Civility in Nursing

Emergent, RN · Feb 9, 2021

How about:

"Do you know how to say please and thank you?"

JKL33 · Feb 10, 2021

Honestly I'm so tired of this topic. Everyone has been on the receiving end of interactions that could have been more civil. Likewise, nearly everyone has had times where they have not spoken or behaved at their best due to various reasons, especially the significant stress of our workplaces. Adults ought to be able to work through things and learn to show some grace to others (on both the sending and receiving ends) without conflating stressed interactions with bullying.

Ask a couple of questions from a more positive perspective, such as "Is there anything you do here at work that helps build a positive work atmosphere?" or "Do you have any tips for communicating positively when working under stress?" Etc.

Good luck. I hope your paper is about more than how terrible incivility and bullying are and how nurses eat their young, etc.

??

allnurses Guide · Feb 13, 2021

On 2/9/2021 at 6:59 PM, JKL33 said:

Honestly I'm so tired of this topic. Everyone has been on the receiving end of interactions that could have been more civil. Likewise, nearly everyone has had times where they have not spoken or behaved at their best due to various reasons, especially the significant stress of our workplaces. Adults ought to be able to work through things and learn to show some grace to others (on both the sending and receiving ends) without conflating stressed interactions with bullying.

Ask a couple of questions from a more positive perspective, such as "Is there anything you do here at work that helps build a positive work atmosphere?" or "Do you have any tips for communicating positively when working under stress?" Etc.

Good luck. I hope your paper is about more than how terrible incivility and bullying are and how nurses eat their young, etc.

??

I really like your answer and suggestion on how to put a psoitive spin on the question. With the job stress especially this past year I think we all have to help care for eachother. Right now I am taking a month off work just to reset my brain and go back strong. I took a little ribbing about it but just stated that I needed the time off and I had a lot of PTO saved up. I cannot begin to tell how the last 12 days has effected me positivey, I am working on projects and cleaning my house and sleeping without an alarm so that I am waking naturally between 9 am and 10 am.

When I am working and not totally swamped myself I will often check in on co-workers to see if they need help, a break, etc... That's how I try to make our building a little bit brighter.

Hppy

TheMoonisMyLantern, ADN, LPN, RN · Feb 13, 2021

14 hours ago, hppygr8ful said:

I really like your answer and suggestion on how to put a psoitive spin on the question. With the job stress especially this past year I think we all have to help care for eachother. Right now I am taking a month off work just to reset my brain and go back strong. I took a little ribbing about it but just stated that I needed the time off and I had a lot of PTO saved up. I cannot begin to tell how the last 12 days has effected me positivey, I am working on projects and cleaning my house and sleeping without an alarm so that I am waking naturally between 9 am and 10 am.

When I am working and not totally swamped myself I will often check in on co-workers to see if they need help, a break, etc... That's how I try to make our building a little bit brighter.

Hppy

I really agree with this. We need to look out for another because we all know the big dogs aren't going to. What I've been trying is to encourage comradery and accountability between the different shifts at work days, evenings, and nights. I've noticed the staff just seem to really dislike to do anything extra for the next shift that might make their day a little easier. So, I've been pushing people on all shifts to look out for the people that follow them and that if we all do that then we'll all have a little easier time when we come into work.

Nursing is a team sport and sadly some units develop a culture where everyone is out for themselves and everyone's waiting for someone to take the first step to work together. Crazy.

Oh and I'm glad you've had a relaxing time off, I'm sure your co-workers will be happy for your return to the grind!

Marie Bailey, MSN · Mar 31, 2021

On 2/9/2021 at 8:59 PM, JKL33 said:

Honestly I'm so tired of this topic. Everyone has been on the receiving end of interactions that could have been more civil. Likewise, nearly everyone has had times where they have not spoken or behaved at their best due to various reasons, especially the significant stress of our workplaces. Adults ought to be able to work through things and learn to show some grace to others (on both the sending and receiving ends) without conflating stressed interactions with bullying.

Ask a couple of questions from a more positive perspective, such as "Is there anything you do here at work that helps build a positive work atmosphere?" or "Do you have any tips for communicating positively when working under stress?" Etc.

Good luck. I hope your paper is about more than how terrible incivility and bullying are and how nurses eat their young, etc.

??

I have a theory. People who get offended by the word “bully” are legit bullies. What do you think? This affects safety & quality of care. Terrorizing your co-workers just b/c you can affects everyone, including patients. I wish these people would be held accountable, so I can come to work & focus on my actual work, instead of dealing with this behavior. Also, this topic matters & needs to be in the limelight. https://eclecticideations.blogspot.com/2021/03/nurse-managers-who-is-really-running.html?m=1

JKL33 · Mar 31, 2021

31 minutes ago, Marie Bailey said:

I have a theory. People who get offended by the word “bully” are legit bullies. What do you think?

I think it depends on how the word is used. There absolutely are bullies.

There are also stressed reactions from people whose normal MO is not to terrorize or bully anyone.

Here's my theory: There are a lot of people who are working with an elevated baseline stress level related to a lot of pressure and a lack of autonomy and control over the situation--yet being expected to retain responsibility for ethics and provision of quality care. An example would be chronic, purposeful short-staffing seen in healthcare. Staff nurses have very little control over this as we control neither the budget nor the decision-making process, yet short-staffing is an integral part of the business plan of very large corporations while we are expected to be kind and ethical angels no matter what they do.

The large corporations know all of this. It is all out of their playbook.

They have co-opted this bullying issue and been very happy to run with it because it is another way to make people other than themselves look like the problem. It's a great way to keep the hens pecking at each other.

Yes, there are bullies, and yes their bullying behavior should not be tolerated. Yes, it is a patient safety issue and a workplace culture issue and all of that. But there is way too much blurring of the lines between chronic/classic bullying and the behavior that is seen when a group of people are purposely stressed to the max. Someone who occasionally doesn't speak with the kindest-possible tone of voice due to the working conditions does not make a bully.

The reason I am tired of this issue is because I think nurses are being taken for a bit of a ride here. There is an aspect of this that just begins to look like gaslighting at some point. As in....oh, everything's fine here except that all of you lowly staff nurses need to stop bullying each other. I think not.

I strive to have a kind and professional demeanor at work, and my choice is to assume that the grand majority of my coworkers are usually doing the same, but are occasionally stressed enough that they may not speak with the kindest, most calm tone. I can handle that.

There are usually one or two actual bullies who cause the majority of the problem and my belief is that they should be dealt with swiftly by management instead of a program where staff-level employees (as a group) are made to look like "the" problem.

Isn't it somewhat curious that all these anti-bullying initiatives never seem to apply to anyone who isn't in a bedside care role? They are mainly directed towards doctors and staff-level nurses, which just so happen to be the two groups of people that billion dollar corporations want to control.

Wuzzie · Mar 31, 2021

9 hours ago, Marie Bailey said:

I have a theory. People who get offended by the word “bully” are legit bullies. What do you think?

I was severely bullied at 2 of my jobs. I am offended when people use the term "bullying" for run of the mill incivility because it dilutes the meaning of the word. The fact that I'm offended by it absolutely does not make me a bully.

mariebailey, MSN, RN · Apr 1, 2021

On 3/30/2021 at 9:02 PM, JKL33 said:

I think it depends on how the word is used. There absolutely are bullies.

There are also stressed reactions from people whose normal MO is not to terrorize or bully anyone.

Here's my theory: There are a lot of people who are working with an elevated baseline stress level related to a lot of pressure and a lack of autonomy and control over the situation--yet being expected to retain responsibility for ethics and provision of quality care. An example would be chronic, purposeful short-staffing seen in healthcare. Staff nurses have very little control over this as we control neither the budget nor the decision-making process, yet short-staffing is an integral part of the business plan of very large corporations while we are expected to be kind and ethical angels no matter what they do.

The large corporations know all of this. It is all out of their playbook.

They have co-opted this bullying issue and been very happy to run with it because it is another way to make people other than themselves look like the problem. It's a great way to keep the hens pecking at each other.

Yes, there are bullies, and yes their bullying behavior should not be tolerated. Yes, it is a patient safety issue and a workplace culture issue and all of that. But there is way too much blurring of the lines between chronic/classic bullying and the behavior that is seen when a group of people are purposely stressed to the max. Someone who occasionally doesn't speak with the kindest-possible tone of voice due to the working conditions does not make a bully.

The reason I am tired of this issue is because I think nurses are being taken for a bit of a ride here. There is an aspect of this that just begins to look like gaslighting at some point. As in....oh, everything's fine here except that all of you lowly staff nurses need to stop bullying each other. I think not.

I strive to have a kind and professional demeanor at work, and my choice is to assume that the grand majority of my coworkers are usually doing the same, but are occasionally stressed enough that they may not speak with the kindest, most calm tone. I can handle that.

There are usually one or two actual bullies who cause the majority of the problem and my belief is that they should be dealt with swiftly by management instead of a program where staff-level employees (as a group) are made to look like "the" problem.

Isn't it somewhat curious that all these anti-bullying initiatives never seem to apply to anyone who isn't in a bedside care role? They are mainly directed towards doctors and staff-level nurses, which just so happen to be the two groups of people that billion dollar corporations want to control.

Your last paragraph is my favorite. I used to be so baffled as to why people who seemed to have no moral compass, swept everything under the rug, & targeted decent employees made it into management at all. Then I learned this. 1% of the general population meets the diagnostic criteria for antisocial personality disorder (laymen's terms, "sociopath"). However, 4% of CEOs meet the diagnostic criteria for sociopath. It's like you see more sociopathic traits the further you go up the food chain. However, I have seen some really decent human beings with strong leadership qualities be completely duped by their manipulative employees lately. I guess if your CEO is a sociopath whose bottom line is always the almighty $, incivility, bullying, disruptive behavior, or whatever label you want to apply to this unwanted behavior among staff nurses & leadership, it's not going to matter to them unless they can see the price tag on tolerating it. There is literally a price tag on it though: staff turnover, poor quality of care, etc., actually cost hospitals an insane amount of $. I liked your response.

mariebailey, MSN, RN · Apr 1, 2021

OP: I have been to hell & back going through all of this. I blogged about it; it's therapeutic. The resources at the bottom of the article offer more information on the spectrum of disruptive behavior & actually delineate words like incivility vs. bullying. The ANA position paper is particularly useful.

https://eclecticideations.blogspot.com/2021/03/nurse-managers-who-is-really-running.html

EDIT: These two are really the pioneers who brought the issue to the surface: http://jsbmcnj.weebly.com/uploads/1/0/8/6/10866812/the_downward_spiral.pdf

ANA Position Statement: https://www.nursingworld.org/practice-policy/nursing-excellence/official-position-statements/id/incivility-bullying-and-workplace-violence/

londonflo · Apr 1, 2021

On 2/9/2021 at 9:08 AM, greysfan_LPN said:

I wanted to come up with questions to poll a few co-workers and other nurses I know for my paper.

Sometimes writing the questionnaire is the easy past until you go to tabulate the responses. Open ended responses are a true headache when you go to summarize data.

Have you investigated the literature to find a tool that has already been piloted and found to be reliable? It is hard in undergraduate to develop a good survey tool with out a review of the literature, pilot studies etc. I am wondering what your 'research course' taught you about this.

If you can't find a tool, try writing to the authors on this subject and ask them how to collect responses.

On 2/9/2021 at 9:08 AM, greysfan_LPN said:

questions to poll a few co-workers and other nurses I know for my paper.

If you truly want this paper to mean something you are just developing a "garbage in and garbage out" survey that means nothing.

There are many areas that great tools have been developed for. Fall Risk. Infection risk. Immobility, med errors. These are not trendy but if you go on to graduate school this could be the foundation of your career, plus it will mean something to your patient care/

Marie Bailey, MSN · Apr 1, 2021

OP: This article has some good metrics/poll questions.
Journal Of Nursing Management & Leadership