilised a realist review methodology with stakeholder input to improve understanding of these complex context-dependent interventions. Initial programme theories were formulated drawing upon scoping searches and reports known to the study team. Purposive systematic searches were conducted to gather grey and published global literature from databases. Documents were selected if relevant to UB in acute care settings while considering rigour and relevance. Data were extracted from these reports, synthesised, and initial theories tested, to produce refined programme theories.

RESULTS

Of 2977 deduplicated records, 148 full text reports were included with 42 reports describing interventions to address UB in acute healthcare settings. Interventions drew on 13 types of behaviour change strategies and were categorised into five types of intervention (1) single session (i.e. one off); (2) multiple session; (3) single or multiple sessions combined with other actions (e.g. training sessions plus a code of conduct); (4) professional accountability and reporting programmes and; (5) structured culture change interventions. We formulated 55 context-mechanism-outcome configurations to explain how, why, and when these interventions work. We identified twelve key dynamics to consider in intervention design, including importance of addressing systemic contributors, rebuilding trust in managers, and promoting a psychologically safe culture; fifteen implementation principles were identified to address these dynamics.

CONCLUSIONS

Interventions to address UB are still at an early stage of development, and their effectiveness to reduce UB and improve patient safety is unclear. Future interventions should incorporate knowledge from behavioural and implementation science to affect behaviour change; draw on multiple concurrent strategies to address systemic contributors to UB; and consider the undue burden of UB on minoritised groups.

STUDY REGISTRATION

This study was registered on the international database of prospectively registered systematic reviews in health and social care (PROSPERO): https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021255490 .

Promoting Civility in the Workplace: Addressing Bullying in New Graduate Nurses Using Simulation and Cognitive Rehearsal

This evidence-based practice project implementation aimed to enhance new graduate nurses' abilities to address workplace bullying. A mixed educational methodology was used. Participants indicated applying learned behaviors to improve communication, peer relationships, teamwork, and patient safety and to address bullying. Civility ratings did not significantly increase from before to after the intervention, presumably because of high baseline ratings. Future research should identify sensitive and specific measures to detect bullying behavior changes.

A Pilot Study to Examine the Effects of a Workplace Cyberbullying Cognitive Rehearsal Mobile Learning Program for Head Nurses: A Quasi-Experimental Study

This study aimed to (1) develop a version of the cognitive rehearsal program that is suitable for cyberbullying and (2) apply the m-learning method to evaluate its effectiveness among head nurses. This study was conducted in July 2021 and comprised 69 South Korean university hospital head nurses. It was evaluated using a nonequivalent control group pretest-posttest and a quasi-experimental design. The program was developed using the Analysis, Design, Development, Implementation, and Evaluation (ADDIE) step process, consisting of 10 scenarios. Variables with proven reliability were used in the program effect measurement. The differences between the experimental and control groups were examined using an independent t-test (perception) or the Mann-Whitney U test (symptom experience, knowledge, and turnover intention). The program positively affected and improved head nurses' knowledge and perception of workplace cyberbullying; however, it elevated their symptom experience and had no immediate impact on turnover intention. The developed program could be applied as a valuable educational strategy in the nursing field. Head nurses act as intermediaries between individuals and the organization. Therefore, they must respond with in-depth knowledge and perceptions of cyberbullying to fulfill their responsibilities of identifying, mediating, and managing cyberbullying among hospital team members.

When Patient Rudeness Impacts Care: A Review of Incivility in Healthcare

Healthcare workers increasingly face incivility and rude behaviors from patients, families, and visitors. Although these are less severe than other types of mistreatment, studies have documented that they may still impact healthcare worker well-being and patient care. Defining and measuring incivility can be challenging because current research relies on the perceptions of the targets. Furthermore, there is often overlap among different types of mistreatment, and much of it goes unreported by those who experience it. Nevertheless, multiple studies have documented that incivility is common in healthcare and has been associated with burnout and intent to leave. In clinical settings, multiple consequences for patient care have been documented, including adverse consequences in the diagnostic and intervention performance of teams, as well as team processes. One theory is that incivility incidents divert cognitive resources away from the intervention and that these experiences may interfere with higher-order reasoning. Although limited research has been performed in the areas of prevention, response to incidents of incivility, and best practices for ameliorating the effects of incivility, some promising interventions have been reported in the literature.

Newly qualified graduate nurses' experiences of workplace incivility in healthcare settings: An integrative review

AIM

To explore, identify and integrate the existing knowledge to categorise the characteristics, likelihood, and consequences of workplace incivility among newly qualified graduate registered nurses. A particular focus of this review is on the experiences of new nurses related to these negative workplace behaviours and the strategies employed by these nurses and their organisations to manage workplace incivility.

BACKGROUND

Workplace incivility has been widely recognised as a global problem in healthcare settings and is known to affect nurses in all facets of their professional and personal life. This might be particularly harmful for newly qualified graduate nurses, as they are unprepared to deal with this uncivil culture.

DESIGN

An integrative review of the global literature, conducted according to the Whittemore and Knafl framework.

METHODS

Database searches (CINAHL, OVID Medline, PubMed, Scopus, Ovid Emcare and PsycINFO), and manual searching generated an aggregate of 1904 articles, which were further screened based on inclusion criteria and eligibility using the Mixed Methods Appraisal Tool (MMAT). Peer-reviewed empirical studies that explored the workplace incivility experiences of new graduate nurses were included in this review. Extracted data were grouped to develop themes and sub-themes.

RESULTS

This review included 14 studies in total with seven quantitative and seven qualitative studies. The data collected from these studies were categorised according to the research questions into a) expectations of civility, b) experiences and exposure to workplace incivility, c) forms and characteristics of incivility, d) sources of incivility, e) consequences of incivility, and f) managing and coping with incivility. Across studies, graduate nurses' views about the prestige and power of the nursing profession are conflicted due to experiences of incivility in clinical practice. New graduate nurses experienced a high but variable prevalence of incivility from their co-workers (25.6-87 %), with manifestations of incivility varying greatly, including eye rolling, yelling, exclusion and sexual harassment. Included studies primarily focused on professional and organisational effects and their outcomes relative to the physical and psychological effects on new nurses.

CONCLUSION

Findings from the literature demonstrate that incivility directed toward newly qualified graduate nurses is prevalent and can have significant negative impact on their self-esteem and confidence, which may ultimately impact on their workforce participation decisions and the quality of patient care. Supportive and empowering work environments are vital not only for improved nurse health and well-being, but also to retain new graduate nurses. The current nursing shortage emphasises the need for such conditions.

Pilot Study Using Cognitive Rehearsal, Simulation, and Biomarker Data to Address Workplace Incivility

BACKGROUND

Workplace incivility poses a threat to patient safety. This intervention pilot study used simulation and biomarker data with newly graduated nurses to explore the impact of incivility on patient care and tested whether cognitive rehearsal could mitigate the effects of workplace incivility.

METHOD

A clinical scenario and script were used by actors to deliver either an uncivil or a hurried but not uncivil handoff report to participants before they conducted a focused patient assessment and administered medications to a standardized patient.

RESULTS

Participants identified gaps in understanding of both handoff reports that resulted in compromised patient care. Quantitative trends showed lower resilience scores and higher stress appraisal scores for participants who received the uncivil handoff report.

CONCLUSION

Although participants expressed confidence using cognitive rehearsal as an intervention before the simulation, responses indicated that a 60-minute session was insufficient to adequately prepare them to effectively address an uncivil nurse encounter. [J Contin Educ Nurs. 2023;54(2):79-88.].

Associations among workplace incivility, stress coping, and nursing performance in hospital nurses: A path analysis

PURPOSE

This study aimed to identify the associations among workplace incivility, stress-coping strategy, and nursing performance and confirm how workplace incivility influences nursing performance through the stress-coping strategy.

DESIGN

This is a descriptive, cross-sectional study. Data were collected using a self-reported questionnaire from 245 nurses working at seven hospitals in Korea between December 2019 and January 2020.

METHODS

The associations among the study variables (workplace incivility, stress coping, and nursing performance) were analyzed using path analysis with bootstrapping.

RESULTS

Supervisors' incivility affected directly and negatively nursing performance although problem-focused coping was mediating between them. By contrast, coworkers' and doctors' incivility was not directly associated with nursing performance through stress-coping strategies.

CONCLUSION

Problem-focused coping enhanced nursing performance and was a more effective stress-coping strategy than emotion-focused coping for nurses affected by coworkers' and doctors' incivilities. Supervisors' incivility may be considered a threatening factor to nursing performance even though problem-focused coping partially mediates between supervisors' incivility and nursing performance.

CLINICAL RELEVANCE

Organizations must prevent all kinds of workplace incivilities from occurring. Nursing managers should periodically monitor the relationship between the supervisors and nurses and be aware of nurses' stress-coping strategies under stressful situations.

Nurse leadership in promoting and supporting civility in health care settings: A scoping review

AIM

This scoping review aimed to identify the existing evidence on how nurse leaders promote and maintain civility amongst nurses in health care settings.

BACKGROUND

Research on managing workplace incivility in nursing, a prevalent and concerning issue worldwide, recommends nurse leaders to command cultural change through strong leadership and civility interventions. However, there is very little empirical evidence summarizing and analysing how nurse leaders pragmatically achieve civility, and combat workplace incivility, in the health care setting.

EVALUATION

A scoping review was undertaken using the electronic databases CINAHL, Emerald Insight, MEDLINE, PsychINFO, PubMed and Scopus. Google Scholar was used to search for grey literature.

KEY ISSUES

The eight studies included in this review describe how nurse leaders promote and maintain civility under four key themes: (1) creating a shared vision, (2) educating self and others, (3) fostering accountability and (4) providing support.

CONCLUSION

The review provides an overview of commonly used strategies and actions that pragmatically promote and maintain civility in the health care setting by nurse leaders, while also highlighting areas of future research needed to strengthen the evidence base.

IMPLICATIONS FOR NURSING MANAGEMENT

It is important for nurse leaders to gain an understanding of evidence-based practices when addressing workplace incivility in order to address this prevailing problem for the future and safety of nurses moving forward.

Effectiveness of educational intervention and cognitive rehearsal on perceived incivility among emergency nurses: a randomized controlled trial

Background

Witnessing or experiencing of incivility affected the nurses’ perception of the ethical climate and quality of their work life. The aim of this study was to investigate the effectiveness of educational intervention and cognitive rehearsal on perceived incivility among emergency nurses.

Method

This study was conducted as a randomized controlled parallel group clinical trial. Eighty emergency nurses participated in this study and were randomly assigned to intervention and control groups during December 2019—March 2020. Cognitive rehearsal program (include of definitions of incivility, ten common incivilities and appropriate practice methods for responding to each and role-plays) was delivered in five two-hour sessions over three weeks on different working days and shifts. The control group received only written information about what incivility is and how to deal with it before the implementation of intervention and one month after the completion of the training sessions, the demographic information form and the incivility scale were completed by the nurses.

Results

The results showed that there was a significant effect on overall incivility, general incivility, and supervisor incivility between the intervention and control groups. However, these significant reductions were seen in control group who received only written education. There were no significant differences in nurse's incivility towards other nurses, physician incivility, and patient/visitor incivility between the two groups.

Conclusion

The cognitive rehearsal program did not decrease perceived incivility among emergency department nurses in the short term.

Trial registration

Our research was registered on clinicaltrials.gov. Registration number: IRCT20200714048104N1, first registration 16/07/2020.

The relationship between polychronicity and job-affective well-being: The moderator role of workplace incivility in healthcare staff

BACKGROUND

Despite the increasing body of research on workplace incivility, the relationship between co-worker/supervisor incivilities and job-affective well-being have received relatively little consideration from the scholars. This study investigates the impact of polychronicity on nurses' psychological well-being in the healthcare sector.

OBJECTIVE

According to COR theory, this study's main objective is to investigate the impact of two aspects of incivilities, co-worker, and supervisor incivilities, as the moderating effect on the relationship between polychronicity and job-affective psychological well-being.

METHODS

The sample data was collected from 260 nurse's staff who were working in hospitals. The proposed model hypothesis was tested through SPSS-Amos-structural equation modeling.

RESULTS

The result shows that polychronic nurses show high job engagement and job performance in a hospital environment. This study's findings revealed that co-workers and supervisors' higher incivility weakens the positive relationship between polychronicity and job-affective well-being.

CONCLUSION

Today, retained the employees are a perilous issue in every organization, especially in hospital sectors, where nurses are working in stressful working environments, facing bullying, harassment, and uncivil behavior from patients' side, co-workers, and supervisor. These types of behaviors are not only affecting employees' well-being, commitment, and job performance but also their mental health and intent to leave. Similarly, the effect on organizational goals, shareholders' value, and progress makes an effective mechanism to control the negative behaviors that would be an apparent advantage for administration and managers to efficiently attain organizational goals.

Hospital nurses experiencing day-to-day workplace incivility: A diary study on the benefits of daily social support

AIM

The present study investigated the adverse effects of daily experienced incivility and the positive role of daily social support during the workday in predicting daily emotional exhaustion after work and vitality and positive affect at bedtime.

BACKGROUND

Despite the broad knowledge of the impact of experienced incivility in different occupations, little is known about day-to-day nurse incivility, much less in the hospital context.

METHOD

After completing a general questionnaire, hospital nurses (n = 96) completed a diary questionnaire twice a day for five consecutive workdays (n = 480 diary observations). The diary design had two levels: 5-day repeated measures (Level 1, day level) nested in persons (Level 2, person level) using an experience-sampling methodology.

RESULTS

Multilevel hierarchical analyses showed that incivility during the workday increased emotional exhaustion after work (t = 3.00, p = <0.05) and reduced vitality (t = -2.48, p = 0.05) and positive affect (t = -2.23, p = 0.05) at bedtime. However, daily social support during the workday was a crucial job resource that directly benefited hospital nurses' daily wellbeing (t = 5.19, p = 0.01 vitality; t = 4.89, p = 0.01 positive affect) and buffered the adverse effects of daily workplace incivility (t = -2.33, p = 0.05).

CONCLUSION

The within-person approach of our findings suggests that supportive practices can reduce day-to-day incivility spirals.

IMPLICATIONS FOR NURSING MANAGEMENT

Nurse managers can promote a civility culture within their units using in service training programmes at work.

The mediating effect of workplace incivility on organization culture in South Korea: A descriptive correlational analysis of the turnover intention of nurses

PURPOSE

The purpose of this study was to understand the mediating effect of workplace incivility on the relationship between nursing organizational culture and turnover intention among nurses.

DESIGN

A descriptive survey was used to collect data. The participants were 170 nurses with more than six months of clinical experience at university hospitals or hospitals with over 500 beds in South Korea.

METHODS

Data were collected using self-report questionnaires. Collected data were analyzed using descriptive statistics, t-test, ANOVA, Scheffé test, and Pearson's correlation. Baron and Kenny's three-step hierarchical regression analysis and the Sobel test were used to determine the mediating effect of workplace incivility on the relationship between nursing organizational culture and nurses' turnover intention.

RESULTS

This study found a full mediating effect of workplace incivility on the association between relationship-oriented culture and turnover intention (Z = -3.02, p = 0.003) and a partial mediating effect of workplace incivility on the association between hierarchy-oriented culture and turnover intention (Z = 2.36, p = 0.018).

CONCLUSION

This study empirically confirmed that nursing organizational culture and workplace incivility directly or indirectly influenced turnover intention, which highlights the seriousness of workplace incivility.

CLINICAL RELEVANCE

This study suggests that there is a need to establish a concrete strategy to avoid a hierarchy-oriented culture and create a relationship-oriented culture. It is important to develop a variety of intervention programs to reduce workplace incivility in order to prevent nurses' turnover.

Taking a Stand Against Workplace Incivility

BACKGROUND

Workplace incivility is a common problem in nursing, and novice nurses are particularly vulnerable to incivility.

METHOD

Cognitive rehearsal training to defend against incivility was presented to resident nurses.

RESULTS

Three months after the educational intervention, 55% of nurses reported that they had witnessed incivility in the past month and 45% reported that they had responded to the incivility when it occurred.

CONCLUSION

Most of the nurses expressed that the training improved their ability to manage incivility. Responses to open-ended comments revealed that incivility adversely affects the workplace and that leaders also may benefit from education on incivility and cognitive rehearsal. [J Contin Educ Nurs. 2021;52(5):232-239.].

An Innovative Civility Intervention Created by a Faculty and Student Action Research Team

BACKGROUND

Incivility is a significant issue in nursing education and practice, contributing to ineffective learning, unprofessional nursing practice, and negative patient outcomes.

METHOD

A team of nursing faculty and students used Action Research to develop a quality improvement project targeting civility. A two-part, evidence-based training was offered to prelicensure nursing students, faculty, and staff. Part one was designed to increase incivility awareness, and part two was intended to enhance communication skills.

RESULTS

Program evaluation data were collected through an anonymous survey and analyzed descriptively for themes. Results indicated students, faculty, and staff perceived the educational innovation as valuable and useful.

CONCLUSION

By using free resources, a college of nursing was able to implement a cost-effective program to begin a conversation and offer a communication strategy to address incivility for students, faculty, and staff. This program design can be adopted by others for use in their organization. [J Nurs Educ. 2020;59(4):214-217.].

Impact of workplace incivility on compassion competence of Korean nurses: Moderating effect of psychological capital

AIM

This study aimed to examine the association between workplace incivility and compassion competence of Korean nurses, as well as the moderating effect of psychological capital.

BACKGROUND

Workplace incivility affects the quality of patient care and as such is worthy of critical examination regarding its impact on the compassion competence of nurses.

METHODS

In this descriptive cross-sectional study, data for 192 Korean hospital nurses were used to analyse the relationship between workplace incivility and compassion competence and the moderating effect of psychological capital.

RESULTS

Workplace incivility was negatively associated with compassion competence of nurses. Furthermore, psychological capital had a conditional moderating effect on the relationship between workplace incivility and nurses' compassion competence. The negative associations of workplace incivility with compassion competence were significant at low and medium levels of psychological capital but not at high psychological capital. Moreover, the association was stronger for those with low psychological capital.

CONCLUSION

Workplace incivility is negatively associated with compassion competence among nurses, and psychological capital has conditional moderating effects in its relationship.

IMPLICATIONS FOR NURSING MANAGEMENT

Management efforts to reduce workplace incivility and to improve nurses' psychological capital are needed to improve patient care quality.

Incivility through the continuum of nursing: A concept analysis

AIM

The aim of this study is to explore the gap between incivility in the workplace and academia and develop a connection to the psychosocial distress effects on the victims.

BACKGROUND

While incivility in nursing has reached epidemic proportions in the past decade, the current definitions of incivility are limited to the workplace or academia and lack consideration of the consequences related to the social well-being of the victim.

DESIGN

Rodgers' evolutionary method was used in this study.

DATA SOURCE

Following the PRISMA guidelines, articles were reviewed from PubMed and CINAHL between 2008 to 2019. Twenty articles describing incivility faced by staff nurses, student nurses, academic faculty, and nursing administrators were included in the final analysis.

REVIEW METHODS

Inductive thematic analysis was used to determine the antecedents, attributes, and consequences of incivility in nursing.

RESULTS

Findings included a culture of incivility and power gradients as antecedents. The attributes of incivility were verbal or non-verbal behaviors that demean, dismiss, or exclude the individual. Consequences of incivility are psychosocial and physiological distress.

CONCLUSION

A broader definition of incivility may be appropriate. Further research is needed to determine interventions to mitigate the effects of incivility.

The Professional Behaviors New Nurses Need: Findings From a National Survey of Hospital Nurse Leaders

AIM

The purpose of this study was to survey hospital nurse leaders throughout the United States to determine which professional behaviors they believe are essential for nursing students to learn in the classroom.

BACKGROUND

This study was part of a multiphase study. The survey was revised from a previous survey administered to nurse leaders in the Midwest.

METHOD

Participants were surveyed using 46 items in the categories of Change, Communication, Conflict, Leadership, and Self-Awareness.

RESULTS

The highest ranked category was Communication, followed by Self-Awareness, Change, Leadership, and Conflict. The highest rated items in each category were communication with patients, accept constructive criticism, manage change, prioritization, and conflict resolution techniques.

CONCLUSION

Nurse educators and leaders can use the findings to continue to refine nursing education.