This is the first-known quantitative study to measure nursing faculty perceptions of faculty-to-faculty incivility. A total of 588 nursing faculty representing 40 states in the United States participated in the study. Faculty-to-faculty incivility was perceived as a moderate to serious problem. The behaviors reported to be most uncivil included setting a coworker up to fail, making rude remarks or put-downs, and making personal attacks or threatening comments. The most frequently occurring incivilities included resisting change, failing to perform one’s share of the workload, distracting others by using media devices during meetings, refusing to communicate on work-related issues, and making rude comments or put-downs. Stress and demanding workloads were two of the factors most likely to contribute to faculty-to-faculty incivility. Fear of retaliation, lack of administrative support, and lack of clear policies were cited as the top reasons for avoiding addressing the problem of incivility
OBJECTIVE To describe the impact of the implementation of interprofessional shared governance and a caring professional practice model (Relationship-Based Care [RBC]) on the staff's self-report of caring, work engagement, and workplace empowerment over a 4-year time frame. BACKGROUND Shared or interprofessional governance has moved mainstream within healthcare settings, particularly within agencies seeking to sustain high reliability in the offering of quality patient care services and/or interest in meeting Magnet® standards or embarking upon the Pathway to Excellence®. Nurse leaders report that organizations having implemented shared governance thrive, citing professional governance as key to workplace engagement and empowerment, particularly related to quality care initiatives. Transition to interprofessional shared governance structures typically takes 2 to 3 years. It is unknown whether related outcome variables are sustainable over time. METHODS Utilizing Watson's theory of human caring and appreciative inquiry as underlying frameworks, a longitudinal, quantitative study design was employed. Interprofessional focus groups and introductory sessions were offered to inform and engage all personnel within the medical center. Motivated units were identified, professional shared governance council members elected, and unit-specific education provided. Quality improvement initiatives were facilitated within unit councils, and formal leadership programs to enhance project guidance and to support staff empowerment skills for the managers of the units that were up-and-running were provided. Preimplementation and postimplementation measurements of staff's caring, workplace engagement and work empowerment were assessed, compared, and trended across units over time. RESULTS Only work empowerment scores among staff working within RBC units were sustainable and increased progressively and significantly over time. Work engagement levels initially rose and then stabilized over time. Caring levels remained stable despite the implementation of a caring professional practice model. Statistically significant correlations were noted between work engagement and empowerment, followed by the relationship between work engagement and caring, followed by the relationship between empowerment and caring. CONCLUSIONS The sustainability of work empowerment is likely related to the periodic provision of education for leaders regarding leading within an empowered work environment. A stronger focus on staff caring, particularly within quality improvement initiatives, with leadership guidance, will be paramount moving forward.
Incivility in healthcare can lead to unsafe working conditions, poor patient care, and increased medical costs. The authors discuss a study that examined factors that contribute to adverse working relationships between nursing education and practice, effective strategies to foster civility, essential skills to be taught in nursing education, and how education and practice can work together to foster civility in the profession.
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