PICO
The PICO question for this study is: Among nurses, how effective is nursing peer review as compared a basic civility tutorial intervention in moderating lateral violence and incivility in the workplace?
Introduction: Key Issues
How Incivility Impacts the Nursing Profession
The issue of incivility in the workplace is one that affects all stakeholders in nursing—from supervisors to nurses on down to patients. Allen, Holland and Reynolds (2015) found, for instance, that when incivility occurs in the nursing environment, nurses can become burned out and can act in a detached manner out of defensiveness. If they feel that other nurses are being rude to them, they will neglect their duties and check out from the workplace environment. It can also lead to higher than normal turnover. Lim and Bernstein (2014) show that it can undermine a culture of care that is needed in the nursing workplace. Incivility can thus create an unstable atmosphere in the nursing profession.
How Incivility Impacts Patient Care
When nurses are negatively impacted by incivility, they stop being engaged, stop showing quality care to patients, and thus the problem of incivility ends up impacting the patient’s care and potentially the patient’s health in a negative manner (Allen et al., 2015). As patient care is the top priority of the nurse, lateral violence should be seen as an impediment to the nurse’s ability to implement quality care. Incivility, however, can causes nurses to call off work or quit altogether (Hamblin et al., 2015). Lateral violence thus impacts patient care by preventing nurses from being fully engaged in their work (Warrner, Sommers, Zappa & Thornlow, 2016) and nurses who are not fully engaged will not be able to show the highest concern and quality care towards patients, which is what patients deserve.
How Incivility Impacts Me as a Nurse
In my own experience, I have seen how incivility can cause dysfunction in the workplace. I myself have even sometimes caught myself being uncivil to others, as it is sometimes an unconscious behavior that goes unnoticed because I am not maintaining the right state of mind. Stanton (2015) shows that incivility is often a behavior that nurses are not even aware they are doing, and this makes it all the more important for nurses to be able to identify and reduce it in the workplace. I know that if I am being uncivil to a co-worker, it comes back to haunt me by making the work environment more difficult, and I know that when I have felt unkindness from others, it has frustrated me and made me not want to be there.
Solutions
The review of literature did help me to identify solutions. Lim and Bernstein (2014) recommended collaboration among nurses to reduce incivility in the workplace. And one way to achieve collaboration is through the nursing peer review process (Bergum et al., 2017). Another potential solution is to focus on organizational culture changes (Johnson, 2015) and increase the positive culture by promoting collaborative care, communication and respect.
The solutions...
References
Allen, B. C., Holland, P., & Reynolds, R. (2015). The Effect of Bullying on Burnout in Nurses: The Moderating Role of Psychological Detachment. Journal of Advanced Nursing, 71(2), 381-390.
Bergum, S. K., Canaan, T., Delemos, C., Gall, E. F., McCracken, B., Rowen, D., ... & Wiens, K. (2017). Implementation and evaluation of a peer review process for advanced practice nurses in a university hospital setting. Journal of the American Association of Nurse Practitioners, 29(7), 369-374.
Hamblin, L., Essenmacher, L., Upfal, M., Russell, J., Luborsky, M., Ager, J., & Arnetz, J. (2015). Catalysts of worker-to-worker violence and incivility in hospitals. Journal of Clinical Nursing, 2458-2467.
Johnson, S. L. (2015). Workplace bullying prevention: a critical discourse analysis. Journal of Advanced Nursing, 71(10), 2384-2392.
Lim, F., & Bernstein, I. (2014). Civility and workplace bullying: Resonance of Nightingale's persona and current best practices. Nursing Forum, 49(2), 124-129.
Manojlovich, M., & Ketefian, S. (2016). The effects of organizational culture on nursing professionalism: Implications for health resource planning. Canadian Journal of Nursing Research Archive, 33(4), 15-33.
Stanton, C. (2015). Action needed to stop lateral violence in the perioperative setting. AORN journal, 101(5), P7-P9.
Warrner, J., Sommers, K., Zappa, M., & Thornlow, D. (2016). Decreasing workplace incivility. Nursing Management (Springhouse), 22-30.
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Introduction Incivility is a problem in many nursing workplaces around the world and it is a problem because people from time to time forget what it is they are there to do. The nurse is there to serve the patient and to support other nurses in their duties to the patient. However, nurses can become unhappy, dissatisfied, angry and unfriendly. They can bully one another, neglect one another, and cause emotional
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