How to Handle Student Incivility

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    This blog discusses the difficult subject of student incivility and practical strategies that nurse educators can employ to effectively handle these situations.

    It’s a sad and indisputable fact that our society is becoming increasingly rude and narcissistic. The emphasis now is on an individual’s “rights,” but not taking personal responsibility or accepting the consequences for one’s actions and decisions. (Witness the sad behavior of some elected officials.) The vast majority of nursing students are professional, earnest, ethical, and carefully follow the policies of the nursing program. That said, there is a tiny minority of students whose behavior can be quite distressful for educators.

    Examples of incivility can be:
    • Making threats (whether explicit or implied)
    • Bullying
    • Rudeness and disrespect (e.g., use of cell phones and texting in class)
    • Sense of entitlement (e.g., demanding the instructor to do this or that)

    This is by no means an inclusive list.

    What are some practical strategies for educators to employ when confronted by these sorts of behaviors?
    • First and foremost, KNOW your learning institution’s and nursing program’s policies for student and faculty behavior (e.g., student handbook).
    • Enforce the policies by clearly and explicitly stating in your syllabus what student behaviors are expected and what behaviors will not be tolerated, along with the consequences.
    • Be consistent, professional, and impartial. Don’t fall into the trap of reacting emotionally but take the time to carefully and thoughtfully respond.
    • Address the behavior immediately. Sometimes it’s easier just to ignore unprofessional behavior, but be advised that such behavior rarely gets better on its own. In fact, the entire learning environment can rapidly disintegrate if the incivility is not dealt with.
    • Document, document, document.
    • Know and follow your chain of command.

    Since your syllabus is your learning contract between you and the learners, it is important to proactively address these types of situations. Here are some examples of clauses from my class syllabi at two different colleges:

    1. Students should be familiar with and follow the class etiquette rules. Students are expected to remain alert and respectfully attentive in class. Respect the faculty lecturer, other students, and the learning environment. No whispering or texting during lecture. No talking when someone else is speaking – one speaker at a time. Disruptive students may be asked to leave.

    2. Please turn all cell phones and beepers off prior to entering the classroom. Texting is expressly forbidden in class. Students found texting in class will be asked to leave.

    3. Personal laptops must be used to take notes during lectures. No surfing the Internet during class.
    Make sure that your use of laptop computers is strictly restricted to matters being discussed in class. While using your computers, take measures to avoid distraction for your fellow students. For example, turn off the sound. Make sure that cell phones are turned off when the class begins. A failure to do so may result in a grade of zero in class participation.

    Common courtesy is defined in the statements that follow: All cell phones or beepers must be turned off during class. Arrive on time, and stay for the entire class period. In this course, we begin with the assumption that the opinions, positions and perspectives of others are worthy of respect. At the same time, we will challenge one another to support and defend our viewpoints with clear and logical arguments. In all events, we treat persons with dignity and respect, even if we personally reject their views. If you need to leave the room at any time for toilet breaks, please close the door quietly after you.
    What have been your experiences with students displaying incivil or disruptive behavior? What has worked for you in dealing with these unpleasant situations? Students, we also welcome your perspectives. Thank you in advance.
    Last edit by Joe V on Jun 13, '11

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    About VickyRN

    VickyRN is a certified nurse educator (NLN) and certified gerontology nurse (ANCC). Her research interests include: the special health and social needs of the vulnerable older adult population; registered nurse staffing and resident outcomes in intermediate care nursing facilities; and, innovations in avoiding institutionalization of frail elderly clients by providing long-term care services and supports in the community. She is faculty in a large baccalaureate nursing program in North Carolina.

    VickyRN has '16' year(s) of experience and specializes in 'Gerontological, cardiac, med-surg, peds'. From 'Under the shadow of His wings...'; Joined Mar '01; Posts: 12,044; Likes: 6,438.

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    50 Comments so far...

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    I'm lucky I guess in that, whenever I've had a student assigned to a patient in my assignment, they've always been professional and kind to the patient. Have not yet had one of these exceptions going on right under my nose, yet.

    On a unit I used to work on though, there was a case in which, while the RN was at lunch, the student was doing their paperwork on a head 2 toe assessment (the one they have to fill in and turn in). The paper they had to fill in called for detailed information about the patient's gait. So, they student asked the patient to stand up from the chair, so they'd be able to witness exactly how stable the patients gait was. The patient was afraid of doing so because they had been told by so many staff not to get up without staff assist. The student insisted, assured the patient they'd be able to help if anything went wrong and basically talked them into trying to stand and walk without assist.

    Of course, the patient fell. But, the student had the door closed. They, fearful of being written up, put the patient back to bed and then proceeded to (with the instructor, not knowing there had been a fall) administer a pain medication because the patient was all of a sudden "sore all over from being in the chair." So, the day passes along, and the night nurse (starting at 7pm) comes in. Well, she found out about the fall from the patient, but found no documentation of a fall.

    It turned into a real circus. Turned out the patient did in fact now have a hairline fx, I think it was one of the legs. Every staff member who had been there that day was interviewed. I was on a completely different wing that where the incident occurred so I didn't have anything to share, but my interview was HARSH and long. I heard the nurse who was at lunch when the incident occurred had mult. interview sessions and cried after almost every one of them.

    Didn't see that student the rest of the semester. I figured as much would happen. Then, one day..........they were there again WITH A DIFFERENT SCHOOL! I was beside myself. More than a few nurses who knew about the incident refused to have that student on their assignment.

    This all caused the instructor to become.................well, nasty. She called the supervisor, went over the managers head about it. It was a really bad scene. Nurses were telling their patients to refuse students whenever that class was around. Finally, in the end, the student was transferred to another clinical group that did its rotations at another hospital.

    Relations with students should be common sense and easy, but they aren't all the time.
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    as a recent grad, i must say that i agree with the op's statement of the situation. your suggestions for dealing with problem students are great and were followed at my school. as a group we held one another accountable. if someone gossiped about how 'so-and-so' was breaking a rule or doing something in an unprofessional manner, the next question would be "have you said something to them about it?" we, the students, policed ourselves. there were those who had a cavalier attitude and tried to beat the system or cheat, but without the support of the group, they were weaned out. no one had to speak to the faculty because we spoke to each other. no one student would be allowed to make the group look bad. i was called out on a couple of occasions and it made me better. we only went to faculty when we saw something so serious that it had to be said, but the person (the offender) was always told. this was a difficult way to operate at first, especially for some of the younger students, but they fast saw the benefits. during the course of this, three people were exposed for regularly stealing the work of others, two people admitted to having drug issues (one quit and applied elsewhere, while the other entered rehab) and one sue-happy person was eventually dismissed from the school permanently. many times students allow these people to exist among them, but one question we always asked each other is "would you hire them on your unit?" as a result i have complete confidence and trust in all of the people i graduated with. i don't always agree with or get along with them, but i do trust them implicitly. faculty should emphasize the need for students to take responsibility for their actions and those of their classmates.
    Shorts, *LadyJane*, timetoshine, and 10 others like this.
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    Classroom incivility is rampant, and I'm not sure if my instructors didn't notice or didn't care. It mainly affects other students, especially if they have a seat at the back of the room, where the distractions in front of them are too numerous to overcome. The main culprit in my classes was technology. I began sitting at the front because the distractions from other students who were texting, playing computer games, answering personal emails (rapid click, click, click of keyboards that weren't associated with note-taking), Facebooking, or IMing each other were irritating to me.

    Sometimes, I think instructors could ban computers in the classroom all together. I rarely used mine except on test days, and my grades did not suffer by using hand-written notes. Is it a coincidence that the top students in my class did not use technology inappropriately in class?
    sonshyngirl, TigerBlood01, WIN007, and 4 others like this.
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    I had a couple of students carrying on conversations during each class and would try to ignore them, as would their fellow students. In fact, some of their fellow students requested they "shush", to no avail. Finally, after trying the pause approach (pausing while talking to see if anyone is really listening, prompting a certain level of discomfort on the listeners until the offenders get the message) and it being unsuccessful, I told them that they were disruptive in the classroom and that they were being unfair to their fellow students,as well as a huge distraction to me. I told them too that they would need to leave the classroom if they continued. On my student eval at the end of semester there was a student comment to the effect : "I paid good money for this class and the teacher was rude to me when she told me to quit talking." Oh my....
    Once, in the clinical setting, I had a student tell me that since she hadn't seen a vaginal delivery yet I should remove the assigned student from the patient she had (who was going to deliver that day, vaginally), so that she could see the delivery. She wasn't too happy with my answer.....
    Spidey's mom, nola1202, and VickyRN like this.
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    I just don't get how someone can work so hard (usually) to finally get into a nursing program and then have the nerve to do something questionable or wrong. Doesn't anyone have any common sense anymore? Jeez louise!
    MissPiggy, CristinaSN, casnee, and 5 others like this.
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    There is another NP student in the clinic where I am doing my clinicals. He can regularly be found lounging in the doctor's chair on his computer, working on his Typhon logs. The doctor is too nice to tell him to beat it, but I know this is an inconvenience for him. I am totally appalled this guy is doing this, to me it seems so rude and tacky. I mentioned this to my preceptor (I know, shouldn't be gossipping, but I was so floored) and all she did was give me this gigantic smile, which tells me she is sort of thinking the same thing.
    RhondaIndyRN and VickyRN like this.
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    I went to a small catholic college in the mid-80's. The worst pre-requisite instructor was an RN and Nun who taught A&P and put the fear of being late to her class among my permanant PTSD top ten list. The door shut and locked at exactly classs time. Her rationale: Being late now is no different than being late when you are a nurse. It is disruptive and rude to your peers and to the instructor.
    I can promise no one ever was disrespectful to Sr. D, she scared the bejeebers out of us!
    I have to admit though, I am rarely late for work even now! There were easier instructors, Lay and Nun, but it made us appreciate the freedom they gave us. (we could drink coffee or a coke in long seminars) instead of abuse their rules.

    As a student then and now, I'd rather have rules than chaos, when it comes to trying to learn. I'd love your classes!
    rawfoodnurse, Armygirl7, opossum, and 8 others like this.
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    I actually think banning computers would be the easiest way to keep the classroom under control, but it doesn't help later when your grads have no self control with staying on task and using things appropriately. The most annoying thing at my school is people constantly interrupting the beginning of lecture to ask if the powerpoint is up, where can I find it, are you sure it's there, under which class? ARGH.
    milzer2012, bsnanat2, and VickyRN like this.
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    I have noticed a lot of this in my nursing program as well, students who think everyone else but them is supposed to ensure their success in the program. They show up unprepared and then make demands on staff and other students. I just keep telling myself that it means fewer people to compete with for jobs! I can't imagine some of these people having much success in the workplace, they are just completely clueless and have no work ethic. Shame on their parents for sending them off to college so woefully unprepared!
    rawfoodnurse, milzer2012, MissPiggy, and 4 others like this.

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