Kimberly Silver DNP, RN Worcester State University  INCIVILITY Training for Nursing Faculty to Foster Teamwork and Collaboration Between Student and Nursing Staff Karen Manning Laboure College Kimberly Silver DNP, RN Worcester State University

Objectives To define incivility To discuss the misconduct within nursing practice incorporating, Nursing Code of Ethic To discuss nursing leadership’s role in the prevention and intervention of incivility To practice communication techniques in confronting bullying behavior To develop a prevention and intervention action plan to prevent incivility

Incivility - Definition Any action that is rude, discourteous, offensive, intimidating, or hostile that interferes with the learning and/or practice environment Evidence suggests that incivility on American college campuses, ranging from insulting remarks and verbal abuse to violence, is a serious and growing concern.

TYPES OF INCIVILITY Lateral/Horizontal Violence: Acts that occur between coworkers, between students, between faculty, and between staff nurses and student. Bullying/Vertical Violence: Acts done by a person in a position of authority

Lateral Violence

Nursing Students’ Perceptions “I asked a question to clarify content and was yelled at and told if I did the reading I would know the answer” “In front of my patient and the nurses on the unit my clinical instructor scolded me for not documenting vital signs before lunch” “I was made to tell the staff nurse that I was not prepared today and that I would not be able to give medications” “I asked the staff nurse a questions and she turned and mumbled, what are they teaching you in school”

Students Experience

Faculty’s Perceptions “The student rolled her eyes when I explained a procedure to her” “ After making out the assignment, a student nastily snapped stating, "I'm not here to do the aides work” “I called and asked my faculty mentor for help and she told me she does not have time and when she was hired for her position she had to figure everything out on her own” She constantly interrupted me during the Faculty meetings.

Incivility can be discreet Arriving late for class/clinical. Using cell phones/texting during class/clinical. Sending an e-mail without a greeting. Using harsh tones or body language, such as rolling eyes. Dismissing or ignoring concerns, thoughts, or input.

Work Environment

What are the things that you can do when your students are on an “uncivil” clinical environment? “Communication with staff, manager, and education is vital to decreasing Incivility.”

Measures to Address Incivility Faculty to Faculty Zero-tolerance expectations for abrasive behaviors Clear communication Self-reflection Cooperate Collaborate Carefully select faculty Refuse to be a victim Monitor for bullying groups Student to Faculty Zero-tolerance expectations for abrasive behaviors Clear communication Shared involvement Self-reflection Criminal background checks Act on warning signals Faculty to Student Zero-tolerance expectations for abrasive behaviors Clear communication Non-threatening environment Shared involvement Self-refection

Active Listening Listen with the same basic courtesies you want to receive: No interrupting Reflect back understanding of views Ask clarifying questions Really listen, don’t respond until you have truly HEARD the other person Use “I” messages

Communicate with Civility Remember pleasantries Don’t interrupt, ask if the person has time Be open-minded Say what you mean Talk to people, not about people Be aware of tone and volume Be respectful, even in disagreement

Avoid Words That Promote Conflict “ You should/you must…” “ You lied…” “ This is so typical of you…” “ You always/you never…” “ The problem is you…” “ If you don’t do this, then I’ll…” “ You’ll never change…” “ You’re being hysterical/ unreasonable…”

Create a Culture of Civility in Nursing Programs Faculty/clinical instructors identify and address incivility across the curriculum Reward/reinforce civil behavior Add Code of Ethics to clinical evaluation Provision 1.5 requires nurses to treat colleagues, students, and patients with dignity and respect and that any form of harassment, disrespect, or threatening action will not be tolerated (ANA Code of Ethics) Building in civility competencies Active listening, Conflict resolution skills, negotiation, dealing with difficult people, Stress management

Civil Behavior Show respect Role Model Show patience with others and yourself Avoid sarcasm, put downs, offensive humor Have a cooperative approach Listen attentively with eye contact Watch body language/personal space Apologize when in the wrong Give each other positive reinforcement Accept and learn from mistakes Adhere to proper email etiquette

Email Is the message more effectively communicated in person? Review before sending Don’t forget pleasantries Be aware of tone

Questions?