NR 500 Week 7: Incivility and Healthful Environments

Sample Answer for NR 500 Week 7: Incivility and Healthful Environments Included After Question

Preparing the Assignment 

Introduction 

This graded discussion will explore the impact of systems theory on a practice problem or issue. Please provide an initial response to the discussion question by Wednesday at 11:59pm MT and two interactive dialogue responses no later than Sunday 11:59 PM MT at the end of WEEK 7. The discussion is worth 75 points. Please refer to the discussion grading rubric for additional criteria. 

Assignment 

Reflect on an experience in which you were directly involved or witnessed incivility in the workplace. Provide a brief synopsis of the situation. How did this make you feel? How did you respond? What were the consequences of this situation? Provide an example of how this negatively affected the work environment and outcomes. How could the situation have been prevented? Discuss strategies that would support a healthy work environment. 

A Sample Answer For the Assignment: NR 500 Week 7: Incivility and Healthful Environments

Title: NR 500 Week 7: Incivility and Healthful Environments

According to the American Nurses Association (2016), “Nurses should model respect and a professional demeanor to help reinforce civility and positive norms.” I feel like this is the most important strategy to use to promote a healthy work environment and decrease incivility within nursing. Nurses should always treat their coworkers and other nurses with respect. By doing this, nurses should offer assistance and encourage and support other nurses. If this was implemented more often by nurses, then the situation I described in my previous post could of easily been prevented and we would not have suffered a loss of a potential great ER nurse.

Another strategy to prevent further occurrences, such as the one I described in my previous post, would be to create an environment that encourages nurses to speak up to leaders. “To help prevent lateral violence in nursing, a culture of safety is needed to create and sustain an environment where team members are encourages to speak up to leaders and peers.” (Stanton, 2015). If nurses aren’t afraid to speak up, then these situations of nurses leaving the job before solving the problem could be prevented.

This is an exceptional post. Currently, among the various challenges faced by healthcare leaders is understanding how to address high nurse turnover rates. Job satisfaction is a primary factor that influences nurses to continue working in an organization. Working environments that are empowering and supportive are linked to higher job satisfaction among the nursing workforce, increased productivity, positive patient outcomes, and reduced turnover rates. Nurses who are happy with their organizations, duties, and treatment by the leadership are more likely to build strong ties to their organization and also enhance their engagement with the organization (Seren Intepeler et al., 2019). Authentic leadership (AL) is associated with positive team operations and outcomes within the healthcare industry. Authentic leaders are all-encompassing and motivating. They also prioritize the needs and interests of their staff over their needs and interests (Baek et al., 2019). Authentic nurse leaders tend to report enhanced levels of job satisfaction and engagement and their staff remains in the organization longer.

Authentic leaders develop supportive environments, which is crucial in facilitating the independence and willingness to work among employees (Baek et al., 2019). Enhanced job engagement, satisfaction, and retention are more vital than ever due to the current crisis of nursing shortage.  The nursing workforce is currently more susceptible to burnout from the continuing psychological distress due to the heavy workload. As such, it is important to improve nursing engagement to rise above the call of duty. Effective nursing engagement is critical in retaining nurses in the organization. AL is been demonstrated to positively impact the needed nursing outcomes such as job engagement, prevention of burnout, job satisfaction, and psychological capital. Therefore, AL can also help to address adverse nursing outcomes and promote a healthy, supportive work environment, which is critical in nursing retention in the organization.

References

Baek, H., Han, K., & Ryu, E. (2019). Authentic leadership, job satisfaction, and organizational commitment: The moderating effect of nurse tenure. Journal of Nursing Management, 27(8), 1655-1663. https://doi.org/10.1111/jonm.12853

Seren Intepeler, S., Esrefgil, G., Yilmazmis, F., Bengu, N., Gunes Dinc, N., Ileri, S., … & Dirik, H. F. (2019). Role of job satisfaction and work environment on the organizational commitment of nurses: a cross-sectional study. Contemporary nurse, 55(4-5), 380-390. https://doi.org/10.1080/10376178.2019.1673668

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NR500NP-60450 Week 7: Incivility and Healthful Environments

This is a graded discussion: 75 points possible

Due Dec 11

Week 7: Incivility and Healthful Environments

No unread replies.No replies.

Purpose

The purpose of the graded collaborative discussions is to engage faculty and students in an interactive dialogue to assist the student in organizing, integrating, applying, and critically appraising knowledge regarding advanced nursing practice. Scholarly information obtained from credible sources as well as professional communication are required. Application of information to professional experiences promotes the analysis and use of principles, knowledge, and information learned and related to real-life professional situations. Meaningful dialogue among faculty and students fosters the development of a learning community as ideas, perspectives, and knowledge are shared.

Activity Learning Outcomes

Through this discussion, the student will demonstrate the ability to:

Examine roles and competencies of advanced practice nurses essential to performing as leaders and advocates of holistic, safe, and quality care (CO1)

Apply concepts of person-centered care to nursing practice situations (CO2)

Analyze essential skills needed to lead within the context of complex systems (CO3)

Explore the process of scholarship engagement to improve health and healthcare outcomes in various settings (CO4)

Due Date

A 10% late penalty will be imposed for discussions posted after the deadline on Wednesday, regardless of the number of days late. NOTHING will be accepted after 11:59pm MT on Sunday (i.e. student will receive an automatic 0 for any portion of the discussion not posted by that time). Week 8 discussion closes on Saturday at 11:59pm MT.

NOTE: To receive credit for a week’s discussion, students may begin posting no earlier than the Sunday immediately before each week opens. Unless otherwise specified, access to most weeks begins on Sunday at 12:01 a.m. MT, and that week’s assignments are due by the next Sunday by 11:59 p.m. MT. Week 8 opens at 12:01 a.m. MT Sunday and closes at 11:59 p.m. MT Saturday.

A zero Is the lowest score that a student can be assigned.

Faculty may submit any collaborative discussion posting to Turnitin in order to verify originality.

Total Points Possible:  75

Requirements:

Discussion Criteria

1. Application of Course Knowledge: of Course Knowledge:

The student post contributes unique perspectives or insights gleaned from personal experience or examples from the healthcare field. The student must accurately and fully discuss the topic for the week in addition to providing personal or professional examples. The student must completely answer the entire initial question.

1. Engagement in Meaningful Dialogue: I. The student responds to a student peer and course faculty to further dialogue.
2. Peer Response: The student responds substantively to at least one topic-related post by a student peer. A substantive post adds content or insights or asks a question that will add to the learning experience and/or generate discussion.

A post of “I agree” with a repeat of the other student’s post does not count as a substantive post. A collection of shallow posts does not equal a substantive post.

The peer response must occur on a separate day from the initial posting.

The peer response must occur before Sunday, 11:59 p.m. MT.

The peer response does not require a scholarly citation and reference unless the information is paraphrased and/or direct quotes are used, in which APA style standards then apply.

Faculty Response: The student responds substantively to at least one question by course faculty. The faculty question may be directed to the student, to another student, or to the entire class.

A post of “I agree” with a repeat of the faculty’s post does not count as a substantive post. A collection of shallow posts does not equal a substantive post.

The faculty response must occur on a separate day from the initial posting.

Responses to the faculty member must occur by Sunday, 11:59 p.m. MT.

This response does not require a scholarly citation and reference unless the information is paraphrased and/or direct quotes are used, in which APA style standards then apply.

• Integration of Evidence: The student post provides support from a minimum of one scholarly in-text citation with a matching reference AND assigned readings OR online lessons, per discussion topic per week.

What is a scholarly resource? A scholarly resource is one that comes from a professional, peer-reviewed publication (e.g., journals and government reports such as those from the FDA or CDC).

Contains references for sources cited

Written by a professional or scholar in the field and indicates credentials of the author(s)

Is no more than 5 years old for clinical or research article

What is not considered a scholarly resource?

Newspaper articles and layperson literature (e.g., Readers Digest, Healthy Life Magazine, Food, and Fitness)

Information from Wikipedia or any wiki

Textbooks

Website homepages

The weekly lesson

Articles in healthcare and nursing-oriented trade magazines, such as Nursing Made Incredibly Easy and RNMagazine (Source: What is a scholarly article.docx; Created 06/09 CK/CL Revised: 02/17/11, 09/02/11 nlh/clm)

Can the lesson for the week be used as a scholarly source?

Information from the weekly lesson can be cited in a posting; however, it is not to be the sole source used in the post.

Are resources provided from CU acceptable sources (e.g., the readings for the week)?

Not as a sole source within the post. The textbook and/or assigned (required) articles for the week can be used, but another outside source must be cited for full credit. Textbooks are not considered scholarly sources for the purpose of discussions.

Are websites acceptable as scholarly resources for discussions?

Yes, if they are documents or data cited from credible websites. Credible websites usually end in .gov or .edu; however, some .org sites that belong to professional associations (e.g., American Heart Association, National League for Nursing, American Diabetes Association) are also considered credible websites. Websites ending with .com are not to be used as scholarly resources

1. Professionalism in Communication: The post presents information in logical, meaningful, and understandable sequence, and is clearly relevant to the discussion topic. Grammar, spelling, and/or punctuation are accurate.
2. Wednesday Participation Requirement: The student provides a substantive response to the graded discussion question(s) or topic(s), posted by the course faculty (not a response to a peer), by Wednesday, 11:59 p.m. MT of each week.
3. Total Participation Requirement: The student provides at least three substantive posts (one to the initial question or topic, one to a student peer, and one to a faculty question) on two different days during the week.

DISCUSSION CONTENT

Category

Points

%

Description

Application of Course Knowledge

20

27

Answers the initial discussion question(s)/topic(s), demonstrating knowledge and understanding of the concepts for the week.

Engagement in Meaningful Dialogue With Peers and Faculty

20

27

Responds to a student peer AND course faculty furthering the dialogue by providing more information and clarification, adding depth to the conversation

Integration of Evidence

20

27

Assigned readings OR online lesson AND at least one outside scholarly source are included. The scholarly source is:

• Evidence-based, 2) scholarly in nature, 3) published within the last 5 years

60

81%

Total CONTENT Points= 60 pts

DISCUSSION FORMAT

Category

Points

%

Description

Grammar and Communication

8

10

Presents information using clear and concise language in an organized manner

Reference Citation

7

9

References have complete information as required by APA

In-text citations included for all references  AND references included for all in-text citation

15

19%

Total FORMAT Points= 15 pts

DISCUSSION TOTAL=75 points

Preparing the Assignment

Introduction

This graded discussion will explore the impact of systems theory on a practice problem or issue. Please provide an initial response to the discussion question by Wednesday at 11:59pm MT and two interactive dialogue responses no later than Sunday 11:59 PM MT at the end of WEEK 7. The discussion is worth 75 points. Please refer to the discussion grading rubric for additional criteria.

Assignment

Reflect on an experience in which you were directly involved or witnessed incivility in the workplace. Provide a brief synopsis of the situation. How did this make you feel? How did you respond? What were the consequences of this situation? Provide an example of how this negatively affected the work environment and outcomes. How could the situation have been prevented? Discuss strategies that would support a healthy work environment.

**To see view the grading criteria/rubric, please click on the 3 dots in the box at the end of the solid gray bar above the discussion board title and then Show Rubric.

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Being a manager and a leader within your profession is two different concepts which many in management and leadership roles tend to forget. Leadership at times comes first, then management. Management involves doing things right; and leadership is doing the right thing. Leadership is the personal traits necessary to establish vision and goals for an organization and the ability to execute them. Leaders show colleagues how a task can be done rather than just giving orders (Azad etc., 2017).  A manager has personal traits necessary to plan, organize, motivate, and manage the personnel and material resources of an organization who are responsible for getting work done through others. Management is the ability to organize details, so work can be successfully achieved. The common goal of both leaders and managers should be learning from others, effective communication, integrity, openness to new ideas, along with adaptability and flexibility (Azad etc.., 2017). These characteristics are characteristics of leaders but should also be exemplified by managers. Creating an environment of civility in management can be summed up in one word “Respect.” When you respect a person personal space, ideas for improvement, creativity, permission to vent professionally, and remove your personal feelings and the “I” out of the equation it becomes more about the individual which in turn improve unit morale and workflow. Do not ever to me discuss negative traits about other co-workers to others in the unit, people talk, and interpretation of the shared conversation get lost. Managers because they are human take things personally, when often the concern has nothing to do with you. The goal ultimately is delivering the best patient care; as team. Remember there is no “I” in teamwork, maybe having a more active unit with scheduling, unit meetings, and suggestion boxes that really takes consideration of what the staff is looking to improve will help.

Reference:

Azad, N., Anderson, Jr, H. G., Brooks, A., Garaza, O., O’Neil, C., Stutz, M. M., & Sobotka, J. L. (2017). Leadership and Management Are One and the Same. American Journal of Pharmaceutical Education, 81 (6), 1-5.

Incivility and Healthful Environment

Incivility is one of the problems which affect the healthcare environment negatively. While some nurses get involved directly in incivility, others experience it as it happens between other staff members. Even though it is a common phenomenon, it sometimes gets overlooked. Incivility has been shown to lead to toxic working environments and poor working conditions. Incivility may take different forms, such as bullying, disruptive conduct, unfair conduct, subtle harassment, and rudeness (Green, 2019). Therefore, the purpose of this assignment is to reflect on an experience of incivility at the workplace.

Some time ago, I experienced a first-hand act of incivility. We were always encouraged in the facility to inquire from colleagues and the senior staff members if there was anything unclear or when in doubt. Therefore, as a way of avoiding medication errors, I approached one of the senior nursing staff to help confirm the details of a medication of I was supposed to administer to a patient in terms of dosage and route. To my surprise, the nurse reacted angrily and rudely, shouting that it was a show of incompetence. The nurse even criticized me in front of others, shouting that my skills were short and that I could not handle the simplest of tasks.

The situation made me feel bad, disrespected, and demoralized. The comments of incompetence and half-baked skills cut into me and bruised my self-esteem. I thought for a while about my competence and ability concerning the skills. I don’t think I did anything wrong to warrant such a dress-down. I was only trying to be extra careful so that I don’t commit any medication errors which can lead to adverse outcomes.

Even though the situation made me feel bad, I contained my anger and walked away from the scene. I did not want to create any commotion as patients were close by. I spoke with another staff member who helped countercheck the medication details. The nurse also indicated that the reaction by the senior nurse was inappropriate and uncalled for and that I did well not to respond violently. I made efforts to meet the nurse leader to hold further discussions regarding the matter and how best to handle such situations in the future.

The situation had various consequences. One of the consequences was a strained relationship between myself and the senior nurse. Since I didn’t like how the nurse addressed me, the situation made our working relationship to get sour. Again, the nurse leader was also willing to come in and mediate to ensure the working relationship was restored. Indeed, mediation is known to be one of the most strategies for resolving conflicts (Kohlhoffer-Mizser, 2019).  The situation also had negative impacts on the work environment and the outcomes. For example, other junior nurses were more withdrawn and never willing to inquire and consult the senior nurses. There is also a potential impact on the outcomes since there are higher chances of making mistakes, such as medication-related errors, when there is no consultation.

The situation could have been prevented by constantly reminding the staff to be gentle and avoid rudeness as much as possible. Talking gently to others helps avert conflicts that could have been caused by rudeness. Various strategies can be used to support a healthy work environment. One of the strategies is encouraging open communication. Open communication helps individuals pass across the intended information and message, preventing conflicts and promoting a healthy environment (Kim et al.,2018). The other strategy is offering support for each other in the work environment. Support ensures that everyone feels comfortable in the work environment, creating a healthy environment.

Conclusion

Workplace incivility has various negative impacts on the staff and the work environment. Therefore, appropriate ways should be used to avoid it. This assignment has described a case of workplace incivility and its impacts.

References

Green, C. A. (2019). Workplace incivility: nurse leaders as change agents. Nursing Management, 50(1), 51–53. Doi: 10.1097/01.NUMA.0000550455.99449.6b

Kim, K. J., Yoo, M. S., & Seo, E. J. (2018). Exploring the influence of nursing work environment and patient safety culture on missed nursing care in Korea. Asian Nursing Research, 12(2), 121-126. https://doi.org/10.1016/j.anr.2018.04.003

Kohlhoffer-Mizser, C. (2019). Conflict management-resolution based on trust?. Ekonomicko-Manazerske Spektrum, 13(1), 72-82. Doi: 10.26552/ems.2019.1.72-82

I recall an experience as a recent graduate nurse in which I was bathing and caring for an eighteen-year-old female patient who had experienced prolonged severe carbon monoxide poisoning. Because of the exposure, she lost her parents and sibling, and she was the sole survivor. She suffered a severe anoxic brain injury that left her mentally devastated. It happened to be my first nursing position straight out of school in the PICU where I had previously worked as a patient care tech. During patient care, the charge nurse came on the overhead speaker in the patient’s room and pretended to talk to the patient. The charge nurse made crude remarks about how the patient was enjoying the bath and needed a boyfriend, would I like to be that man for her? I was in the middle of bathing the patient with another staff nurse when we heard the voice come over the speaker. At the moment that it happened I was not sure how to take the comments. However, I knew enough to know that her actions and comments were inappropriate and far from the standard of care.
As a male nurse, I was still learning how to best care for female patients. Each time I cared for a female patient I was extra intentional in showing respect, dignity, and upholding their privacy whenever possible. This situation caught me off guard and made me feel uncomfortable. My first reaction was to smile, but then the seriousness of the patient’s unfavorable prognosis caught my attention and helped redirect my focus back to the severity of her condition and vulnerability. I was not bothered so much about what the implications of the comment implied towards me as a male nurse but was troubled by the notion that we as health care providers were misbehaving toward the patient and in many ways taking advantage of her mental state and preying on her inability to defend herself. I merely justified the event in my mind and labeled it as the staff just being silly. The charge nurse and other staff members got a real laugh out of the whole thing as the story was retold latter that day. 

Regarding the consequences of the situation, most would argue and say nothing happened because none of the patient’s family or relatives and other neighboring families ever found out. As for implications for the patient, one might think it did not matter since she is incapable of understanding what took place. Had a family member heard about the incident or a member of leadership, the situation could have cost the charge nurse her job or at minimum caused for a movement to re-educate the staff on ethical practice standards of best care.
According to Andersson and Pearson, as cited in (Hunt, & Marini, 2012), the term “incivility” encompasses low-intensity behavior that lacks a clear intent to harm, but violates social norms and can cause harm. According to Lambert, Lambert & Ito, as cited in (Hunt, & Marini, 2012), nurses who have less than satisfactory relationships with their coworkers are more likely to leave their jobs. While I did not have any intentions on leaving my job after the incident, I could have turned this negative situation into a decisive, constructive learning moment in which all staff members could have reflected upon its possible negative implications. I might have gained some resistance from my co-workers, but ultimately an environment conducive to excellence is one worth fighting and advocating for. Unfortunately, I allowed my voice to go unheard, and I failed to support civility. I should have imaged my daughter or loved one laying there in that patient’s bed and treated her with compassion and empathy. 

According to Pearson and Porath, as cited in (Hunt, & Marini, 2012), incivility impacts on inter-professional team function through disruption of relationships and poor cooperation, and grievances. This situation negatively affected the work environment because each nursing provider failed to work towards a basis of civility in which we would love thy neighbor and was unable to demonstrate respect for this precious soul. All parties involved missed the opportunity to stop these rude comments, thoughtless acts, or negative gestures which were a form of aggression just in a less intense form: verbal rather than physical, passive rather than active, indirect rather than direct, and subtle rather than overt. The cycle of negativity continued because we chose to stay nonjudgmental. A charge nurse and every nurse ought to withhold a position of leadership and leadership qualities lacked during that incident. Nursing is a field in which caring is the backbone of all we strive to do, and we failed to uphold that promise. ANA’s Code of Ethics for Nurses states that nurses are required to “create an ethical environment and culture of civility and kindness, treating colleagues, co-workers, employees, students, and others with dignity and respect.” Similarly, nurses must be afforded the same level of respect and dignity as others (ANA, 2015), all these standards were omitted during this occurrence. Strategies that would support a healthy work environment start with continuous self-reflection and self-awareness on our own actions thoughts and perceptions. Confronting negative behavior or perceptions immediately in a nonjudging way with constructive criticism is crucial. ANA defines a healthy nurse as one who actively focuses on creating and maintaining a balance and synergy of