Nurse Incivilities: Does it Start in Academia?

Having experienced incivilities both in practice and academia as a faculty member, I wonder from where these incivilities stem. Is there an environment that initiates the behaviors that extend into another environment where the behaviors fester, eventually becoming part of the cultural norm? This article provides a different approach and thoughts at the end to hopefully provoke readers to reflect on incivilities in practice and potentially the possibility that it begins in academia.

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Nurse Incivilities: Does it Start in Academia?

I have experienced incivilities in both practice and academia as faculty. I have witnessed my colleagues experience incivilities that resulted in them leaving shortly after starting a position. Nurses have judged my ability to manage a unit due to assumptions about my experience, age, and more. Roughly halfway into my career, I transitioned to a faculty position, working first in a practical nursing program, next in a pre-licensure program, and finally as a director of nursing. I have come to ponder whether the incivilities that occur in practice start in our nursing programs and continue to fester in practice.

Whatever Do You Mean, Incivilities Start in Academia?

Researchers identified incivilities as behavior not conducive to a mutually respectful classroom environment (Small et al., 2019). This study discussed both faculty and students contribute to the incivilities experienced during the nursing programs. Students felt that their contribution to incivilities related to accountability regarding engagement and faculty was because of teaching styles, ineffective teaching methods, and inequitable treatment of students (Small et al., 2019). The incivilities that students experience negatively impact their learning and create barriers to their success during their educational journey. Individuals at the most risk of experiencing incivilities are new graduate nurses and nursing students (Palumbo, 2018). This study asked why interventions are not mandatory, with the documentation proving that incivilities begin in nursing education (Palumbo, 2018). Palumbo (2018) identified the scarcity of research dedicated to incivilities experienced in nursing school even after the scarcely available research identifies that nursing students are experiencing incivilities. Modeling of civil behavior by faculty creates an example for students to follow. The punitive ways of nursing programs continue to exist based on the current faculty’s experience as nursing students. I have heard faculty state the words of this are what I experienced, and this is how it should be done. I go into a reflective period when I hear this statement and ask why. Why would we want our students and future practicing nurses to experience the same stress and, for some nurses, horrific experiences in nursing school? Why would we not want to improve our students’ experience by creating a rich, engaging learning environment?

Even Though You Did Not Ask, Here Are My Thoughts

In education, I hear faculty say that I have to keep everything the same so it is equal for all students. However, academic institutions are working to create a diverse, equitable, and inclusive culture. The equality piece is elevated to being equitable for all. Some students will require services to support their journey providing the opportunity for that student to be successful. There will also be students who do not require support services and will have the opportunity to succeed in their program. As a nurse, we create care plans that are individualized to our patients, creating that unique ability for the patient to achieve optimal patient outcomes.

Students should have individualized plans like the patients we have or are caring for in practice. Each student will bring a unique quality and experience to our nursing practice, which we desperately need nurses. There will also be times when a student should not continue in the program for various reasons. The reason could be time, current life situation, and more. That difficult conversation must take place, ensuring the conversation is individualized to the student. The goal is also to create an honest and supportive environment for the student’s abilities. As faculty, we are responsible for creating a physically and psychologically safe space for our students to gain foundational knowledge and develop their critical thinking to provide safe, proficient care in the future. As we age, we will rely on their care.

Now I ask all who are reading this to reflect on the possibility of having a rich, engaging learning environment that is equitable for our students and faculty.

What kind of practices would this instill in our nursing students to bring into practice? Could it be one that is caring, forgiving, supportive, and loving?

References/Resources

Palumbo, R. (2018). Incivility in nursing education: An intervention. Nurse Education Today, 66, 143-148.

Small, S. P., English, D., Moran, G., Grainger, P., & Cashin, G. (2019). “Mutual respect would be a good starting point:’ students’ perspectives on incivility in nursing education. Canadian Journal of Nursing Research, 51(3), 133-144.

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jknaack

About jknaack

Hi everyone! My name is Jenny and I am an individual looking to change the ways of nursing in hopes of creating an engaging and supportive culture for all nurses. No longer are the ways of "nurses eat their young" as I often hear still in this day and age this phrase being spoken.

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Specializes in Med-Surg.

This is a great article. I have been a bedside med-surg nurse for 15 years and for the last year, faculty for a practical nursing program. Nursing needs a culture shift. Nursing needs to get with the times. We can't always do things because that's the way things have always been done.

 

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I don’t know if this is an incivility, but I almost went to a graduate school program a few years ago. I will leave out details to remain anonymous but one of the school leaders encouraged me to take a day off work to shadow her on something but when I got to the school, she cancelled my visit, saying too many of us were going to the site and that she didn’t want to overwhelm the workers. So her and her group went but I was left behind, having taken a day off of work and using PTO. Then she encouraged me to call sick a few days later to do the shadowing again. I didn’t call sick but requested the day off and shadowed her.  The whole experience rubbed the wrong way. I hadn’t quit my job, and she didn’t seem to care that I wanted to be courteous of my PTO requests and source of income. I don’t regret not pursing that degree and ended up going to graduate school elsewhere. I still am at my employer and am glad I have a good relationship with them. This and an other factors helped me with my decision. 

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Specializes in nursing ethics.

Incivility to put it nicely occurs through all walks of life everywhere. Why should college or nursing school be any better? And what is called incivility differs widely. Professionals or nonprof.  Nastiness can happen anywhere 

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Specializes in geriatric, home health.
On 12/19/2022 at 1:48 PM, ~Shrek~ said:

I don’t know if this is an incivility, but I almost went to a graduate school program a few years ago. I will leave out details to remain anonymous but one of the school leaders encouraged me to take a day off work to shadow her on something but when I got to the school, she cancelled my visit, saying too many of us were going to the site and that she didn’t want to overwhelm the workers. So her and her group went but I was left behind, having taken a day off of work and using PTO. Then she encouraged me to call sick a few days later to do the shadowing again. I didn’t call sick but requested the day off and shadowed her.  The whole experience rubbed the wrong way. I hadn’t quit my job, and she didn’t seem to care that I wanted to be courteous of my PTO requests and source of income. I don’t regret not pursing that degree and ended up going to graduate school elsewhere. I still am at my employer and am glad I have a good relationship with them. This and an other factors helped me with my decision. 

I am glad you didn't go to that graduate school. That leader is a very irresponsible example and poorly representing that school. Either she has major issues, or the entire school is poorly managed. Either way, I'm glad you went to a reputable and professional school. I'm sure you got a lot better quality education at the school you went to as opposed to the other one.

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Specializes in nursing ethics.

My post above needs clarity. I am just saying that we cannot expect no incivility in colleges when it is so common everywhere. But this does not justify incivility or make it okay. A higher standard is always preferred. So I oppose the relativist attitude so popular.  

 

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Specializes in Progressive Care Unit/Observation, Critical Care.

Upfront, I'll admit I'm jaded.

Incivility is never appropriate; however, life is tough. I cut my teeth in nursing in the United States Army, first becoming an LPN/EMT under their tutelage. One benefit of such an approach (besides the incentive to stay in shape) was a focus on the outcome of learning instead of the process of learning. More specifically, feelings, while important, were secondary to learning the material and passing the class. In the service, if you failed out of one of their schools it meant you were recycled to the "needs of the Army," which on any given day could be cook, truck driver, gasoline specialist, artilleryman, etc. [read: mostly likely something you didn't want to do...]

It might be worth a qualitative analysis to determine how different generations define incivility. Having completed three courses of graduate studies, I assure you I have run into every type of professor out there. Typically, if the professor engenders an attitude of incivility, I make it my business not to become "butt hurt" over it, move on, and get done what I need to.  In my most recent foray into nursing education (finished my ADN after 22 years as LPN), I was shocked at how modern nursing students in their 20-30's correlated incivility with the request of doing work. "This is so unfair" is a mantra paraded about by those who think reading five chapters of material a week is too much.

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