How to Handle Student Incivility

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

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.

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.
  4. 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.
  5. 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.

Specializes in Gerontological, cardiac, med-surg, peds.
DolceVita said:
Vicky,

I agree that the texting etc. is rude but if a student is so completely distracted in a controlled environment like a classroom how does that bode for them practicing as a nurse?

Before everyone goes bonkers -- this is an honest question that I have never asked a professional educator. I am not getting at people with ADHD.

Thank you for your question, DolceVita. I suppose this is something for the subject of another blog. You may want to refer to my blog on "Students with Disabilities." In the case of a student with a bona fide disability who requires accommodations (such as this student), I do not question but abide by the law. I do my best to assist the student in whatever way I can and with a genuine, helpful attitude. One of this student's specified accommodations was a "quiet, distraction-free classroom." I believe nursing is a large-enough profession with numerous subspecialties, that students with severe ADHD can find their niche somewhere under our tent. He may not be a good candidate for a chaotic ICU or med-surg floor, but I could see him working in telephone triage or home health, and doing an excellent job in that environment.

Hi Vicky,

I am new to allnurses but I am glad I found the site. I am a Registered Nurse with 18 years of experience. I will admit, in Nursing school, when I went, they were tough. I actually got a clinical failure because I allowed the DIRTY linen to touch the floor. I was pulled asside by my clinical instructor, who was a former nun (regardless) and had to explain to her what I did wrong. We were on our toes at all times (we, the students). We were literally fearful of the instructors. I hate to say this to you, but we actually hated them.

Now, I have a story to tell and I have nothing but respect for you nursing educators/instructors.

I was laid off from a hospital job here in NY five years ago. Desperate for work, a friend of mine told me about a home care agency where I could get work right away. It was around the holidays and I did just that.

The past 3 years I have been taking care of a 24 (now) year old young man with Duchennes MD. I NEVER treated him like a "patient". He went to college during the fall, worked on the computer, could read, write, and was smarter than most kids his age.

About a year after I had started working with him, his mother entered LPN school. Her first half of the schooling was completed in June 2010. Then she was to restart her last half in September 2010. I believe after Labor Day. Well, around September THIRD, 2010 she started saying "I'm going to have to call in sick to work because I have to finish my homework", or I'm going to need quiet 'cause I gotta do my homework". I finally said "what homework?" Well, she then showed me a list of 50 medications in which she had to write about each one of them...you know, the category, indication, adverse reactions, dosages, side effects, etc. etc. Well, stupid me offered to help her. And so did 3 other nurses who were supposed to be there taking care of her son. I felt bad, having been there but little did I know I was enabling her until I found out she was given this "homework" assignment THREE MONTHS EARLIER. Now, I am not, by any means, a racist, however, this woman's first language, I will tell you, is not English, however she speaks English very well, except for her grammar.

Now, after completing about 13 of those 50 medications for her, writing about 3 pages on each one and having spoken to another nurse who took care of her son, and she completed nine of the medications, I guess I was a little po'd to discover she received a grade of A and did not even have the decency to thank me or at least the other nurse I knew who did the work for her.

Throughout the semester, she would come home from school complaining that this instructor had it out for her, and her friends. I would defend her and say, well, if I were you, I would distance myself from your "friends" because you are getting As and maybe you feel she is judging you on the company you keep". Then, I just happen to ask (I'll call her Mary) Mary a question. She was always saying that the instructor had her little "pets", etc. etc. I finally asked "Mary" are the instructors pets White? and she said "yes". Then, I would say the last 4 months I was on the case was nothing but a living hell. This woman would continuously tell me not to treat her son like a patient WHICH I NEVER DID. One day, he was complaining of some pain in his rt. lower quadrant and what does she do.....pull out her stethescope and started listening to his bowels. Having been in critical care for years, no I don't assume, however, "if your son had three bowel movements today already, chances are, he has bowel sounds!!! She started getting this know-it-all attitude with me and would start fights with me saying "this is my son, and I am a Nurse now (oh really, what I FORGOT she hadn't learned yet). I noticed she favored her son's nurses who were MINORITIES. I don't care if this is politically correct or not, IT'S THE TRUTH. I'm tired of tip toeing around the issue.

I wound up leaving the case because there was fraud going on. The mother of this young man would pull out blank notes from his chart and give them to one of the nurses(who was supposed to relieve me, yet WAS NEVER THERE WHEN I LEFT). She would falsely document three shifts worth of work, submit a time sheet and get paid. I knew what was going on. How could a nurse come in at 10:30PM on a Tuesday and work until 10:30PM on a Wed. Work three 8 hr. shifts in a row, going to school full time, a one year old at home AND hold another job? Then, I discovered from the tenant that this nurse never showed up. Well, I guess when the mother knew I wasn't stupid, she started treating me like garbage, basically forcing me out of the job. I have no regrets leaving, only to the young man I was taking care of.

What's been bothering me Vicky is the fact that this woman cheated her way through LPN school, admitted to taking amphetamines (illegally) to stay awake and then gets a grant from the state to pay her way through RN school.

This has been a long, drawn out story, but the behavior you described of your students seems to be going on every where. It seems as though they have a sense of entitlement. When the mother of the boy I was taking care of used to come home and complain about the instructors, I used to think, "she'll never survive as a nurse" and I hope for the sake of the community and the Nursing Profession, she doesn't survive. Attitudes like hers, texting, being disruptive, skipping class, should be grounds for immediate failure or dismissal.

I give you credit and believe me never thought I would give credit to a nursing instructor (because when I went to school NOTHING was tolerated!!) I give you credit and I think we should bring the "whip" back to the classroom. We need to weed out the ones who really don't care to be there and raise the standards of intolerance. Then, maybe I would have a job!!

To Vickyrn

I had just posted a reply to your story and have to apologize for my spelling and grammar. I'm usually a stickler about that. Also, would you advise me to report this woman to the school she attended. I believe she already passed her LPN boards, or just let it go? I guess I firmly believe that if they are allowing people like herself to enter Nursing school, it's becoming a sad state of affairs and I will be looking for a new career.

MaxMomma: I read your replied to VickyRN re: student incivility. I'm new to all nurses, so I don't know if people go back and read responses from a blog that was posted a month ago. Anyway, I would like you to read it if you get a chance and possibly give me some advice. I could not agree with you more in your last reply. I was actually watching the O'Reilly Factor the other night and the topic between Bill O'Reilly and Laura Ingraham was about this generation today and how we live in such a narcissistic society. It seems like they all have a sense of entitlement, that we owe them something. I am presently not working and CANNOT find a hospital job. 17+ years of experience. I go on interviews and I feel good when I leave and THEN, no phone call, no email...nothing. I had to quit my last job because I felt I was being forced out of there and I truly believe it was discrimination on the part of the mother. Since she started LPN school, she started copping an attitude with me. She happens to be a minority and would speak in her native tongue if she was ******** about something. She constantly complained that there was an instructor who had her pets. I asked her one day if her "pets" were white, she hesitated and said yes. I am Caucasion and there were only TWO other Caucasion nurses on this case. One of the nurses never showed up, yet the mother of the boy I was taking care of would pull out progress notes out of his chart and give them to her to document on (as if she was there), then signed her time sheet AND SHE GOT PAID. When the mother suspected I knew what was going on, she would make my life miserable. I even called the medicaid fraud line and reported this nurse. I should really call the state boards and have them investigate and take her license away. This nurse who is also a "minority" and the mother are now in RN programs. When the mother finished her LPN school, she would say "I'm a nurse now and swing the stethescope around her head. In my reply I spoke of how she got her son's nurses to do her homework, she was taking illegal amphetamines to get through school and I used to think to myself....."if she ever completes RN school, she will fall flat on her face. BUT, she'll never go anywhere because she works for the state in a psychiatric center her in NY and she's got it made. For the sake of patients, I really hope she gets kicked out. That may sound cruel, but the ******** she used to talk about that happened in her class (and she would laugh about it) would NEVER BE TOLERATED 20 years ago when I was in school. The first day of class when I started Nursing school, they made an announcement and said "look around". There are 120 students here today and by the end of the year, half of you will be gone. AND THEY WERE RIGHT! We need to go back to the old way of schooling. There's a reason those instructors are tough and it's because NURSING IS TOUGH! These schools admit just about anyone today and it shows when you start precepting new grads, they're lazy and "oh, we have to hand out bedpans....I thought the aids did that." I actually worked with a girl who was going on to become a NP and the patient she had that night in the SICU, needed a soap suds enema. She said, I've never done that before. So I explained it to her and she goes "well, yeah, I know how to set it up, but what do you do after the fluid is in?" So this other nurse and I said, just put him on the bedpan. Then(get ready for this) she says "but how do I do that?" So the other nurse and I repeated ourselves and she says, "I've never done that before" and I said "put a patient on a bedpan?"! and she says "no". I said, "how the hell did you go through 4 years of nursing school without ever putting a patient on a bedpan? I was floored. Then she says, 'well, this isn't what I really want to do anyway. I'm going to school to become a neonatal NP. Oh, so I guess that excuses her from the "dirty" work. This is long enough. I could go on and on and on. It's really a sad state of affairs with this upcoming generation. I don't have children and I'm thinking, maybe that was God's plan, because I'm all about tough love and hard work and my kids would probably be beaten up because all of the other parents molly coddle their kids. P.S. I'm looking for a career change because I've seen and done enough!

I am a older student and must say I was agast at the way students behaved in my LPN class. Rude, load and vulgar. The one teacher encouraged them and they all became drinking buddies after class. (one student had a DUI accident, killing someone the night before their NCLEX) I think if we as nurse want to be seen, treated and payed as professionals we need to act it. The class room should be a place to learn how to behave as an adult and as a professional. I am in a RN program that is online so I don't have much interaction with other students now!

Hello everyone i am a pre nursing student i am very inspired by all the professional people

on ALLNURSES i am happy to be a part of this forum and am looking forward to nursing school and fullfilling my life long dream of a nursing career Thank you for allowing me to respond here.

OMG....Student Incivility is why I quit teaching nursing school 2 yrs ago after 6 years of FT teaching!!! Their sense of entitlement and the rudeness was the most unfortunate part of teaching!!! I only went to school 15 years ago.....boy, have times changed!!!

I also see a certain sense of entitlement and incivility in people who are younger than I. I have frequently wondered if it's not just me, the old guy. I don't think so.

I believe that we have stopped having expectations of others, particularly younger people and there is absolutely nothing wrong with having adult expectations of ourselves and those around us.

A certain 23 year old I know is completely incapable of functioning in the adult world she now lives in and consequently chooses to remain (mentally) in the world she grew up in where she was never expected to do anything she didn't WANT to do.

This is terribly sad to see.

As a student I find it very frustrating when others are talking, texting, and surfing the internet in class. I find myself hoping the professor will say something to put an end to these activities during class. I know other students feel the same way but we don't want to say anything to the other students. Mostly for fear of offending someone who has connections or they may end up part of a group activity.

Specializes in Ortho/Peds/MedSURG/LTC.

The street smart trashy gals who lie to get free funding for their college, who told me put your car in your momma's name, rent a trailer, don't own anything - who could somehow afford all those cigarettes. The group of the smart kids that sit on the 4th row - yep all 7 of them had old tests - BIG advantage as in answers. This age - "don't snitch"...but the rest of us knew and we won't forget how you cheated to get through school. Don't be so blind teachers. Have heart for those who come to class and don't get the hand me down everythings. Have heart for the older nursing student that have teens at home doing their best who spend 24,000 of their hard saved money to get into a field dominated by young, rude, classless, lazy gals (its not our job) who are "robots" when it comes to patient care.

It is possible that the new grad never even had the opportunity to place a patient on a bed pan while in school. Some of the nursing schools in my state have a difficult time placing students into clinical slots, even with the bare minimum hours required. My school was brutal on nursing theory, not nursing skills.

And honestly, as a student, I thought(on med-surg) the aids/techs/whatever were responsible for that kind of work when possible and RNs were supposed to perform that function if it couldn't be delegated.

Nursing school pushed for critical thinking; not technical skills. Technical skills were expected to be picked up on along the way.

Haern said:
These schools admit just about anyone today and it shows when you start precepting new grads, they're lazy and "oh, we have to hand out bedpans....I thought the aids did that." I actually worked with a girl who was going on to become a NP and the patient she had that night in the SICU, needed a soap suds enema. She said, I've never done that before. So I explained it to her and she goes "well, yeah, I know how to set it up, but what do you do after the fluid is in?" So this other nurse and I said, just put him on the bedpan. Then(get ready for this) she says "but how do I do that?" So the other nurse and I repeated ourselves and she says, "I've never done that before" and I said "put a patient on a bedpan?"! and she says "no". I said, "how the hell did you go through 4 years of nursing school without ever putting a patient on a bedpan? I was floored. Then she says, 'well, this isn't what I really want to do anyway. I'm going to school to become a neonatal NP. Oh, so I guess that excuses her from the "dirty" work.
Specializes in CNA/LPN.

It's been insane in my A&P class, and class is just getting started. I was sitting in the middle of the room, but opted to move myself up to the front. Too many students texting under the desks, talking, snickering, fiddling with their bags, etc. - the front of the classroom is the best place to be! You can't very well get too distracted up there by the others who care less about the course than you. I've recently had enough of my own person distractions (a toothache from a horrible molar!) and I'm too busy eliminating my personal ones, to try to eliminate others around me. My tooth is getting extracted this afternoon! Usually, I'm a procrastinator on these kind of (scary) things, but it's affecting my ability to focus 100% in lecture, so I'm getting it taken care of!

All in all, the very front of the class is the place to be.