Introduction
Workplace incivility is an immense concern in medical institutions. Scholars usually characterize it as low-level disruptive behavior that violates the mutual trust and respect standards of the workplace and has an uncertain intention to hurt the victim (Zhang et al., 2018). Workplace incivility is unkind, disrespectful, demeaning, and insulting behavior. It can pervade a full workplace and is common in hospital environments. It might be detrimental to the long-term growth of healthcare and medical organizations. When discussing workplace incivility, it usually has two areas of impact: internal and external. The internal area of damage significantly impacts workers’ emotional and psychological health, frequently resulting in exhaustion, diseases, somatic complaints, stress, and depression in nursing professionals.
However, the external area influences patient care and the overall efficiency of the healthcare organization. Anger, resentment, and physical repercussions can prevent nurses from improving their work skills. Intimidating and destructive behavior can result in medical mistakes, decrease positive patient outcomes, and raise healthcare costs (Abdollahzadeh et al., 2017). In light of recent changes to the healthcare system, it has become more important to address these issues. Thus, while incivility impacts individual nurses’ clinical judgment by leading to more stress, it additionally has repercussions for the workplace, such as high turnover, low productivity, and poor communication, including poor cooperation and team efficiency.
Incivility Impact on Nurses’ Clinical Judgement
Workplace incivility impacts nurses’ clinical judgment in multiple ways, including a decrease in confidence and distractions. Depression, as well as other negative feelings, are common among incivility victims, and these conditions substantially jeopardize both their physical and mental well-being. Victims frequently feel separated from their surrounding interactions at the organizational level, with constant pressure and bullying from other medical employees, they experience a decrease in confidence, leading to poor clinical judgment (Abdollahzadeh et al., 2017).
For example, it was discovered that among newly graduated nurses, dangerous medicine administration methods were associated with situations with non-supportive workplace relationships (Armstrong, 2018). In this situation, having meager experience and undergoing incivility lowered their sense of self-worth and confidence, putting the health of their patients at risk. As a result, incivility actions can have an impact on a nurse’s sense of self-worth, and clinical judgment, which can have an impact on patient safety.
Moreover, incivility can be detrimental to patient treatment at the workplace due to poor concentration and distractions. The factor of poor concentration and distractions stems from abusive behavior that affects the condition of the nurse. According to study results, nurses have stated that disrespect at work has endangered patients by drawing attention away from work and upsetting them emotionally (Armstrong, 2018).
Additionally, a strong link was shown between the standard of care given by practicing nurses and their encounters with rudeness while working (Armstrong, 2018). For example, nurses claimed that being rude enhanced their likelihood of providing patients with incorrect treatment or service (Armstrong, 2018). Here, due to a lack of focus, the nurses or other medical professionals might employ different tools or medications, which will affect the patient’s health directly. Finally, a link between occupational disrespect and posttraumatic stress disorder in nursing professionals was discovered. As a result, when exposed to disrespect, bullying, and other kinds of incivility behaviors, nurses lack proper control of patient care and clinical judgment.
Issues that Occur with Workplace Incivility
Additionally, it is worth mentioning that workplace incivility is commonly the result of organizational disruptions and increased costs. In a sense, workplace incivility is highly detrimental to not only the well-being of patients and employees but organizations as well. The first issue that occurs as a result of workplace incivility is the reduced job performance of the staff members. Scholars define job performance as the amount of work that an employer expects from a worker over the course of a given length of time (Zhang et al., 2018). Nursing professionals’ job performance in healthcare environments is correlated with enhancements in health outcomes and behavior patterns, which are both related to patient experience and quality of life.
Objectives and the determination to achieve them are what determine how well an employee does their job. Studies analyzed by Zhang et al. (2018) demonstrate that nurses’ mental health, professional productivity, and well-being are all adversely affected by incivility. Researchers have established a link between rudeness and poor work performance, which is entirely driven by emotional fatigue (Zhang et al., 2018). Consequently, it is important to focus on enhancing new nurses’ productivity from a work capability and requirements standpoint. As a result, damaging behavior in the workplace needs to be studied and eliminated, and professionals should be encouraged to create policies and procedures to lessen its recurrence.
High employee turnover is the second problem brought on by rudeness at work. Job satisfaction among staff and organizational loyalty may indeed decline or disappear, and turnover rates may rise as a result. The results of the study by Kanitha & Naik (2021) showed a substantial association between manager incivility and intention to leave the company. Stress among nurses was associated with their intention to leave (Kanitha & Naik, 2021). Workplace stress was strongly correlated with the intention to leave, and 35% of the employees claimed they would change jobs if they were presented with a better opportunity (Kanitha & Naik, 2021). Thus, due to incivility, organizations might struggle with the retention of employees.
Incivility Impact on Workplace Communication
Among the major contributing elements to incivility is improper communication, particularly with patients and among team members. Being inconsiderate and hostile, particularly in the workplace, encourages the creation of unions or groupings among workers, which lowers work efficiency as a whole. In this sense, healthcare professionals tend to have closed-looped communication, alienating other medical staff (Abdollahzadeh et al., 2017). This has an adverse effect on the staff morale as well as how they handle the patients. In the end, some healthcare workers might opt for excessive sick leave that will burden the institution, lead to staff turnover, and frequently medical malpractice.
Another way in which workplace incivility affects communication is that it significantly reduces team cooperation. The first reason for reduced team cooperation and efficiency is that healthcare employees do not have access to the data and details that are necessary for the implementation of certain tasks (Kanitha & Naik, 2021). Another reason is that with a lack of access to information and recourses that are required, medical employees will have reduced motivation to provide the results due to decreased incentives and output. As a result, reduced team cooperation not only separates the employees and contributes to the inability to construct a full team but leads to unequal distribution of resources and information.
Current Initiatives to Decrease Incivility
Finally, when it comes to current initiatives that organizations implement to decrease incivility, they are based on the training of staff and incorporating a civility culture. The first approach incorporated by most institutions is the training of staff on effective communication, teamwork, leadership abilities, and civility training (Bambi et al., 2017). It is believed that such sessions and additional materials provided to the employees will increase their cooperation and allow them to know more about each other (Bambi et al., 2017). Additionally, employees often learn mediation and dispute management lessons, which promotes less tension between team members and improves patient safety.
On a deeper level, the goal of the training initiative is to educate staff about the organization’s policy against workplace incivility and its consequences. The results of the studies show that employees are becoming more knowledgeable about the zero-tolerance approach (Zhang et al., 2018). The results confirm the effects of regular training programs that are advised for bringing about beneficial social transformation (Zhang et al., 2018). Using cognitive repetition, resolving conflict, and emotional intelligence instruction, the training should continue to develop understanding and prevent disruptive conduct from improving nurse interaction.
Another initiative implemented by the institutions is the restructuring of the mentality and culture of the firm. In this sense, the management of the organizations frequently conducts gatherings to share and learn about the respective culture (Bambi et al., 2017). Here, employees can share their feelings and learn more about team mentality. The frequent gatherings allow to build of connections among the team members and resolve conflicts. Moreover, team building activities allow the management to identify and address the weaknesses of the employees, as well as emphasize the strengths that will contribute to the team.
Finally, having proper conduct norms is a general necessity and adequate initiative used by organizations. Having strict guidelines sets a specific framework that promotes positive behavior patterns and outlines penalties for negative behavior patterns (Bambi et al., 2017). In this sense, employees are aware of the consequences of unprofessional attitudes and are encouraged to cooperate with other team members and practice civility techniques instead of bullying, alienating, or disrespecting other medical professionals. Without proper frameworks and guidelines, employees will tend to proceed with abusive and harassing communication approaches, reducing team morale. Such initiative can be employed via team gatherings or the distribution of the necessary professional material.
Conclusion
Therefore, incivility has consequences for the workplace, such as high employee turnover, reduced performance, and poor communication, including poor cooperation and team efficiency, in addition to impacting individual nurses’ clinical judgment by increasing stress. Incivility at work has various effects on nurses’ clinical judgment, including a decline in confidence and distractions. It is also important to note that workplace incivility frequently leads to organizational disruptions, greater expenses, and a higher turnover rate, all of which are caused by poorer work performance. Improper communication, particularly with patients and among team members, is one of the main causes of incivility.
Being hostile and abusive, especially at work, promotes the formation of unions or other groups among employees, which reduces overall job productivity. Incivility at work also harms teamwork, which is another manner in which it impairs communication. However, some initiatives assist organizations in reducing incivility at work. Most institutions start by teaching their staff members how to communicate effectively. Restructuring the firm’s culture and mindset is another project that the institutions have put into place. Appropriate behavior standards are a common requirement and a good effort utilized by companies.
References
Abdollahzadeh, F., Asghari, E., Ebrahimi, H., Rahmani, A., & Vahidi, M. (2017). How to prevent workplace incivility?: Nurses’ perspective. Iranian Journal of Nursing and Midwifery Research, 22(2), 157–163. Web.
Armstrong, N. (2018). Management of nursing workplace incivility in the health care settings: A systematic review. Workplace Health & Safety, 66(8), 403-410. Web.
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(5), 39–47. Web.
Kanitha, D., & Naik, P. R. (2021). Experience of workplace incivility and its impact on stress and turnover intention among the nurses working at a hospital: Cross-sectional survey approach. Iranian Journal of Nursing and Midwifery Research, 26(3), 285–287. Web.
Zhang, S., Ma, C., Meng, D., Shi, Y., Xie, F., Wang, J., Dong, X., Liu, J., Cang, S., & Sun, T. (2018). Impact of workplace incivility in hospitals on the work ability, career expectations and job performance of Chinese nurses: A cross-sectional survey. BMJ Open, 8(12), 1-9. Web.
