The emergency department is one of the most high stress environments in healthcare facilities. This is due to the variety and numerous acute stressful activities and events (Ahwal & Arora, 2015). Nurses are not excluded from the stressful environment in the emergency departments. Some of the challenges within the emergency department that tend to increase the stress on nurses include aggression incidents, being involved in resuscitation, death of patients, the need to make fast and accurate decisions that may be physically and emotionally very challenging (Ahwal & Arora, 2015).
In the case where the stress and stressful environment are not managed appropriately, there may be severe negative effects on the provider, patient and even the facility. Some of these negative consequences include poor patient outcome, compromised patient safety and dissatisfaction for the nurses, burnout, and negative health effect of the nurses and reduced organizational productivity (Yuwanich et al., 2017). There is therefore need for the nurses and other providers to learn how to handle the stressful events and work environments including the emergency departments. From the scenario, communication and collaboration with other providers have been identified as being important aspects and strategies that help nurses cope with the stressful environment at work. These are very important and helpful. Strategies that can help improve coping with the stressful environment include debriefing such as talking and seeking help from other colleagues, positive reframing such as smiling and taking time to rest, sleep, meditate and exercise among others (Yuwanich et al., 2017).
References
Ahwal, S., & Arora, S. (2015). Workplace stress for nurses in emergency department. IJETN, 1(2), 17-21.
Yuwanich, N., Akhavan, S., Nantsupawat, W., & Martin, L. (2017). Experiences of occupational stress among emergency nurses at private hospitals in Bangkok, Thailand. Open Journal of Nursing, 7(6), 657-670.
I agreed with your post Sunday, Incivility among healthcare workers can thus lead to unsafe working conditions and the safety of a patient. Care providers and organizational leaders must communicate in a way that fosters civility and empowers nurses to speak up. They must strive to create and sustain a healthy work environment where courtesy is evident. Overall, Companies should come up with a no tolerance policy for incivility in the workplace. The procedure could have a penalty resulting in every infringement, verbal caution for the initial offense, written caution for the second mistake, non-payment leave for the third one, and termination. The department of human resources should be included in the policymaking process. If incivility at the workplace is tolerated, destructive behaviors become commonplace and continue in the working environment. Each team member in a company should be educated on the right professional characters with the job code of conduct. Both staff and nurse managers must have the ability to identify it, taking it seriously, and cease the action in its ways.
References
Broome, M. E., & Marshall, E. S. (2021). Transformational leadership in nursing: From expert clinician to influential leader (3rd ed.). Springer Publishing Company.
Cimarolli, V. R., Bryant, N. S., Falzarano, F., & Stone, R. (2022). Factors associated with nursing home direct care professionals’ turnover intent during the covid-19 pandemic. Geriatric Nursing, 48, 32–36. https://doi.org/10.1016/j.gerinurse.2022.08.012Links to an external site.
Clark, C. M. (2019). Combining cognitive rehearsal, simulation, and evidence-based scripting to address incivility. Nurse Educator, 44(2), 64–68. https://doi.org/10.1097/nne.0000000000000563Links to an external site.
I have been through the same type of experience that you have when it comes to nurse compensation. All intensive care units (ICU) nurses in my workplace received a pay incentive for taking care of high acuity patients. The medical surgical nurses made the same argument that they have higher nurse to patient ratios, which made their job more physically demanding. Since our hospital is unionized, this disagreement led to the ICU pay incentive being taken away. Although I am an ICU nurse, I was ok with the decision for the pay incentive to be taken away. I believe that ICU nurses should not be compensated based solely on the acuity of their patients. This can lead to bullying and a toxic work environment between nurses. A toxic work environment can result in loss of motivation, restricted productivity, clinical errors, burnout, and increased turnover (Wei et al., 2018). Ultimately this leads to poor patient care and higher hospital mortality rates. I am frequently floated to the med surge unit when the ICU census is low, so I would never want there to be tension between me and the other nurses. I would rather have a healthy working relationship with the med surge nurses, so they are more receptive to helping me become familiarized with the med surge floor. In return, I can help by offering my ICU skills, such as inserting a peripheral intravenous line on a difficult patient.
When it comes to compensation, I believe pay incentives should be awarded based on education and years of experience instead of patient acuity. This levels the playing field for every nurse no matter where they work. Awarding a pay increase for receiving higher education, passing a national certification, or implementing a patient project pushes a nurse to grow professionally. This puts the focus on nursing education and career development. Continuous education improves the quality of nursing care and increases the effectiveness of patient care, consequently maintaining and enhancing patient safety (Mlambo et al., 2021).
Mlambo, M., Silen, C., & McGrath, C. (2021). Lifelong learning and nurses’ continuing professional development, a metasynthesis of literature. BioMed Central Nursing, 20(62). https://doi.org/10.1186/s12912-021-00579-2
Links to an external site.
Wei, H., Sewell, K. A., Woody, G., & Rose, M. A. (2018). The state of science of nurse work environments in the United States: A systemic review. PubMed Central, 5(3), 287-300. https://doi:10.1016/j.ijnss.2018.04.010
Working in a peaceful environment is all that every individual needs to perform their work to the best of their ability. The Clark healthy workplace inventory is a tool use to assess the health of workplace (Clark 2015). When an individual is in a workplace and the environment is very toxic, the productive is less, motivation is less and morals of the staff are at all time low which can affect the consumers which in this case the patient. Before this assessment, i was aware of some of the negative aspect of the workplace incivility but did not release that my workplace can be very toxic and uncomfortable for some staff to work peacefully. There are various issues that happens in every floors (units) in different days, times and shifts which can greatly affect the patience, staffs and family members.
There are various incivility among workplace not to exclude gossiping, belittling, disrespect among staffs, inappropriate jokes, bullying and lack of communications. Based on my results of 72 of the civility test, my workplace happens to be in the range of mildly civil which most of the common incivil issues that most workplace do encounter doesn’t happen at my facility. There are are lot of reason why any environment can be considered civil or not. At my workplace which is a nursing rehab facility with a psych unit included, there are lower retention rate among staff both regular nurses and managerial positions staffs. There are instances where there will be staff meeting only on how respectful and courteous we the old staffs are to be towards new staff to make the environment very welcoming to boost the retention rate in the facility.
The major issue at the facility i worked for is lack of communications among staff during change of shifts, rounds, improper break time and cleanliness at the work stations. The are many instances that i experienced incivility at the job but the one that happens a lot at the nursing home among new and old nurses is bullying. The workplace bullying has been on the raise but majority of individuals refuse to report such incivility to the management due to fear of retaliations from others staff members. There are various ways individuals are encourage to report such behavior to the appropriate department which in some cases, little or nothing will be done of such behavior. There was a particular season nurse on the psych unit who always bully, belittle and disrespect new staff nurses on that unit. She will refuses to work behind new nurses. She was receiving nursing report from a new nurse who happened not to complete a new admission that arrived at the facility at 2:10pm. She began calling the new nurse “lazy ass nurse who can’t seems to complete anything to the fullest.” This incident was witnessed by a family member who was leaving the facility and happened to be at the elevator.
The season nurse was so loud that another patient who room was close to the nursing station also heard her rude comment towards the new nurse. Since she refuses to take the admission report from the new nurse, this particular nurse stayed over after punching out from the system and completed the admission. Before leaving the facility , the new nurse wrote a very detail experienced that she encountered from the season nurse and inform the DON that she won’t be returning back to the place again. Also both the family member and the patient who witnessed this incivity both wrote a letter to the DON. The next day a meeting was held which the rude incivility listed above was made aware to all staffs in the meeting. The season nurse was then suspended for a whole week which upon her returned back to the job, she repeated a similar behavior again towards another season nurse and was eventually fired. To solve such problem, there was a policy place for zero tolerance of bullying, use of inappropriate languages and disrespect among staffs which the ultimate results include suspension not to exclude termination of employment. The civility of an organization is crucial as it influences the health of a workplace, which significantly affects employee job satisfaction, performance, and productivity (Broome & Marshall, 2021).
Conclusion.
Incivility can lead to shortages of staffs, lack of motivation and stress among employees. This is very unfortunate for anyone to work in such unpleasant environment. When the Clark healthy assessment tool are used in the workplace, the environment becomes pleasant for the workers, less errors are made due to the less stress that are among the workers.
Reference
Broome, M., & Marshall, E. S. (2021). Transformational leadership in nursing: From expert clinician to influential leader (3rd ed.). New York, NY: Springer.
Clark, C. M., Olender, L., Cardoni, C., Kenski, D. (2011). Fostering civility in nursing education and practiceLinks to an external site.. The Journal of Nursing Administration, 41(7/8), 324–330.