Dr. Renee Thompson – How Incivility Shows Up in Nursing

This post is part of a series of posts on nurse bullying and conflict in the workplace written by Dr. Renee Thompson, DNP, RN, CMSRN. Dr. Thompson is one of the top professional development and anti-bullying thought leaders in nursing.

I spend the majority of my time helping organizations eliminate workplace bullying. To do this, it’s important that I “pull back the covers and lift up the gown” within the organization and find out what’s really happening. This is what I typically find: some bullying, but not a lot. However, I usually find an awful lot of incivility!

Incivility is defined as rude or unsociable speech or behavior. Someone cuts in front of you while you’ve been waiting in line forever, a coworker who ignores you when you say hello, or perhaps the employee who uses the last piece of paper in the printer but doesn’t fill the tray – incivility is rampant.

I hear people complaining a lot about the rude and miserable humans out there who seem to have no consideration for others. However, uncivil behavior and rudeness can’t just be everyone else. We each have to check ourselves in the mirror and ask the question: Am I contributing to an uncivil world?

Take the incivility test! You’re leaving the mall. The parking lot is crowded with many cars waiting for a space to open up. You get into your car. While putting on your seat belt, you notice that someone is waiting for your spot. Do you…

  • hurry so that you can give them your spot quickly?
  • take your sweet time and let them wait?

Be honest! What do you do?

What happens when incivility shows up in the nursing profession?

An experienced nurse sits back and watches a new nurse drown. Or sets them up to fail only to come to their rescue at the last minute. A medsurg nurse is pulled to an ICU. The charge nurse takes one look at her, rolls her eyes and says, “They sent us THIS? Why bother?”

Nurses only help the nurses they like and dump on the nurses they don’t like. Is this incivility, bullying, or something else?

I’ve written about these differences many times but basically, for a behavior to be considered bullying, there must be a target, the behavior has to be harmful, and most important – the behavior has to be repeated over a period of time. Incivility tends to be low level behaviors that would be considered by most as rude, disrespectful, inconsiderate, and unprofessional. Incivility shows up as eye rolling, condescending body language, or dumping on the next shift.

When incivility shows up in nursing, not only does it impact the work environment in a negative manner, it impacts the nursing profession as well. Of the new nurses who quit their job in their first year, 60 percent quit due to the bad behavior of their coworkers. Many of these nurses quit the profession all together. We are hemorrhaging really great nurses due to bullying and incivility.

According to our Code for Ethics for Nurses with Interpretive Statements (ANA, 2015), nurses are to, “Practice with compassion and respect for the inherent dignity, worth, and unique attributes of all people.” Therefore, bullying and incivility are in direct violation of our sacred code.

Disruptive behaviors whether you call it bullying or incivility happen because they can. It takes willing individuals and leaders to stop it.

What can you do to create a more civil, professional, and supportive work environment?

  1. Make decisions based on what’s best for patients: This means, you go out of your way to help a nurse care for his/her patient even if you know dang well he/she wouldn’t help you. Why? Because that patient is somebody’s mother, father, sister, brother, child. Would you behave differently if the patient in the bed was your family?
  2. Always be the consummate professional: Incivility begets incivility. Well it works the same way for professionalism too. Kindness, compassion, and respect beget kindness, compassion, and respect. When you extend kindness to a nurse and treat that person in a professional manner even if he/she has not been kind to you, you are role modeling the way nurses should treat each other. Because of mirror neurons in the brain, you will influence others to do the same.
  3. Speak up when you witness incivility: The number one strategy to eliminate bullying and incivility is for the witness to speak up – not the target. When you see disrespectful behavior from your colleague, say something. By ignoring bad behavior, you (we) are condoning it.

I love this quote by the late George Washington, “Every action done in company ought to be with some sign of respect to those who are present.”

We each have to do our part to address incivility in our profession. We cannot afford to lose one more good nurse if we are going to do what we were called to do: care for the sick. And as we all recited the Florence Nightingale pledge when we became nurses, “I will do all in my power to maintain and elevate the standard of my profession…”

Together, we can stop the cycle of bullying and incivility in nursing! Thanks for reading, take care and stay connected!

-Renee