Respond to your colleagues by explaining how the  leadership skills they described may impact your organization or your  personal leadership, or by identifying challenges you see in applying  the skills described.

At least 2 references in each peer responses!

Incivility and bullying have long been a problem within nursing and the healthcare profession.  Edmonson defines incivility as “the destructive and harming behaviors of disrespect and degradation” (Edmonson, 2017 p. 40).  In nursing it is known as “getting a thick skin” and “eating their young” (Edmonson 2017).  Incivility is harmful to the individual, patients, the organization, and has long-term negative effects.  It not only harms the individual but it can affect patient care and decrease morale in the work place.  Incivility can contribute to medical errors, preventable adverse outcomes, poor patient satisfaction, and increase cost of care.  It can create unhealthy and hostile work environments and can undermine the nurse’s idealism and professionalism.  Yet, disruptive behaviors such as incivility and bullying are tolerated in many settings and can cause clinicians, managers and staff to seek positions elsewhere.   Some key behaviors of incivility include rude comments, offensive or condescending language, public criticism, screaming, and disregard for interdisciplinary input on patient care (Lachman 2017).  Disruptive behaviors can have long lasting negative effects and affect the health and well-being of individuals due to psychological and physical stressors.  They can develop stress related disorders resulting in feelings of failure, tension and depression (Kim 2018).

Healthful environments are grounded in a culture that values diversity supports communication, trust and collaboration.  To create a culture of civility that promotes a safe environment it is the responsibility of nurse leaders to support staff.  One strategy to creating a culture that does not tolerate incivility would be to socialize new and current employees.  Rather than let the day-to-day interactions of employees establish expectations, the nurse leader should clearly define behaviors that are acceptable and unacceptable to everyone.  Establish expectations of how staff should treat each other and post those guidelines (Smith 2018).  A second strategy to creating a healthful environment is to have a team approach to establishing team norms of civility.  Team members determine how norms are put into use and how to abide by them.  This approach will establish accountability among all team members of the organization (Clark 2016).  Having an honest and open approach to communication where people should not be afraid of telling their stories will help to empower people so speak out.  Creating a culture of structural empowerment allows people to regain their power, speak out against disruptive behaviors, and lower the levels of incivility (Lachman 2015).  An empowered culture will help maintain strategies that are in place, reduce tolerance of incivility and hold people more accountable.

When I was a nursing student I witnessed behaviors where the preceptor was deliberately being hard on the student, fortunately I had a preceptor who was nice and enjoyed teaching me.  As I entered the work force my first job was in the ED.  The manager of the ED was a nurse and she had an open policy where if anybody had issues they can come to her and discuss their grievances.  I noticed that the morale of the department was always good and everyone got along well.  The manager used a communication strategy called CUS (concerned, uncomfortable, safety) where people can come to her to address concern, state uncomfortable situations, and focus on safety.  When people have disagreements, the manger would talk to both of them in the office at the same time and let each person talk about their grievances.  It seemed to work pretty well as issues were promptly resolved and everybody seemed happy with the results.

References:

Clark, C. M. (2016).  Principled leadership and the imperative for workplace civility.  American Nurse Today, 11(11), 32-33.

Edmonson, C., Bolick, B., & Lee, J. (2017).  A moral imperative for nurse leaders: Addressing incivility and bullying in health care.  Nurse Leader, 15(1), 40-44.

Kim, J. (2018).  Relationship between incivility experiences and nursing professional values among nursing students: Moderating effects of coping strategies.  Nurse Education today, 65, 187-191.

Lachman, V. D. (2015).  Ethical issues in the disruptive behaviors of incivility, bullying, and horizontal/lateral violence. Urologic Nursing, 35(1), 39-42

Smith, J. G. (2018).  Establishing norms of respect: Strategies for nurses and managers.  American Nurse Today, 13(6), 44-45.

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