Workplace Environment Assessment
I handed the Clark Healthy Workplace Inventory survey to 5 of my colleagues. As an acute care nurse, I was slightly biased as I chose one more nurse from my unit. The breakdown of colleagues who participated in the survey was as follows: me, another nurse from my unit, an anesthesiologist, a doctor from my department, and a nurse from the oncology unit. According to my survey, I gave the hospital a score of 75 for mildly healthy. The doctor gave a score of 80 for moderately healthy; the anesthesiologist gave a score of 65 for barely healthy, and my nurse colleague from my unit gave it a score of 85 for moderately healthy, while the nurse from the oncology unit gave it a score of 55 for barely healthy. Generally, the total scores were good, but while qualitatively going through the specific items, all employees seemed to agree that there was no comprehensive mentorship program that covered all employees. While this particular point was eye-catching, the other interesting, specific point that all survey-takers agreed on was that they would recommend the workplace to their colleagues and friends.
It surprised me that the results varied from person to person, and it was impossible to draw a pattern from the results. The other surprise was that there was even a single low score that indicated a barely healthy score. The one idea that I believed before the assessment that was confirmed was that the workplace was too big to have a homogenous sentiment about a matter. Before handing out the survey, I knew there would not be uniformity as people with different personalities headed different departments. While I found the overall sentiment was positive, I agreed with the idea that one can never generalize without wide research using statistical tools and research design.
The results show the presence of a discrepancy in the civility perception at the workplace. In statistical terms, the sample was not sufficient to conduct a proper statistical analysis; there was no deviation from the methodology since Clark’s inventory provides for at least one person taking the survey. However, the results indicate that the workplace needs to develop a more comprehensive program to encourage civility. While the majority gave the hospital at least an average healthy environment score, the low scores indicate that there are workers who may be suffering in silence. Failing to speak is a negative aspect and is as bad as the primary agents themselves (incivility, bullying, and mobbing) in terms of impact on patient care (Armstrong, 2018). Silence is an indicator of communication breakdown between the workers and the management.
The lack of a mentorship program that covered all employees was a significant indictment of the workplace and is probably an indicator of a sentiment of deficit among all employees. Once more, the overall opinion indicates that the hospital management needs to establish a program for the entire facility. The point about all employees agreeing that they would recommend the company to their friends and family was a redeeming sentiment. This is because even the employee that rated the company as barely safe indicated that they would recommend it. This was probably a bigger indictment of themselves than the hospital, but that is why one needs to survey a larger sample.
Literature Review
Cognitive rehearsal can be used in curbing incivility and lateral violence in the workplace. In a study involving 26 newly-licensed nurses, the participants said that despite the difficulty in the methods, they helped reduce violence rates in the workplace (Griffin & Clark, 2014). Cognitive rehearsal consists of three parts: participation in didactic instruction, learning and rehearsal of specific phrases that can be used in uncivil circumstances, and participation in practice to reinforce rehearsal and instruction. There are preventative and restorative measures to curb incivility, and cognitive rehearsal is in the latter category.
A study was carried out to investigate the phenomenon of incivility in education and practice in the nursing profession. The literature review highlights the seriousness of the issue, including its prevalence and negative impact on care (Clark et al., 2011). The study showed that newly graduated nurses in clinical settings were disproportionately impacted by incivility. The Clark framework for investigating the issue found that incivility in education is caused by stress, student attitude, faculty superiority, lack of skills, and work overload. On the other hand, in practice, factors contributing to incivility were similar to the ones for education, such as work overload, lack of knowledge, organizational conditions, and unclear expectations. In both circumstances, a common mitigation factor was leader mentorship and effective communication.
Much literature has been written about incivility in the workplace. In an article on My American Nurse, Clark (2015) wrote about inspiring civil discourse in the workplace. The article talks about the need to maintain an environment of civility in the workplace; the practice fosters the ability of employees to perform their jobs. In my organization, the following factors could help improve civility in the workplace; Clark (2015) identified factors that made a healthy workplace: communication, collaboration, decision-making, proper staffing, authentic leadership, and meaningful recognition. In addition, the survey revealed that some employees had issues that they had not communicated; therefore, adopting effective communication could improve the situation.
Evidence-Based Strategies
One of the best strategies for alleviating the civility problem in the workplace is staff stress management. According to Clark et al. (2011), incivility in nursing education is caused by work overload, organizational deficiencies, unclear roles, and a lack of knowledge and skills. These same factors are also common in nursing practice. Therefore, it would be a significant step to work to reduce stressors at work, translating to reduced incivility. According to Griffin & Clark (2014), incivility, mobbing, and bullying are significant factors in employees’ job satisfaction, mental health, output, and commitment. These are vital factors to the ultimate goal of healthcare, which is patient care. Employees who are happy and satisfied will deliver better care.
Another strategy that can be employed to solve the issue of lateral violence in nursing is managerial involvement. According to Clark (2015), standards for a healthy working environment include skilled communication, effective decision-making, genuine collaboration, authentic leadership, and meaningful recognition. These crucial standards seem great on paper and would have the semblance of a panacea, but they require work and are practically unachievable without support from the topmost levels of management (Bambi et al., 2017). As indicated in the survey, there is a disconnect between perception and what needs to be achieved. Most of the staff were jolted into realization by the nature of the questioning, indicating that while they may have thought the working environment was okay, the questions seemed to make them realize the workplace’s deficiencies. The ultimate responsibility lies with the management to create the best possible working environment through best practices.
General Notes and Comments
Lateral violence and incivility are some of the biggest threats to professional conduct in the healthcare industry. Nurses, in particular, are disproportionately affected because of such factors as proximity to patients, seniority in the workplace, and gender. The problem has been observed to occur both in education and practice. Some solutions to the issue are preventive, while others are restorative. Ultimately, the best solution to the problem requires wholehearted input from management.
References
Armstrong, N. (2018). Management of nursing workplace incivility in the health care settings: A systematic review.Workplace Health & Safety, 66(8), 403–410.
Bambi, S., Guazzini, A., De Felippis, C., Lucchini, A., & Rasero, L. (2017). Preventing workplace incivility, lateral violence, and bullying between nurses A narrative literature review. Acta bio-medica : Atenei Parmensis, 88(5S), 39–47. Web.
Clark, C. M. (2015). Conversations to inspire and promote a more civil workplace.American Nurse.
Clark, C. M., Olender, L., Cardoni, C., & Kenski, D. (2011). Fostering civility in nursing education and practice: Nurse leader perspectives. JONA: The Journal of Nursing Administration, 41(7/8), 324–330.
Griffin, M., & Clark, C. M. (2014). Revisiting cognitive rehearsal as an intervention against incivility and lateral violence in nursing: 10 years later. The Journal of Continuing Education in Nursing, 45(12), 535–542.