Change Implementation and Management Plan

Civility in the workplace is essential to promote a healthy workplace environment for employees along with those they serve. According to the American Association of Critical care. Nurses, there are six standards for establishing a healthy work environment, including skilled communication, effective decision making, appropriate staffing levels, effective collaboration, authentic leadership, and meaningful recognition (Broome & Marshall, 2021). The American Nurses Association Code of Ethics clearly highlights that nurses have the responsibility of fostering safe, ethical, and civil workplaces.

Completing the Work Environment Assessment to determine the overall civility score of my workplace yielded a score of 53. Based on this score my work environment is considered to be very unhealthy. My assessment was dominated by somewhat untrue statements, three somewhat true statements and one completely untrue statement. Incivility can include rude, impolite, disrespectful behaviors and other behaviors that violate norms (Marshall & Broome, 2017). I believe what makes my work environment so uncivil is the inability of all staff to trust leadership and the lack of accountability.

The current nursing leader in place came friends and family of that leader as employees, which has created an unhealthy environment. I have experienced incivility because of this, mental health technicians have disrespected me and patients and when I approached leadership, I was told it would be addressed. After that incident I felt that I could not approach leadership because the conversation had been shared with others, getting back to the staff member involved which then caused conflict. The staff member was never directly addressed, the MHT continues to talk inappropriately to staff and patients and I believe it is because the  MHT is a close friend of the director of nursing.

Incivility in our profession can have negative effects on staff, the team, and the organization (Clark, 2019). According to Clark (2015), staying silent and not addressing uncivil behavior as difficult as it may can increase stress, impact job performance, and eventually put patient care at risk. Learning about an evidence-based technique like cognitive rehearsal to address incivility will be helpful to me in the future. Cognitive rehearsal is designed to decrease anxiety and increase confidence through practice of this technique to effectively address a stressful environment. To address the problems nurses should understand the significance of effective communication. Clark (2015) states that engaging in clear courteous communication promotes a  civil work environment, enhances teamwork and collaboration, and ultimately improves patient care outcomes. According to Griffin and Clark (2014), one of the ways of fostering healthy work environments includes performing institutional assessments to assess incivility, organizational culture to facilitate the implementation of targeted interventions.

References  Broome, M., & Marshall, E. S. (2021). Transformational leadership in nursing: From expert         clinician to influential leader (3rd ed.). Springer

Clark, C. M. (2019). Combining cognitive rehearsal, simulation, and evidence-based scripting to       address incivility. Nurse Educator, 44, 64-68.  https://doi.org/10.1097/NNE.0000000000000563

Clark, C. M. (2015). Conversations to inspire and promote a more civil workplace. American     Nurse Today, 10(11), 18–23. https://pubmed.ncbi.nlm.nih.gov/29792131/

Marshall, E., & Broome, M. (2017). Transformational leadership in nursing: From expert       clinician to influential leader (2nd ed.). Springer.