Nurse Leaders’ Perceptions on Factors Contributing to Incivility and Attributes of Collaborative Work Environments






Kenia Prera, MSN, BSN, RN, PHN

Thesis Abstract

 

BACKGROUND:  

Incivility in the nursing workplace continues to be a growing burden to the profession of nursing.

Terms such as workplace violence, workplace bullying, lateral/ horizontal violence, and vertical

violence have all been used interchangeably to describe the type of new age violence nurses are

encountering in the workplace today. The literature reports incivility prevalence rates in healthcare

upwards of 80%, while non-healthcare related industries have a prevalence rate of just 15%.

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Meanwhile, prevalence rates of workplace bullying in nursing alone are currently trending at 40- 60%

worldwide. Aggressive behavior in the nursing workplace lends itself to so much more than a toxic

work environment, dishonesty, poor communication, little productivity, and inefficient collaboration. It

directly impacts the wellbeing and mental health of the nurses who are targeted making it difficult for

them to carry out normal tasks. Consequently, this lends itself to medication errors, lapses in

judgment, and inadvertently compromising the heart of it all – the patients.

 

As a result, the organization begins to reap the effects of incivility with worsening morale, poor reputation, job

satisfaction, employee retention, increased turnover, and ultimately a deteriorating bottom-line. Once

an organization’s bottom line is impacted and all that is left are the toxic employees and perpetrators

that started the catastrophic cascade of events, there is very little hope of making a full recovery. Still,

it does not end there. The repercussions of incivility are felt on a global scale, as it further burdens the

nursing shortage crisis as well as the waning reputation of the once golden nursing profession.

 

PURPOSE:

This study explored organizational factors that perpetuate incivility and those which contribute to effective teamwork and collaboration as perceived by nurse leaders.

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The following research questions (RQs) were used to create the foundation of the study in which various other interrelated concepts were identified and explored further.

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1) Which organizational factors contributing to incivility and workplace bullying do nurse leaders cite most often?

2) Which organizational attributes deemed necessary to promote a collaborative work environment were most often cited  by nurse leaders?

 

DESIGN: The researcher used a non-experimental, quantitative, correlational descriptive design to complete this study. The design included online surveys and an independent web-based company to collect the data from participants completing the surveys. 

 

SETTING & SAMPLE: The study incorporated the use of an online web-based platform through which data was collected via online surveys. The survey allowed the researcher to collect information including demographic data. Through this web-based platform, participants were able to respond to Likert scale type questions designed by the researcher. The sample consisted of 58 registered nurses. 

 

METHODOLOGY: This study incorporated the use of both non-probability and purposive sampling through the use of a web-based survey consisting of Likert style questions. 

 

RESULTS: It was found that nonverbal innuendos had the highest frequency ratings in terms of uncivil behaviors encountered. The most common form of incivility identified was vertical incivility. The most frequently cited organizational factors contributing to incivility were found to be organizations with frequent turnover in leadership and organizations with high nursing staff turnover. The most frequently cited attributes of organizations found to foster teamwork and collaboration were organizations that value mutual respect and those which provide regular training and education. 

 

CONCLUSION: Further qualitative focused group studies would be recommended to inquire upon some of the subjective feedback provided by participants in this study. The data clearly reveals that incivility and bullying in the nursing workplace continues to be an issue in 2024 and as we embark upon a new year, it is more crucial than ever to band together and eliminate incivility, bullying, and workplace violence altogether from nursing. 

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