Nurses often have to deal with a lot more than unfavorable patients — more than the cranky ones and the know-it-alls combined. They also often have to face workplace incivility, which occurs in many hospitals, clinics and healthcare establishments.
But what exactly is workplace incivility, how does it uniquely affect nurses and what can nurses do to combat workplace incivility? Here's what you should know.
What is meant by workplace incivility?
Workplace incivility has been defined as "low-intensity deviant behavior with ambiguous intent to harm the target, in violation of workplace norms for mutual respect" and more specifically refers to "uncivil behaviors [that] are characteristically rude and discourteous, displaying a lack of regard for others," according to 1999 research published in the Academy of Management Review.
Researchers have been studying workplace incivility for years.
"In recent years, many studies have been conducted on various types of workplace violence and its negative effects on both individuals and organizations; these studies have concerned different dimensions of aggressive behaviors ranging from physical violence and harassment to milder forms such as psychological aggression, all of which can be seen as counterproductive work behavior," write researchers Eva Torkelson, Kristoffer Holm, Martin Bäckström and Elinor Schad in their study "Factors contributing to the perpetration of workplace incivility: the importance of organizational aspects and experiencing incivility from others" published in the journal, Work and Stress. "One of these dimensions is workplace incivility, a subtle form of interpersonal negative behavior characterized by rudeness and disrespect."
They also explain that, while the phenomenon of workplace incivility is "closely related to and partially overlaps with other types of workplace mistreatment" like bullying and harassment, it is different in that it is lower in intensity. This, of course, sometimes makes it difficult to perceive.
But while workplace incivility isn't always obvious, it's still prevalent.
In fact, according to a 2016 study published in the Journal of Organizational Behavior, "workplace incivility is ubiquitous." The study finds that an estimated 98 percent of workers experience incivility, with 50 percent experiencing such conduct at least weekly.
The researchers also note that "the monetary cost of experiencing incivility is estimated at $14,000 per employee annually, due to project delays and cognitive distraction from work" — alarming statistics since "incivility affects many employees and has a large ﬁnancial impact on the organizations they work for.
And, when employees are subjected to workplace incivility, there are also human costs. They may withdraw from their work, avoid their colleagues, retaliate against the instigator, take their frustrations out on clients or customers, spend less time at work or even quit.
Workplace incivility is so harmful, in fact, that U.S. companies spend 13 percent of their time just addressing the fallout of incivility in their offices and workplaces, according to the aforementioned research.
What is incivility in nursing?
Wondering more specifically, what is incivility in healthcare and what is the importance of incivility in nursing?
According to The National Institute of Occupational Safety and Health (NIOSH), nurses might face the following four types of violence in their work environment:
- Criminal Intent: "In Type 1 violence, the perpetrator has no legitimate relationship to the business or its employees, and is usually committing a crime in conjunction with the violence (robbery, shoplifting, trespassing)."
- Customer/client: "Type 2 violence is the most common in healthcare settings. This course considers the customer/client relationship to include patients, their family members and visitors... Research shows that this type of violence occurs most frequently in emergency and psychiatric treatment settings, waiting rooms and geriatric settings, but is by no means limited to these."
- Worker-on-worker: "Type 3 violence between coworkers is commonly referred to as lateral or horizontal violence. It includes bullying and frequently manifests as verbal and emotional abuse that is unfair, offensive, vindictive and/or humiliating, though it can range all the way to homicide. Worker-on-worker violence is often directed at persons viewed as being 'lower on the food chain' such as in a supervisor to supervisee or doctor to nurse, though the incidence of peer-to-peer violence is also common."
- Personal relationship: "In Type 4 violence, the perpetrator has a relationship to the nurse outside of work that spills over to the work environment. For example, the husband of a nurse follows her to work, orders her home and threatens her, with implications for not only this nurse but also for her coworkers and patients."
Workplace incivility falls into the third category, primarily.
"The early years of practice represent a significant confidence‐building phase for newly‐graduated nurses, yet many new nurses are exposed to disempowering experiences and incivility in the workplace," write the researchers of the study "Effects of workplace incivility and empowerment on newly‐graduated nurses’ organizational commitment," published in the Journal of Nursing Management.
In fact, there's been tons of research done on incivility in nursing, in particular.
"Workplace incivility (WPI) is a significant problem in healthcare centers, disturbing not only the clinicians enduring the negative behaviors but also the care that is delivered under the shadow of incivility," write the researchers of the study "How to Prevent Workplace Incivility?: Nurses' Perspective," published in the Iranian Journal of Nursing and Midwifery.
This is a huge issue in healthcare, in particular, because not only are nurses affected, but patients can be impacted, as well.
"Individuals who experience incivility, either as targets or witnesses, may suffer numerous negative behavioral, psychological, and somatic effects," the researchers go on. "In addition, threatening and disruptive actions can also lead to medical errors, reduce patient satisfaction and increase the cost of care; meanwhile, with the recent modifications in the health care system, such concerns have become even more crucial to address."
How can nurses combat incivility in healthcare?
Nurses can take some steps to combat workplace incivility in healthcare. Here are three moves they can make when they spot workplace incivility.
1. Confront colleagues who display poor behavior.
Confronting a colleague who displays poor behaviors like workplace incivilities is the first step that a nurse can take, if they feel comfortable doing so. Often times, workplace incivility stems from stress, and they might actually be able to lend their colleague a hand to help relieve the colleague of their stress — and, as such, themselves.
2. Rework their schedule, if possible.
While avoiding colleagues isn't ideal, it may be possible to rework schedules so that nurses who just don't work well together don't have to work the same shifts all the time. This gives them some space, as well as ensures that patients aren't directly affected by any workplace hostility.
3. Report the incident.
Nurses should always report workplace incivility when they spot or experience it. If the hospital, clinic or healthcare institution isn't aware of the behavior, there's nothing it can do to help the situation.
AnnaMarie Houlis is a feminist, a freelance journalist and an adventure aficionado with an affinity for impulsive solo travel. She spends her days writing about women’s empowerment from around the world. You can follow her work on her blog, HerReport.org, and follow her journeys on Instagram @her_report, Twitter @herreport and Facebook.