Introduction
The purpose of this paper is to reflect on a work environment assessment regarding healthcare. Operating in healthcare can, at times, be stressful. Due to the job’s stressful nature, sometimes healthcare experts neglect to speak in a considerate and polite manner. Nevertheless, safe patient care depends on our capacity to effectively manage stress, handle our emotions, and communicate respectfully.
Relationships among workers can affect their capability to perform their tasks and their fidelity to the company and provide safe, quality care for the patients. The American Code of Ethics for Nurses states that they must promote ethical, secure, and civil workplaces (Clark, 2015). Nurses must learn the skills to address incivility, and organizational managers must encourage an environment where they feel empowered to speak up.
Consequently, every member of the Nursing specification must raise awareness regarding the benefits of encouraging civility to protect and promote patient safety. In a work environment having high stress where change is continuous and where system and demanding assignments are expected, decisions and other members’ ideas of the health care team might mean no risk to patients or the difference between harm.
Work Environment Assessment
From the results of Clark’s Healthy Company Inventory, where I am employed, it attained a score of 75, which is regarded as mildly healthy. I have consistently enjoyed functioning at my institution as the nurses have always been heard and valued. The organization has a new CEO who started leading for the past two years, and regrettably, the job nature has been exceptionally altered and not so right. The out-turn of the Assessment of the work environment indicates adverse change. The company’s colossal number upholds and lives the organization’s mission as collaboration and teamwork is apparent. It has a beautiful mentorship program, and there exist many chances for growth and development, while there are also competitive wages and benefits.
There is no unity between the leadership and staff related to communication and transparency. The organization continues to take supplies away without any warning. We just came in one day, and it’s gone. The most recent things that have been taken out are our water pitchers, adult briefs, deodorant, and IV therapy. We are told to use Styrofoam cups and that deodorant is not a necessity. Rumor has it the adult briefs were taken away to try and prevent pressure ulcers. IV therapy was taken away due to budget, and there is little to no explanation or communication. This has led to an uncertain work environment, and the staff does not feel valued, and thus, we have had several people quit. This has caused most floors to have fewer teams to work and has led to entire hostile work conditions.
I was astonished that my company’s work environment range of civility was only mildly healthy; I expected it to fall in the field of moderately healthy. Another surprising factor is how much employee satisfaction, engagement, and morale affect an organization’s civility. I have always identified civility as being polite and respectful to one another. After conducting the Assessment, I realized many factors contribute to the courtesy of an organization. One idea that I believed before conducting the evaluation was that communication and teamwork are essential to a healthy work environment, as the Assessment confirmed this. The inventory outcomes recommend a workplace that is mildly healthy. Regarding the results, the company I am employed with should enhance transparency, employee satisfaction, and communication. Refining these characteristics will develop workplace health and civility.
Reviewing the Literature
Clark (2015) argues that healthy communication must exist to achieve health and civility within an organization. Leaders need to promote open discussion and continuing dialogue regarding a healthy workplace’s fundamentals to obtain healthy communication. Discussing similarities, differences and identifying ways to improve the environment can be beneficial (Clark, 2015). The DESC model is a framework that can be used to structure a civility conversation. The DESC model elements include expressing a particular situation, describing concerns, and revealing other options and consequences (Clark, 2015).
Genuine esteem represents civility to others, including presence, time, a purpose to pursue a usual ground. Treating everyone with courtesy and respect is necessary for effective communication, productive conflict negotiation, and team building. According to Clark (2015), incivility is the show of disrespectful or rude behavior that can cause physiological or psychological distress for the parties involved and, if not addressed, may lead to a threatening or unsafe situation. Incivility acts can take different forms like verbal and uncivil nonverbal behaviors and failure to react when warranted, mainly when victim’s safety is in danger.
The main reason the organization I work for scored only mildly healthy on the job Environment Assessment is lack of unity among the managers and staff and directly related to communication. With all of the recent changes within my organization, the work environment has become very stressful. Nurses and management do not communicate with civility. Nurses have to learn the skills to share in uncivil situations. Management needs to foster an environment where nurses can express concerns regarding the well-being of the patients. The theory contemporary to Clark’s task (2015) conveys unhealthy communication. Clark (2015) recognizes that critical dialogues are rugged and offers strategies to make these conversations less stressful.
An example of an uncivil encounter that frequently takes place between management (Issa) and nurses (Nginde): “Hey Nginde, there is an admission targeted on the board. You are going to take it.” Nginde has already discharged three patients and has taken two admissions. He has five patients, while other nurses have three. He hasn’t completed his other entries, is behind on charting and his med pass. He also hasn’t had lunch yet and is starving. Nginde decides he needs to deal with this situation. Here is how he might use the DESC model with his manager.
Describe: “Issa, I can appreciate your need to assign admissions to a nurse. We all agree that having clear assignments is vital to patient care.”
Explain: “I am overwhelmed and very behind because I just received two admissions. I am not able to provide safe, high-quality care to another admission.”
State: “I realize that as a manager, it is your responsibility to make sure every patient has a nurse. But I’d like to talk about alternative options for this admission because I am unable to care for this patient.”
Consequence: “Let’s work together to discuss alternatives for this admission. I need to have a voice in decisions that affect me.”
Health-Based Strategies to Create High-Performance
Inter-Professional Teams
Pre-briefing and prior learning are strategies focused on the relationship between incivility, remaining silent when uncivil encounters occur, and the potential impact this has on patient safety (Platt Tarafdar & Williams, 2019). Sadly, vulgar experiences have been made to be the norm. When incivility occurs, the Management and Staff do not intercede. Instead, everyone pretends not to see it. Providing staff and control with the education that supports the correlation between disrespect and patient safety will hopefully be enlightening and inspire change.
Cognitive rehearsal is a strategy that is evidence-based for teaching effective communication, and it enlightens the uncivil workmates that it is unacceptable to act in an impolite way (Griffin & Clark, 2014). Currently, the staff does not intervene when incivility occurs because they do not know how to. But addressing the incivility when it occurs may have tremendous success in stopping the behavior. Cognitive rehearsal gives staff the tools to manage incivility promptly and civilly.
Monthly staff meetings are currently held. These meetings now include any organizational changes, new policies, safety concerns, and staff questions, concerns, or suggestions. We have never developed a shared vision and a culture of civility. A great way to foster civility would be to create a shared vision and courtesy culture during a meeting (Clark et al., 2011).
The other strategy is before learning, whereby there is a growing acceptance concerning the incivility effect in healthcare workplaces regarding the low performance of either the bystanders or recipients. The impact of incivility contains a critical place in healthcare before learning; hence it has not been well explored. Nurses should engage in persistent learning as a requirement to have an essential part of advanced knowledge in the healthcare workplace (Ng Niven & Hoel, 2019). From the professional performance perspectives and patient well-being, the patients’ interests, learners, and teachers enable this education to be effective and as efficient as possible.
My organization currently has some fantastic nurses who pride themselves on providing high-quality patient care and living its mission. A strategy to bolster this practice would be to reinforce positive behavior (Clark et al., 2011). Strengthening positive action can be simple. A simple email from management recognizing the behavior goes a long way. Even a meal ticket for a free lunch in the cafeteria would be much appreciated. People will continue to work hard when they feel their efforts don’t go unnoticed.
Conclusion
Incivility in a healthcare institution can lead to unsafe working conditions and the safety of a patient. Care providers and organizational leaders must communicate in a way that fosters civility and empowers nurses to speak up. They must strive to create and sustain a healthy work environment where courtesy is evident. Overall, Companies should come up with a no-tolerance policy for incivility in the workplace. The procedure could have a penalty resulting in every infringement, verbal caution for the initial offense, written caution for the second mistake, non-payment leave for the third one, and termination. The Department of Human Resources should be included in the policymaking process.
If incivility at the workplace is tolerated, destructive behaviors become commonplace and continue in the working environment. Each team member in a company should be educated on the right professional characteristics with the job code of conduct. Both staff and nurse managers must have the ability to identify it, taking it seriously, and cease the action in its way.
References
Clark, C. M. (2015). Conversations to inspire and promote a more civil workplace [PDF document]. Web.
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. Journal of Continuing Education in Nursing, 535-542.
Ng, K., Niven, K., & Hoel, H. (2019). ‘I could help, but…’: A dynamic sense-making model of workplace bullying bystanders. Human Relations, 0018726719884617.
Platt, N., Tarafdar, M., & Williams, R. A. (2019). The complementary roles of Health Information Systems and Relational Coordination in alcohol care pathways: The case of a UK hospital [PDF document]. Web.