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Creating and Sustaining Civility in Nursing Education - Chapter 2

Creating and Sustaining Civility in Nursing Education - Chapter 2

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Published by Brent Patrick
By Cynthia Clark, PhD, RN, ANEF, FAAN
By Cynthia Clark, PhD, RN, ANEF, FAAN

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Published by: Brent Patrick on Feb 28, 2013
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03/01/2013

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Chapter 2
The Costs andConsequences of Incivility:Rationale for Change
“Civility costs nothing and buys everything.” –Mary Worley Montagu
This chapter discusses:
•Thehumanandscalcostsofincivility•Reasonsforaddressingincivility•Civilityandadvancingournation’shealth
The High Cost of Incivility
Thecostsofincivilityarevastandimpactusinmyriadways.Disruptiveandintimidatingbehaviorscanhavenegativeandlastingeffectsonindividuals,teams,andorganizations.Recently,IwasdeeplymovedwhilereadingtheforewordofanexcellentbookauthoredbyPearsonandPorath(2009),
The Cost o Bad Behavior: How Incivility IsDamaging Your Business and What to Do About It.
TheforewordiswrittenbyWarrenBennis,ascholarlygiantandconsultantintheeldoforganizationalleadership.Bennistitlestheforeword“LittleMurders”andwritesagrippingaccountofhisobservationsofincivilityintheworkplaceinthelate1950swhilestudyingdoctor-nurserelationships.Thestory
 
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Creating & Sustaining Civility in Nursing Education
takesplaceinanoperating-roomtheaterbetweenagiftedsurgeonandanORnurse.Duringaparticularlygruelingandlengthysurgicalprocedure,thesurgeongrewmoreandmoreinfuriatedanddemandingofthenurse.Inhisestimation,thenursewastooslowandfailedtohandhimthesurgicalinstrumentsinaproperway.Thesurgeonscreamedatthenurseinaprofaneandextremelydemeaningmanner.Thenurserespondedwithherownlevelofragebyslammingtheinstrumentsintothesurgeon’shandwithsuchviolentforcethatthedoctor’spalmwasrawandreddened.Bennisandhiscolleagueslaterdescribedthenurse’sbehavioras“spitefulobedience”andconcludedthatincivilityisapervasiveconditioninworkplacesaroundtheworld,onethattendstobeheightenedwhentheworldissufferingfromdiscontentanduncertainty.Bennis’graphicandvividdescriptionofdoctor-nurseincivilitymadealastingimpressiononme.First,Bennischosetofocusonthebusinessofhealthcaretoillustratethecostsandimpactofincivility.Forme,thiswasajarringaspectofthestory,becauseeventhoughitwasindirect,itwasastoryaboutus—thedoctorsandnurseswhosejobitistodeliverqualitypatientcareandtoadvocateforpatientsafety.Second,tothisday,Iwonderwhathappenedtothepatient.Whatwastheimpactofsuchaerceandaggressiveencounteronthepatient?Iwasleftreelingfromtheaccountandwasremindedonceagainabouttheseriousconsequencesofincivility,particularlyinhealthcare,wherethestakesarehighandtheoutcomecanresultinlifeordeath.PearsonandPorath(2009)foundthat95%ofAmericanworkersreportedexperiencingincivilityfromcoworkersandconcludedthatincivilityoccursin“nearlyallsettings,bypeopleofallages,aspartoftheirdailyroutine”(p.23).Asaresult,manyworkersareactivelydisengagedandlessproductive,andsomeintentionallyunderminetheirorganizationandtheircoworkers.Theauthorspresentasetofactionstepsandmathematicalequationstocalculatethecostofevenoneuncivilemployeeinanorganization.Asanexample,theauthorsdescribetheimpactofoneuncivilemployeeinahospital—thecostsofincivilityescalatewhenoneincludestheexpensesassociatedwithsupervisingtheemployee,managingthesituation,consultingwithattorneys,andinterviewingwitnesses(doctors,nurses,patients,andothersimpactedbytheoffenderorwhowitnessedtheincivility).Inthiscase,thehospitallostmorethan$25,000asaresultofoneuncivilepisode.
 
19
Chapter 2:
The Costs and Consequences of Incivility
the Costs of InCIvIlIty
35% o workers in the United States have experienced bullying frsthand.62% o the bullies are men.58% o the targets are women.80% o the time, women bullies target other women.30% o bullied employees will resign rom their jobs, and 20% o those who witness bullying will also leave the organization.The annual cost to U.S. organizations is around $300 billion.
Center(2011);TheWorkplaceBullyingInstitute(2010)
Thisimportantinformationshouldbeofinteresttoallemployersandemployees.AsImentionedinChapter1,Ioftenhearpeoplesay,“Wedon’treallyhaveanincivilityproblem,becauseweonlyhaveoneortwotoxicemployees,orjustafewstudentswhobehavebadly,oronlyacoupleofuncivilfacultyinournursingschool—soit’snobigdeal.”Again,Istronglycontendthatthecostofevenoneuncivilindividualcanhaveadeeplysystemiceffectandpotentiallydevastateaworkplace.Clearly,incivilityintheworkplaceisaseriousproblem.Nearlyadecadeago,FarkasandJohnson(2002)foundthat79%ofsurveyrespondentsagreedthatrudenessandincivilityweregrowingandseriousproblemsintheUnitedStates.InamorerecentstudybyKRCResearch(2011),investigatorsfoundthat65%ofrespondentsbelievethattheUnitedStateshasamajorcivilityproblemandthatAmericansexpectcivilitytoerodeevenfurtheroverthenextfewyears.Theresearchersalsofoundthat43%oftherespondentsreportedexperiencingincivilityatwork,and38%believethattheworkplaceisbecomingmoreuncivilanddisrespectfulthanafewyearsago.Theacademicsettingisnoexception.ClarkandSpringer(2010)studiedacademicnurseleaders’perceptions
of incivility and found that student and faculty stressors, such as heavy
workdemands,nancialpressures,andlackofadministrativesupport,canleadtoincivility.Theacademicnurseleadersinthestudymadeseveral

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