1
|
Graber J, Ivory R, Saylor J. Incivility and the faculty shortage in nursing academia. Nursing 2024; 54:58-60. [PMID: 39051962 DOI: 10.1097/nsg.0000000000000043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/27/2024]
Affiliation(s)
- Jennifer Graber
- At the University of Delaware in Newark, Del., Jennifer Graber is an associate professor and the associate dean of academic affairs & practice initiatives, Rebecca Ivory is an adjunct assistant professor, and Jennifer Saylor is an associate professor and the associate dean of faculty and student affairs
| | | | | |
Collapse
|
2
|
Freedman B, Li WW, Liang Z, Hartin P, Biedermann N. The prevalence of incivility in hospitals and the effects of incivility on patient safety culture and outcomes: A systematic review and meta-analysis. J Adv Nurs 2024. [PMID: 38515008 DOI: 10.1111/jan.16111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 12/15/2023] [Accepted: 02/06/2024] [Indexed: 03/23/2024]
Abstract
AIM Workplace incivility is a barrier to safe and high-quality patient care in nursing workplaces and more broadly in tertiary hospitals. The present study aims to systematically review the existing evidence to provide a comprehensive understanding of the prevalence of co-worker incivility experienced and witnessed by nurses and other healthcare professionals, the effects of incivility on patient safety culture (PSC) and patient outcomes, and the factors which mediate the relationship between incivility and patient safety. METHODS A systematic review with narrative synthesis and meta-analysis was undertaken to synthesize the data from 41 studies. DATA SOURCES Databases searched included MEDLINE, PubMed, SCOPUS, CINAHL, PsycInfo, ProQuest, Emcare and Embase. Searches were conducted on 17 August 2021 and repeated on 15 March 2023. RESULTS The pooled prevalence of experienced incivility was 25.0%. The pooled prevalence of witnessed incivility was 30.1%. Workplace incivility was negatively associated with the PSC domains of teamwork, reporting patient safety events, organization learning/improvement, management support for safety, leadership, communication openness and communication about error. The composite pooled effect size of incivility on these domains of PSC was OR = 0.590, 95% CI [0.515, 0.676]. Workplace incivility was associated with a range of patient safety outcomes (PSOs) including near misses, adverse events, reduced procedural and diagnostic performance, medical error and mortality. State depletion, profession, psychological responses to incivility, information sharing, help seeking, workload and satisfaction with organizational communication were found to mediate the relationship between incivility and patient safety. CONCLUSION Experienced and witnessed incivility is prevalent in tertiary hospitals and has a deleterious effect on PSC and PSOs. A better understanding of the mechanisms of this relationship will support the development of interventions aimed at reducing both incivility and patient harm. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE IMPACT This study quantifies the effect of incivility on PSC and outcomes. It provides support that interventions focusing on incivility are a valuable mechanism for improving patient care. It guides intervention design by highlighting which domains of PSC are most associated with incivility. It explores the profession-specific experiences of workplace incivility. REPORTING METHOD This report adheres to PRISMA reporting guidelines. PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution. The focus of this study is the nursing and healthcare workforce, therefore, patient or public involvement not required.
Collapse
Affiliation(s)
- Benjamin Freedman
- James Cook University, Townsville, Queensland, Australia
- Townsville University Hospital, Douglas, Townsville, Australia
| | - Wendy Wen Li
- James Cook University, Townsville, Queensland, Australia
| | - Zhanming Liang
- James Cook University, Townsville, Queensland, Australia
| | - Peter Hartin
- James Cook University, Townsville, Queensland, Australia
| | | |
Collapse
|
3
|
Berger S, Grzonka P, Frei AI, Hunziker S, Baumann SM, Amacher SA, Gebhard CE, Sutter R. Violence against healthcare professionals in intensive care units: a systematic review and meta-analysis of frequency, risk factors, interventions, and preventive measures. Crit Care 2024; 28:61. [PMID: 38409034 PMCID: PMC10898135 DOI: 10.1186/s13054-024-04844-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Accepted: 02/19/2024] [Indexed: 02/28/2024] Open
Abstract
BACKGROUND To assess the frequency, risk factors, consequences, and prevention of violence against healthcare workers in intensive care units. METHODS PubMed, Scopus, Google Scholar, EMBASE, Cochrane, and Web of Science were searched for studies on violence against healthcare workers in adult intensive care units. Risk factors, patient characteristics, and implications for healthcare workers were collected. Study quality, bias, and level of evidence were assessed using established tools. RESULTS Seventy-five studies with 139,533 healthcare workers from 32 countries were included. The overall median frequency of violence was 51% (IQR 37-75%). Up to 97% of healthcare workers experienced verbal violence, and up to 82% were victims of physical violence. Meta-analysis of frequency revealed an average frequency of 31% (95% CI 22-41%) for physical violence, 57% for verbal violence (95% CI 48-66%), and 12% for sexual violence (95% CI 4-23%). Heterogeneity was high according to the I2 statistics. Patients were the most common perpetrators (median 56%), followed by visitors (median 22%). Twenty-two studies reported increased risk ratios of up to 2.3 or odds ratios of up to 22.9 for healthcare workers in the ICU compared to other healthcare workers. Risk factors for experiencing violence included young age, less work experience, and being a nurse. Patients who exhibited violent behavior were often male, older, and physically impaired by drugs. Violence was underreported in up to 80% of cases and associated with higher burnout rates, increased anxiety, and higher turnover intentions. Overall the level of evidence was low. CONCLUSIONS Workplace violence is frequent and underreported in intensive care units, with potential serious consequences for healthcare workers, calling for heightened awareness, screening, and preventive measures. The potential risk factors for violence should be further investigated. SYSTEMATIC REVIEW REGISTRATION The protocol for this review was registered with Prospero on January 15, 2023 (ID CRD42023388449).
Collapse
Affiliation(s)
- Sebastian Berger
- Clinic for Intensive Care, Department of Acute Medicine, University Hospital Basel, Petersgraben 4, 4031, Basel, Switzerland.
| | - Pascale Grzonka
- Clinic for Intensive Care, Department of Acute Medicine, University Hospital Basel, Petersgraben 4, 4031, Basel, Switzerland
| | - Anja I Frei
- Clinic for Intensive Care, Department of Acute Medicine, University Hospital Basel, Petersgraben 4, 4031, Basel, Switzerland
| | - Sabina Hunziker
- Medical Faculty, University of Basel, Basel, Switzerland
- Medical Communication and Psychosomatic Medicine, University Hospital Basel, Basel, Switzerland
| | - Sira M Baumann
- Clinic for Intensive Care, Department of Acute Medicine, University Hospital Basel, Petersgraben 4, 4031, Basel, Switzerland
| | - Simon A Amacher
- Clinic for Intensive Care, Department of Acute Medicine, University Hospital Basel, Petersgraben 4, 4031, Basel, Switzerland
- Medical Communication and Psychosomatic Medicine, University Hospital Basel, Basel, Switzerland
| | - Caroline E Gebhard
- Clinic for Intensive Care, Department of Acute Medicine, University Hospital Basel, Petersgraben 4, 4031, Basel, Switzerland
- Medical Faculty, University of Basel, Basel, Switzerland
| | - Raoul Sutter
- Clinic for Intensive Care, Department of Acute Medicine, University Hospital Basel, Petersgraben 4, 4031, Basel, Switzerland
- Medical Faculty, University of Basel, Basel, Switzerland
- Department of Clinical Research, University of Basel, Basel, Switzerland
| |
Collapse
|
4
|
Mtsoeni L, Matlala S, Downing C. Newly qualified intensive care nurses' lived experiences of being a shift leader in a private healthcare institution in Gauteng, South Africa. Int J Nurs Sci 2023; 10:351-358. [PMID: 37545775 PMCID: PMC10401342 DOI: 10.1016/j.ijnss.2023.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Revised: 06/12/2023] [Accepted: 06/19/2023] [Indexed: 08/08/2023] Open
Abstract
Objective Newly qualified intensive care nurses (NQICNs) are expected to execute the shift-leading role immediately after graduation. Critical reasoning, problem-solving, decision-making, and evidence-based clinical judgment are thus essential skills for intensive care nursing graduates. This study aimed to explore and describe NQICNs' lived experiences of being shift leaders. Methods This descriptive qualitative study was based on the data collected through semi-structured individual interviews. Five NQICNs in five hospitals from one region in Gauteng, South Africa, were interviewed between September and December 2019. NQICNs working as shift leaders for 10 to 12 months after intensive care training were eligible for inclusion in the study. Data were analyzed using the four steps suggested by Giorgi. Results The results revealed three themes and seven sub-themes. NQICNs suffered greatly intrapersonally (NQICNs reported intrapersonal suffering, manifesting as pre-shift anxiety, severe work stress, and post-shift exhaustion; NQICNs employed coping mechanisms and either fought, fled, or froze during conflict or crises; NQICNs lack of shift-leading experience did not match their heavy load of responsibilities and accountability); the NQICNs interpersonally matured and empowered themselves (NQICNs experienced support and challenges on an interpersonal level; NQICNs improved their interpersonal relationships and felt proud of and empowered by their professional growth); NQICNs highlighted various requirements to help them manage the high demands of leading shifts (others should fulfill certain needs to enable NQICNs to handle the shift-leading role; self-awareness as a need to enable NQICNs to embrace the shift-leading role). Conclusion A greater understanding of NQICNs and their unmet needs will enable nurse managers, educators, and nurses to better support NQICNs' evolution from novice to competent shift leaders.
Collapse
Affiliation(s)
- Lucky Mtsoeni
- Department of Nursing, University of Johannesburg, Doornfontein, Johannesburg, South Africa
| | - Sidwell Matlala
- Department of Nursing, University of Johannesburg, Doornfontein, Johannesburg, South Africa
| | - Charlené Downing
- Department of Nursing, University of Johannesburg, Doornfontein, Johannesburg, South Africa
| |
Collapse
|
5
|
Aljuaid NH, Alharbi MF. The Relationship Between Workplace Incivility and Patient Safety in Pediatric Nurses. J Nurs Care Qual 2023; 38:211-219. [PMID: 36729668 DOI: 10.1097/ncq.0000000000000685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND Workplace incivility may directly influence nurses' involvement in patient safety; however, research on this topic in the pediatric setting has yet to be established. PURPOSE The purpose of this study was to address the prevalence of workplace incivility in pediatric settings in Saudi Arabia (SA) and examine its impact on patient safety culture. METHODS A cross-sectional study design was used. Surveys, including the Nursing Incivility Scale and Hospital Survey on Patient Safety Culture, were sent to nurses across 6 pediatric units in Taif, SA. RESULTS A total of 300 nurses completed the surveys. A significant negative modest correlation was found between incivility and patient safety domains ( P < .05). A higher stress score was associated with older age (>35 years), Saudi nationality, and subdegree education. CONCLUSION This study found that pediatric nurses experience high rates of incivility, mostly originating from patients and their families.
Collapse
Affiliation(s)
- Noof H Aljuaid
- Pediatric Intensive Care Department, Children's Hospital, Ministry of Health, Taif, Saudi Arabia (Ms Aljuaid); and Maternal and Child Health Nursing Department, College of Nursing, King Saud University, Riyadh, Saudi Arabia (Dr Alharbi)
| | | |
Collapse
|
6
|
Clark CM, Kardong-Edgren S, Willhaus J. Pilot Study Using Cognitive Rehearsal, Simulation, and Biomarker Data to Address Workplace Incivility. J Contin Educ Nurs 2023; 54:79-88. [PMID: 36720094 DOI: 10.3928/00220124-20230113-07] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
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.].
Collapse
|
7
|
Kim EH, Yi Y. Associations among workplace incivility, stress coping, and nursing performance in hospital nurses: A path analysis. J Nurs Scholarsh 2022. [PMID: 36510252 DOI: 10.1111/jnu.12864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 11/16/2022] [Accepted: 11/28/2022] [Indexed: 12/14/2022]
Abstract
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.
Collapse
Affiliation(s)
| | - Yeojin Yi
- College of Nursing, Hanyang University, Seoul, South Korea
| |
Collapse
|
8
|
Nauman S, Malik SZ, Saleem F. The slippery slope effect of patient incivility: unleashing the roles of surface acting and receiving help in employees’ unethical behavior and organizational citizenship behavior. INTERNATIONAL JOURNAL OF HUMAN RESOURCE MANAGEMENT 2022. [DOI: 10.1080/09585192.2022.2129418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Shazia Nauman
- Riphah School of Business and Management, Riphah International University, Lahore, Pakistan
| | | | - Farida Saleem
- College of Business Administration, Prince Sultan University, Riyadh, Saudi Arabia
| |
Collapse
|
9
|
Martin LD, Zadinsky JK. Frequency and Outcomes of Workplace Incivility in Healthcare: A Scoping Review of the Literature. J Nurs Manag 2022; 30:3496-3518. [PMID: 36056563 DOI: 10.1111/jonm.13783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 07/27/2022] [Accepted: 08/29/2022] [Indexed: 11/27/2022]
Abstract
AIMS To evaluate the frequency and outcomes of workplace incivility in healthcare for nursing management. BACKGROUND Incivility in the workplace is a significant problem that is important to nurse managers, as it goes directly against the fundamental values and ethics of providing high-quality care to patients. The Joint Commission (2021) and the American Nurses Credentialing Center have called on healthcare organizations to identify and intervene in the problem of workplace incivility. EVALUATION Studies included in this scoping review were those that measured and analyzed the frequency and outcomes of workplace incivility in healthcare. Four databases were searched, and 28 articles were reviewed. Evaluation was based on general quality, including study characteristics, instruments, and statistical analyses. KEY ISSUES Studies used a quasi-experimental design, and most focused on the Registered Nurse population. The Workplace Incivility Scale was the most commonly used instrument to measure workplace incivility frequency. The most frequently studied work-related outcomes were burnout, satisfaction, and turnover. CONCLUSIONS Although the frequency of workplace incivility in healthcare is not clear, its consequences are substantial. Multiple studies have revealed significant relationships between workplace incivility and work-related outcomes that are important to nurse managers. Research is needed on non-nursing healthcare professionals, and validation studies are needed on instruments used to measure workplace incivility frequency. IMPLICATIONS FOR NURSING MANAGEMENT The findings of this review can help nurse managers better understand the phenomenon, frequency, and impact of workplace incivility in the healthcare setting and move toward addressing the problem of workplace incivility among nurses and other healthcare professionals.
Collapse
|
10
|
Xia B, Wang X, Li Q, He Y, Wang W. How workplace incivility leads to work alienation: A moderated mediation model. Front Psychol 2022; 13:921161. [PMID: 36118448 PMCID: PMC9478481 DOI: 10.3389/fpsyg.2022.921161] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 08/11/2022] [Indexed: 11/13/2022] Open
Abstract
Workplace incivility remains a prevailing issue and has significant potential for harmful consequences. This study aims to investigate the influencing mechanism of workplace incivility on work alienation from the perspective of targets. Based on the social exchange theory, our research examines the role of interpersonal trust as a mediator along with the moderator of career resilience in the said association. Through a two-wave-time-lagged quantitative research design, a sample of 315 nurses from China was investigated with questionnaires on workplace incivility, work alienation, interpersonal trust, and career resilience. The results indicated that workplace incivility was positively related to work alienation with interpersonal trust as a mediator. Workplace incivility caused a decline in interpersonal trust, which led to work alienation. Career resilience buffered such an impact. High career resilience weakened the association linking workplace incivility to interpersonal trust. Organizations should pay more attention to workplace incivility and consider empowering nurses’ career resilience, which could alleviate the negative impact of workplace incivility.
Collapse
Affiliation(s)
- Bingnan Xia
- School of Business Administration, Zhejiang Gongshang University, Hangzhou, China
| | - Xiaochen Wang
- School of Business Administration, Zhejiang Gongshang University, Hangzhou, China
| | - Qing Li
- School of Marxism, Communication University of Zhejiang, Hangzhou, China
- *Correspondence: Qing Li,
| | - Yuzhen He
- School of Business Administration, Zhejiang Gongshang University, Hangzhou, China
| | - Wei Wang
- Hangzhou Zhongxing Hospital, Hangzhou, China
| |
Collapse
|
11
|
Rauman PA. Conflicting Working Relationships Among Nurses: The Intersection of Should Nursing, Double Domination, and the Big Picture. Can J Nurs Res 2022; 55:230-240. [PMID: 35903883 DOI: 10.1177/08445621221115250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background Research conducted on conflict between Registered Nurses (RNs) has established that it happens regularly within the hospital setting, that it adversely affects the health and well-being of RNs, impacts the effective functioning of the health care organization, and compromises quality patient care. In this article, the phrase conflicting working relationships (CWRs) is used to represent working relationships between RN peers that are non-collegial, uncaring, and non- supportive, and inclusive of the behaviours associated with incivility, horizontal violence, and bullying, among others. Purpose To examine how nursing, including nursing knowledge and practice, is socially organized within the hospital setting and how this organization is linked to CWRs between RN peers. Methods Interviews were conducted with 17 RNs, followed by text analysis and mapping guided by institutional ethnography (IE) as the research methodology. Results The intersections between should nursing, double domination, and the big picture threads shows work environments where RNs struggle to provide appropriate care and conflict has become institutionalized. The intersection between threads can be used as caution areas for RNs and individuals in leadership positions to reflect on nursing practice when conflict is being experienced. Conclusions The contextual variables surrounding professional nursing practice are very influential with respect to how RNs relate to each other. A new type of dialogue about the organization of nursing practice in the hospital setting is needed to support more relational practices between RNs.
Collapse
Affiliation(s)
- Peggy Ann Rauman
- Memorial University Newfoundland and Labrador, 30 Bay Bulls Road, St. John’s, NL, A1G 1A3, Canada
| |
Collapse
|
12
|
Kerterz L, Garbarini J. Incivility in the Health Care Environment: Special Focus on the Operating Room. Prof Case Manag 2022; 27:213-220. [PMID: 35617540 DOI: 10.1097/ncm.0000000000000581] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Louise Kerterz
- Louise Kerterz, DNP, MSN, ANP-BC, CNS, CNOR, is an advanced practice clinical nurse specialist at New York-Presbyterian Hospital/CUIMC for more than 12 years. She is a graduate of St. Francis School of Nursing, received her BSN from New Jersey City University, her MSN/nurse practitioner from Seton Hall University, and her doctor of nursing practice from Saint Peters University. She is currently working on her dissertation at Seton Hall University, where she is pursuing a PhD in nursing. She has more than 30 years of nursing experience in the operating room
- Joni Garbarini, MS, BSN, RN-C, has more than 25 years of experience in case management and was a rehabilitation liaison for acute and subacute patients for 10 years. She earned her master's degree in health science from NJCU in 1997 after graduating with a bachelor's degree in nursing in 1992. She earned her case management certification in 2020
| | - Joni Garbarini
- Louise Kerterz, DNP, MSN, ANP-BC, CNS, CNOR, is an advanced practice clinical nurse specialist at New York-Presbyterian Hospital/CUIMC for more than 12 years. She is a graduate of St. Francis School of Nursing, received her BSN from New Jersey City University, her MSN/nurse practitioner from Seton Hall University, and her doctor of nursing practice from Saint Peters University. She is currently working on her dissertation at Seton Hall University, where she is pursuing a PhD in nursing. She has more than 30 years of nursing experience in the operating room
- Joni Garbarini, MS, BSN, RN-C, has more than 25 years of experience in case management and was a rehabilitation liaison for acute and subacute patients for 10 years. She earned her master's degree in health science from NJCU in 1997 after graduating with a bachelor's degree in nursing in 1992. She earned her case management certification in 2020
| |
Collapse
|
13
|
Sommovigo V, Bernuzzi C, Setti I. Helping others not always helps ourselves: the relationship between victim incivility and emergency workers' burnout through work-to-family conflict. INTERNATIONAL JOURNAL OF WORKPLACE HEALTH MANAGEMENT 2022. [DOI: 10.1108/ijwhm-09-2021-0183] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
PurposeThis study aims to analyse whether and when victim incivility may be related to work-to-family conflict and then burnout among emergency workers.Design/methodology/approachA total of 304 Italian emergency workers from five firehouses and six emergency rooms completed questionnaires, examining: victim incivility, work-to-family conflict, social support seeking and burnout symptoms. Descriptive analyses, confirmatory factor analyses and structural equation models were conducted.FindingsVictim incivility was positively associated with burnout symptoms, both directly and indirectly, as mediated by work-to-family conflict. Additionally, social support seeking exacerbated (rather than mitigated) the impact of work-to-family conflict on burnout symptoms.Practical implicationsOrganisations can greatly benefit from implementing family-friendly practices and providing their workers with training programmes on how to deal with difficult victims.Originality/valueThis study contributes to the existing literature on workplace incivility and work–life interface by supporting for the first time the notion that victim incivility can spill over into emergency workers' family domain and by clarifying how and when victim incivility is related to burnout symptoms.
Collapse
|
14
|
El Ghaziri M, Johnson S, Purpora C, Simons S, Taylor R. Registered Nurses' Experiences With Incivility During the Early Phase of COVID-19 Pandemic: Results of a Multi-State Survey. Workplace Health Saf 2022; 70:148-160. [PMID: 34318719 PMCID: PMC8322958 DOI: 10.1177/21650799211024867] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Incivility among workers in the health sector is recognized as an occupational hazard. The COVID-19 outbreak brought sudden and profound changes to many health care settings, many of which have been identified as antecedents to workplace incivility. The purpose of this retrospective study was to explore the experiences of registered nurses with workplace incivility, cyber-incivility, and incivility outside of work during the early phase of the COVID-19 pandemic. METHODS This mixed-methods study used convenience sampling. Data were collected from June to September 2020 via an online survey, which consisted of both closed- and open-ended questions. Participants were recruited from national nursing organizations and unions. Data were analyzed using descriptive statistics and thematic analysis for open-ended responses. FINDINGS A total of 526 nurses' responses were included in the analysis. More than one third experienced greater incivility at work during the COVID-19 outbreak than before the pandemic (37.4%), and almost half (45.7%) said they witnessed more incivility than before the pandemic. Cyber-incivility and incivility outside of work were also issues. Qualitative results indicated that respondents felt they were on edge during this period. Other themes included leadership failure, fractured co-worker relationships, heightened incivility from patients and families, and hostility and ostracism from the general public. CONCLUSION/APPLICATION TO PRACTICE Occupational health nurses, nursing leaders, and staff nurses need to work to restore relations that were fractured by incivility during the pandemic. In the future, improved preparedness, including establishing clear channels of communication, may lessen incivility by decreasing role stress and organizational chaos.
Collapse
|
15
|
Xiaolong T, Gull N, Asghar M, Jianmin Z. The relationship between polychronicity and job-affective well-being: The moderator role of workplace incivility in healthcare staff. Work 2021; 70:1267-1277. [PMID: 34842212 DOI: 10.3233/wor-205286] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
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.
Collapse
Affiliation(s)
- Tao Xiaolong
- School of Business Administration and Tourism Management, Yunnan University, Kunming, China
| | - Nida Gull
- School of Economics and Management, Yanshan University, Qinhuangdao, Hebei, China
| | - Muhammad Asghar
- School of Economics and Management, Yanshan University, Qinhuangdao, Hebei, China
| | - Zhang Jianmin
- School of Business Administration and Tourism Management, Yunnan University, Kunming, China
| |
Collapse
|
16
|
Carmona-Cobo I, Lopez-Zafra E. Hospital nurses experiencing day-to-day workplace incivility: A diary study on the benefits of daily social support. J Nurs Manag 2021; 30:1577-1589. [PMID: 34773929 DOI: 10.1111/jonm.13510] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 10/25/2021] [Accepted: 11/03/2021] [Indexed: 11/27/2022]
Abstract
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.
Collapse
|
17
|
Affiliation(s)
- Shanna Ramsey-Haynes
- Shanna Ramsey-Haynes is the former director of education and Magnet program at Cancer Treatment Centers of America and is currently the Magnet program director at Emory University Hospital Midtown in Atlanta, Ga
| |
Collapse
|
18
|
Mgboji GE, Woreta FA, Fliotsos MJ, Zafar S, Ssekasanvu J, Srikumaran D, Zhao J, Buccino DL, Regan L. Prevalence of incivility between ophthalmology and emergency medicine residents during interdepartmental consultations. AEM EDUCATION AND TRAINING 2021; 5:e10653. [PMID: 34522830 PMCID: PMC8427183 DOI: 10.1002/aet2.10653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 06/30/2021] [Accepted: 07/15/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVES Since incivility is linked to adverse effects in patient care and health care worker well-being, evaluation of the prevalence of incivility during the formative years of residency training is warranted. The aim of this study was to determine the perceived presence and degree of incivility between emergency medicine (EM) and ophthalmology residents during emergency department (ED) consultations. METHODS We conducted a single-site, survey-based study, targeted to ophthalmology and EM residents. The survey we distributed included questions adapted from validated and widely used surveys measuring incivility in the workplace (Workplace Incivility Scale) and incivility within the ED. RESULTS Ophthalmology (13/15, 86.7%) and EM (42/48, 87.5%) residents participated, with an overall response rate of 55 of 63 (87.3%). Most residents (47/55, 85.5%) reported some degree of incivility during consultations, with a greater proportion of females reporting incivility (100%) than males (77.4%, p = 0.033). A total of 52.7% of respondents reported occurrence of incivility on a quarterly basis; 21.8% reported monthly, 10.9% weekly, and none daily. Incivilities were reported most commonly during nonurgent consults (85.5%). The two most common incivilities reported by trainees were when the other party paid little attention to their statements or opinions (80% of residents) or doubted their professional judgment (74.5% of residents). More female trainees reported jokes being told at their expense compared to males (15.8% vs. 0%, p = 0.049). Residents most often attributed incivility to stress (78.2%), loss of empathy/burnout (63.6%), or attempts to shift responsibility to another party (60.0%). Among EM residents surveyed, incivility was identified as occurring most often during consultations with surgical specialties. CONCLUSIONS Incivility during interdepartmental consultations between EM and ophthalmology is commonly reported by physicians-in-training. It occurs more often during consultations deemed as nonurgent and is more commonly reported by females. Given its associations with adverse outcomes, interventions to decrease incivility early in training may be warranted.
Collapse
Affiliation(s)
| | - Fasika A. Woreta
- Wilmer Eye InstituteJohns Hopkins School of MedicineBaltimoreMarylandUSA
| | | | - Sidra Zafar
- Wilmer Eye InstituteJohns Hopkins School of MedicineBaltimoreMarylandUSA
| | - Joseph Ssekasanvu
- Department of EpidemiologyJohns Hopkins Bloomberg School of Public HealthBaltimoreMarylandUSA
| | - Divya Srikumaran
- Wilmer Eye InstituteJohns Hopkins School of MedicineBaltimoreMarylandUSA
| | - Jiawei Zhao
- Wilmer Eye InstituteJohns Hopkins School of MedicineBaltimoreMarylandUSA
| | - Daniel L. Buccino
- Department of PsychiatryJohns Hopkins University School of MedicineBaltimoreMarylandUSA
| | - Linda Regan
- Department of Emergency MedicineJohns Hopkins University School of MedicineBaltimoreMarylandUSA
| |
Collapse
|
19
|
Vargas EA, Mahalingam R, Marshall RA. Witnessed Incivility and Perceptions of Patients and Visitors in Hospitals. J Patient Exp 2021; 8:23743735211028092. [PMID: 34263026 PMCID: PMC8252437 DOI: 10.1177/23743735211028092] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Research has examined instances of incivility witnessed by physicians, nurses, or employees in hospitals. Although patients and visitors are members in hospitals, witnessed incivility from their perspective has rarely been empirically investigated. The aims of the current study are 2-fold: (1) to investigate the forms of incivility patients/visitors witness in hospitals and (2) to examine whether these patients/visitors believe these incivilities impact the target’s sense of perceived control. An integration of interpretative phenomenological analysis and thematic analysis was used to code qualitative data (N = 77). Eight themes of witnessed incivility and 3 themes for impact on perceived control were identified. The results illuminate patterns of incivility targeted at marginalized groups, historically underrepresented in hospital-focused incivility research (eg, homeless individuals, incarcerated individuals, the elderly individuals). The majority of witnesses believed the incident of incivility would negatively impact the target’s perception of control, possibly affecting their experience and health. The current study demonstrates that empirically investigating witnessed incivility from the patient/visitor perspective provides critical information about the unique patterns of mistreatment occurring within hospital contexts.
Collapse
Affiliation(s)
- Emily A Vargas
- Department of Psychology, University of Michigan, Ann Arbor, MI, USA.,Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | | | - Riley A Marshall
- Department of Psychology, University of Michigan, Ann Arbor, MI, USA
| |
Collapse
|
20
|
Psychometric Development of an Instrument Measuring Social Bullying in Nursing Academia: Item Development and Content Validation. Nurse Educ 2021; 46:E45-E49. [PMID: 32833879 DOI: 10.1097/nne.0000000000000907] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Social bullying in academic nursing schools is an understudied area, yet extant research shows it is prevalent. PURPOSE The purpose of this study was to generate a formal definition for academic social bullying and content validate an instrument measuring it in academic nursing. METHODS Classic psychometric theory and survey design were used to develop an instrument measuring academic social bullying. Extensive literature review and analysis of existing instruments were conducted; 108 items indicating bullying behaviors and organizational characteristics were created. This study targeted establishing initial content validity. Forty nurse experts who had experienced or published on academic bullying were invited; 24 responded. Experts rated agreement with relevance/appropriateness of items using a Likert scale and provided comments. RESULTS Forty items with content validity indexes near 0.80 and supportive comments were retained. A formal definition was developed from experts' feedback. CONCLUSIONS Insights regarding differences between bullying and incivility were obtained.
Collapse
|
21
|
Abstract
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.].
Collapse
|
22
|
Keller S, Yule S, Zagarese V, Henrickson Parker S. Predictors and triggers of incivility within healthcare teams: a systematic review of the literature. BMJ Open 2020; 10:e035471. [PMID: 32513884 PMCID: PMC7282335 DOI: 10.1136/bmjopen-2019-035471] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVES To explore predictors and triggers of incivility in medical teams, defined as behaviours that violate norms of respect but whose intent to harm is ambiguous. DESIGN Systematic literature review of quantitative and qualitative empirical studies. DATA SOURCES Database searches according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline in Medline, CINHAL, PsychInfo, Web of Science and Embase up to January 2020. ELIGIBILITY CRITERIA Original empirical quantitative and qualitative studies focusing on predictors and triggers of incivilities in hospital healthcare teams, excluding psychiatric care. DATA EXTRACTION AND SYNTHESIS Of the 1397 publications screened, 53 were included (44 quantitative and 9 qualitative studies); publication date ranged from 2002 to January 2020. RESULTS Based on the Medical Education Research Study Quality Instrument (MERSQI) scores, the quality of the quantitative studies were relatively low overall (mean MERSQI score of 9.93), but quality of studies increased with publication year (r=0.52; p<0.001). Initiators of incivility were consistently described as having a difficult personality, yet few studies investigated their other characteristics and motivations. Results were mostly inconsistent regarding individual characteristics of targets of incivilities (eg, age, gender, ethnicity), but less experienced healthcare professionals were more exposed to incivility. In most studies, participants reported experiencing incivilities mainly within their own professional discipline (eg, nurse to nurse) rather than across disciplines (eg, physician to nurse). Evidence of specific medical specialties particularly affected by incivility was poor, with surgery as one of the most cited uncivil specialties. Finally, situational and cultural predictors of higher incivility levels included high workload, communication or coordination issues, patient safety concerns, lack of support and poor leadership. CONCLUSIONS Although a wide range of predictors and triggers of incivilities are reported in the literature, identifying characteristics of initiators and the targets of incivilities yielded inconsistent results. The use of diverse and high-quality methods is needed to explore the dynamic nature of situational and cultural triggers of incivility.
Collapse
Affiliation(s)
- Sandra Keller
- Center for Surgery and Public Health (CSPH), Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Steven Yule
- Center for Surgery and Public Health (CSPH), Brigham and Women's Hospital, Boston, Massachusetts, USA
- STRATUS Center for Medical Simulation, Boston, Massachusetts, USA
- Department of surgery, Harvard Medical School, Boston, Massachusetts, USA
- Department of Clinical Surgery, University of Edinburgh, Edinburgh, United Kingdom
| | - Vivian Zagarese
- Department of Psychology, Virginia Tech, Blacksburg, Virginia, USA
| | - Sarah Henrickson Parker
- Department of Psychology, Virginia Tech, Blacksburg, Virginia, USA
- Fralin Biomedical Research Institute (FBRI) at Virginia Tech Carilion, Roanoke, Virginia, USA
- Center for Simulation, Research and Patient Safety, Carilion Clinic, Roanoke, Virginia, USA
| |
Collapse
|
23
|
Woo CH, Kim C. Impact of workplace incivility on compassion competence of Korean nurses: Moderating effect of psychological capital. J Nurs Manag 2020; 28:682-689. [PMID: 32072694 DOI: 10.1111/jonm.12982] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Revised: 01/12/2020] [Accepted: 02/14/2020] [Indexed: 12/30/2022]
Abstract
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.
Collapse
Affiliation(s)
- Chung Hee Woo
- College of Nursing, Konyang University, Daejeon, South Korea
| | - Chanhee Kim
- College of Nursing, Dong-A University, Busan, South Korea
| |
Collapse
|