NURS 6053 Discuss Workplace Environment Assessment

NURS 6053 Discuss Workplace Environment Assessment

NURS 6053 Discuss Workplace Environment Assessment

Incivility refers to a milder form of uncivil behavior conducted with the aim of harming the target.  All forms of incivility entail dysfunctional interpersonal relationships attributed to high employee turnover and low quality of care (Kisner et al., 2018). Nurses have a responsibility to establish and promote healthy interpersonal relationships with one another. They need to know how their communication and behavior or failure to act can cause incivility (Abdollahzadeh et al., 2017). This essay will analyze the results from the Work Environment Assessment, review literature on incivility, and explore evidence-based strategies to create high-performance interprofessional teams.

Work Environment Assessment

Results of the Clark Healthy Workplace Inventory

My workplace scored 67/100 on the Clark Healthy Workplace Inventory. The result suggests that the workplace environment is Barely Healthy (Clark, 2015). This was an unexpected score, as I expected to have at least a score in the moderately healthy range.  I was surprised that we only scored 5 points in only four items. It is somewhat surprising that our organization could only score the maximum points in only four items, which means that we have a long way to promote a healthier workplace. The four items include: Promotion of Teamwork and collaboration, Treating employees fairly and respectfully, using effective conflict-resolution skills, and Providing competitive salaries, benefits, compensations, and other rewards.  

According to Karen Tomajan, an advocate is one that pleads, defends, or supports a cause or interest of another (2012). Nurses are trained to advocate for their patients, but we must advocate for each other and ourselves as leaders. Collaboration, negotiation, and compromise can help a nurse leader promote change on behalf of staff members. Communication has been seen to be a critical factor in good leadership. This also applies to nurse leaders advocating for their employees and communicating with employees/colleges seeking input, following up, being aware, and providing open communication. Creating a reasonable, safe, and tolerable working condition can increase engagement, reduce stress and anxiety, and promote higher employee satisfaction, leading to better employee satisfaction. Research studies have shown this to improve patient outcomes. Using data from the American Nurses Association’s National Database of Nursing Quality Indicators, researchers discovered that a 25 percent increase in nurse job enjoyment over two years was linked with the overall quality of care increase between 5 and 20 percent (Walker, 2018). Case studies have linked on different occasions that there is a correlation between employee satisfaction and patient care.

I was also surprised that my workplace scored 1 point in two items in the Clark Inventory. This was surprising because our organization belongs to a caliber that should not have very low scores on matters associated with healthy workplaces.  The two items that had the lowest score were: The workload being reasonable, manageable, and fairly distributed and Organization attracting and retaining the best and the brightest.

Before completing the Clark Inventory, I assumed that unreasonable and unmanageable workload is a primary cause of failing to retain the organization’s best staff. I believed that unbearable nursing workloads and nurses shortages are interconnected, in that each leads to the other. This was confirmed by the assessment, where I established that the high unmanageable nursing workload in our workplace is the primary reason for failing to retain staff.

What the Results Suggest About the Health and Civility of My Workplace

The assessment results indicate a stressful work environment that can be attributed to an unreasonable, unmanageable, and unfairly distributed workload.  A Barely Healthy workplace suggests a problem with the organization’s leadership; in that, the leaders are more goal-oriented than people-oriented. This results in the management focusing more on meeting its clients’ needs at the expense of the staff needs (Abdollahzadeh et al., 2017).  The results also mean that the staff’s needs may be overlooked, and their voice is not often considered during policy-making. Furthermore, they suggest that the staff may not be adequately engaged in making decisions that affect them, and the leadership does not recognize shared governance.

 Despite the average results, the organization scored highly in items that indicate high civility in the workplace. These items include: Promotion of Teamwork and collaboration, Treatment of employees fairly and respectfully, and Use of effective conflict-resolution skills (Clark, 2015). The high scores in these items suggest that a culture of civility has been developed in the workplace.  It also means that the employees have strived to create and maintain civil, healthy work environments by communicating clearly and effectively, despite the harsh working environment. Besides, it shows that the staff manages conflict in the workplace respectfully and responsibly.

Reviewing the Literature

The article by Clark (2015) presents the concept of healthy work environments. The article mentions the six standards by AACN that are vital in establishing and sustaining healthy work environments, namely, skilled communication, effective decision-making, true collaboration, appropriate staffing, meaningful recognition, and authentic leadership (Clark, 2015). Clark also presents other standards from her research, crucial in promoting healthy work environments, which include: A common organizational vision, values, and team norms; Emphasis on both formal and informal leadership; Creation and sustenance of a high level of the individual, team, and organizational civility; and Civility conversations at all organizational levels.

Clark argues that when an uncivil encounter occurs, we may require to address it by having a critical conversation with the uncivil person. One needs to be well-prepared for this critical conversation, speak with confidence, and use respectful expressions (Clark, 2015). Critical conversations are often stressful. Thus, while taking a direct approach to resolving a conflict, it requires courage, know-how, and lots of practice. By having this conversation, one can end the silence that surrounds incivility. The article presents the DESC model, which can be used to address incivility in the workplace. The DESC model has four elements: D-Describe the specific situation, E-Express your concerns, S-State other alternatives; and C-Consequences stated (Clark, 2015). The critical conversations can occur more effectively when one is well-equipped with tools like this DESC model.

How the Concept Presented In the Article Relates To the Results of the Work Environment Assessment

The concept on the standards of sustaining a healthy work environment relates to the assessment results, in that ineffective decision-making, lack of appropriate staffing, and lack of authentic leadership in the organization has resulted in a less healthy environment. Lack of authentic leadership is evident in the workplace environment, which suggests that the organization’s leaders have not put much effort into ensuring the staff work in a healthy work environment. The leaders at my organization do not initiate or encourage open discussions and dialogues on promoting a healthy workplace. If they do so, they could have identified key factors that create a harsh working environment, such as inadequate staffing.

Ineffective decision-making by failing to engage the employees has contributed to a less healthy workplace. This is because the staff’s opinions on enhancing the workplace environment are not incorporated in policy-making. The low assessment results can be related to the employees’ failure to initiate a critical conversation with the management on issues that affect them. Perhaps, if we expressed their concerns to the leaders, we could be heard, and the various issues that negatively impact the workplace could be addressed. The tense relationship between the employees and the management can be attributed to the lack of conversations between the two groups, which is critical in ending the silence surrounding incivility.

How My Organization Could Apply the Concept to Improve Organizational Health

My organization can apply the identified standards to enhance organizational health by having direct and transparent communication at all organizational levels to promote respect among the staff and between the staff and the supervisors. The management can actively engage the staff by consulting or involving them in decision-making and developing organizational policies (Griffin & Clark, 2014). Additionally, the organization’s employees can apply the concept of critical conversation to discuss with the management on issues affecting them, such as inadequate staffing (Clark, 2015). Critical conversations can be started among the employees to help solve conflicts, especially between different professions, to help create strong intra- and interprofessional health teams.  

Evidence-Based Strategies to Create High-Performance Interprofessional Teams

Strategies That Can Be Implemented To Address Any Shortcomings

The article by Clark (2019) discusses the use of Cognitive Rehearsal to address incivility that threatens patient safety.  Cognitive rehearsal (CR) is a technique employed in behavioral science whereby people work with a skilled facilitator to identify and rehearse effective methods of addressing a problem or social situation (Clark, 2019). It is intended to lessen anxiety, enhance confidence, and increase impulse control by practicing effective methods to solve potentially stressful situations. CR has been established to be an effective strategy to solve incivility in clinical practice and educational settings (Clark, 2019). A planned, rehearsed response presents a chance to convey expectations for appropriate behaviors and future interactions.

The article by Kisner et al. (2018) discusses the Mixed-intervention strategy, which effectively addresses incivility. The strategy entails the following steps: Providing personal support, education, and mediation between the perpetrator and the target. Using corrective action to discipline the perpetrator and educating the target to handle aggression (Kisner et al., 2018). The strategy also involves imposing policies and penalties to deal with aggressive behaviors. The last step is encouraging social interaction and interventions that promote collective responsibility in creating a safe and supportive culture.

Strategies That Can Be Implemented To Bolster Successful Practices

Successful practices in the workplace environment can be enhanced by holding Team-building sessions in organizations. The team-building sessions should build trust, engage staff in decision-making, clarify roles, and role-model positive interactions. Simulation can be employed in these sessions to promote better teamwork and collaboration. For instance, the simulation activity can involve a nurse role-modeling positive interactions with other nurses. The role-modeling can be useful in demonstrating to the staff the power of positivity in employees’ communication.

Organizations can develop and impose a zero-tolerance policy for incivility, which clearly outlines uncivil behaviors. The policy should be clear that incivility will not be tolerated in the organization, and if it happens, consequences will result. For instance, the policy can indicate that a staff who displays uncivil conduct will be given a verbal and written warning for each violation, and after three violations, they will be terminated. A policy is a very effective strategy as it outs employees conducting incivility on notice. Once the policy is developed, the management can conduct staff development programs for staff and managers about the zero- incivility tolerance policy. The programs can include enhancing communication skills, challenging culprits, and using silence to facilitate thinking.


Abdollahzadeh, F., Asghari, E., Ebrahimi, H., Rahmani, A., & Vahidi, M. (2017). How to Prevent Workplace Incivility?: Nurses’ Perspective. Iranian journal of nursing and midwifery research22(2), 157–163.

Clark, C. M. (2019). Combining cognitive rehearsal, simulation, and evidence-based scripting to address incivility. Research in Nursing Education| Nurse Educator44(2), 64-68.

Clark, C. M. (2015). Conversations to inspire and promote a more civil workplace. American Nurse Today10(11), 18-23.

Griffin, M., & Clark, C. M. (2014). Revisiting cognitive rehearsal as an intervention against incivility and lateral violence in nursing: 10 years later. The Journal of Continuing Education in Nursing45(12), 535-542.

Kisner, T. (2018). Workplace incivility: How do you address it?. Nursing201948(6), 36-40.

You may think your current organization operates seamlessly, or you may feel it has many issues. You may experience or even observe things that give you pause. Yet, much as you wouldn’t try to determine the health of a patient through mere observation, you should not attempt to gauge the health of your work environment based on observation and opinion. Often, there are issues you perceive as problems that others do not; similarly, issues may run much deeper than leadership recognizes.

There are many factors and measures that may impact organizational health. Among these is civility. While an organization can institute policies designed to promote such things as civility, how can it be sure these are managed effectively? In this Discussion, you will examine the use of tools in measuring workplace civility.

To Prepare:

  • Review the Resources and examine the Clark Healthy Workplace Inventory, found on page 20 of Clark (2015).
  • Review and complete the Work Environment Assessment Template in the Resources.

By Day 3 of Week 7

Post a brief description of the results of your Work Environment Assessment. Based on the results, how civil is your workplace? Explain why your workplace is or is not civil. Then, describe a situation where you have experienced incivility in the workplace. How was this addressed? Be specific and provide examples.

By Day 6 of Week 7

Respond to at least two of your colleagues on two different days by sharing ideas for how shortcomings discovered in their evaluations and/or their examples of incivility could have been managed more effectively.

Submission and Grading Information

Results of the Clark Health Workplace Inventory concluded that the organization I am employed with is a moderately healthy

workplace (Clark, 2015). I am surprised that the results fell in the category they did, I expected a lower score. The reasoning behind

the score I expected was because of the current pandemic. Employees are leaving for higher paying jobs and many have been

unhappy with the stress caused by the pandemic. However, the employees of the organization share the same vision to improve

the lives of the community and we have leaders that are open to listening to our concerns, maintaining a civil work environment. I

was also surprised by the emphasis by the assessment regarding employee self-care and teamwork. Even during the pandemic, ourNURS 6053 Discuss Workplace Environment Assessment

organization as encouraged self-care giving quiet rooms with massage chairs and our manager has been available even on

weekends and late at night to ensure the unit’s needs are being met. During the stress and chaos of the pandemic, I moved to the

intensive care unit. I was met by a unit that was constantly full of high acuity patients than normal even for the ICU. However, I

found that the team worked well together and communicated effectively presenting a work environment that was civil and healthy

and I am proud to be apart of .

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The main idea that I had regarding the results was that the organization runs smoothly because of the shared mission, values

and goals of the organization. Christus Good Shepherd’s mission is to extend the healing ministry of Jesus Christ with core values of

dignity, integrity, excellence, compassion, and stewardship. The vision of Christus Health is to be a leader and advocate in the

creation of innovative health and wellness solutions to improve the lives of the individuals of the community so that all may

experience the healing love of Jesus Christ (Christus Health, 2021). However, as shown by the results of the assessment not falling

in the top category, the current pandemic has put a strain on certain aspects including competitive pay and tension in everyday


One instance where I have felt that I had an uncivil encounter was when I was in the ICU and one of the physicians started yelling

orders at me during a stressful situation and griping in front of the patient that it was late in the day to be inserting lines and such.

Clark (2015) states that the most effective way to stop incivility is to address it when it occurs. However, this takes practice and

requires effective communication and competent dialogue. At the time, I was unable to address the physician outside of the

patient’s room, however I have a wonderful team that did address it with the doctor. The team member gently spoke with the

physician in the appropriate environment and reminded him that we are all exhausted, but that appropriate communication is

essential to decrease work stress between staff and provide safe and effective patient care. Working under conditions of civil

communication, promotes role performance of team members (Liu, et. al., 2020). Even under stressful working conditions, it is

important for each team member to promote a civil working environment to support optimum work performance of each team



Christus Health (2021). Christus Health: Our vision, mission, and values. Retrieved from


Clark, C.M. (2015). Conversations to inspire and promote a more civil workplace. American Nurse Today, 10(11), 18-23. Retrieved


Liu, Y., Vashdi, D. R., Cross, T., Bamberger, P., & Erez, A. (2020). Exploring the puzzle of civility: Whether and when team civil

communication influences team members’ role performance. Human Relations, 73(2), 215–241. https://doi-

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RE: Discussion – Week 7

Initial Post


Based off the Clark Healthy Workplace Inventory, my place of employment is rated as mildly healthy. It scored an average of 69 (Clark, 2019). Overall, this assessment made me think about what my organization has to offer and how I am valued as an employee but there are a few things that need to improve. Civility is about more than just politeness, although politeness is a necessary first step (Spath & Dahnke, 2021). It is about disagreeing without disrespect, seeking common ground as a starting point for dialogue about differences, listening past one’s preconceptions, and teaching others to do the same. Civility is the hard work of staying present even with those with whom we have deep-rooted and fierce disagreements (Spath & Dahnke, 2021). It is political in the sense that it is a prerequisite for civic action. But it is political, too, in the sense that it is about negotiating interpersonal power such that everyone’s voice is heard, and nobody is ignored (Spath & Dahnke, 2021).

After completing the Clark Healthy Workplace Inventory and scoring a 69 for my place of employment, this lets me know that my workplace is mildly healthy and a civil place of employment (Clark, 2019). A mildly healthy workplace is one in which workers and managers collaborate to use a continual improvement process to protect and promote the health, safety and well-being of all workers and the sustainability of the workplace by considering the following, based on identified needs (Stoewen, 2016):

  • Health and safety concerns in the physical work environment;
  • Health, safety and well-being concerns in the psychosocial work environment, including organization of work and workplace culture;
  • Personal health resources in the workplace; and
  • Ways of participating in the community to improve the health of workers, their families and other members of the community.

There was a time when I faced incivility at my workplace. After Covid-19 started the healthcare system took a tumble. Nursing shortage grew even bigger, and more nurses left their primary place of employment and went traveling. One morning working on a covid unit with 16 patients who were all Covid and there were only two nurses. It was me who have been a nurse for over 10 years and a new nurse with less than 1 year of experience. We both had 8 patients and they kept us busy. I became so tired and exhausted and just started crying. It seems like the floor manager did not care because she was supposed to help us and was no where to be found. Then nursing supervisor was contacted and it was like they could not send us any help and therefore we had to toughen it out. At that moment I felt my place of employment was incivility and we were not valued as employees although we were putting our nursing license on the line as well as not providing the proper care to our patients.




Clark, C. (2019, November 11). Conversations to inspire and promote a more civil workplace. Let’s end the silence that surrounds incivility. Retrieved from American Nurse Today website:

Spath, T., & Dahnke, C. (2021). What is Civility? – The Institute for Civility in Goverment. Retrieved from The Institute for Civility in Goverment website:

Stoewen, D. L. (2016). Wellness at work: Building healthy workplaces. The Canadian Veterinary Journal = La Revue Veterinaire Canadienne, 57(11), 1188–1190. Retrieved from

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.


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 Nursing48, 32–36. to an external site.

Clark, C. M. (2019). Combining cognitive rehearsal, simulation, and evidence-based scripting to address incivility. Nurse Educator44(2), 64–68. to an external site.

 An environmental assessment is a chance to navigate and watch the workplace, learn more about the environment in which employees work and the physical factors that support or hinder employee health, and assess the organizational and physical workplace for health dangers and threats (CDC, 2021). The work environment should promote quality healthcare, patients’ safety, and clinical well-being. Bullying, incivility, and workplace violence are obstacles to creating secure workplaces for workers (Broome & Marshall, 2020, p. 255). Understanding my workplace’s civility score is crucial for identifying its strengths and weaknesses and the elements that contribute to its improvement.

My workplace received an 80 out of 100 for overall civility score on the Clark Healthy Workplace Inventory. According to the assessment, this score signifies that the workplace is moderately healthy. At 80 percent, my organization has essential assets, including alignment with a shared vision and mission and intense employee appreciation. This score did not surprise me because my workplace is magnet recognized. Broome and Marshall (2020), noted that Magnet recognition signifies quality and a hallmark of excellence (Broome & Marshall, 2020, p. 130). Magnet hospitals measure high nurse satisfaction, workload, and support for nursing practice because of effective communication.

A healthy work environment necessitates effective communication, efficient teamwork, decision-making, and genuine leadership. Employee interactions can impact how well they perform their duties, how loyal they are to the company, and most importantly, how well patients are cared for (Clark, 2015, p.19). In order to promote a healthy workplace, leaders must encourage free conversation and dialogue. My organization employs a diverse workforce and values each employee’s contributions to the team.

Personal experience

My workplace also has shortcomings; It scores 80% as being civility, and the remaining 20% signifies incivility. Human wants, and demands are insatiable; satisfying a whole workforce without some form of grievances is challenging. For example, ICU Nurses in my organization complained of not receiving higher compensation than the floor employees. They stated they are more exposed to deadly diseases and double as Rapid Respond team and Code Blue Responders to the other units, in addition to their primary assessment. This complaint led to a compensatory incentive of pay increment during the COVID-19 Pandemic to the ICU and Emergency staff. However, staff in the other units did not accept the condition because they complained of higher workloads, leading to overworking the staff and staff shortage. With these grievances, they wrote petitions that removed the incentive within six weeks of inception.

Addressing Incivility

Workplace incivility harms staff members’ physical and mental health and their job fulfillment, productivity, and commitment to the workplace. It also places a significant financial burden on healthcare organizations. Employee retention, recruiting, and job satisfaction are all negatively impacted by incivility, bullying, and workplace mobbing, which exacts a heavy toll on individuals, teams, and organizations (Griffin & Clark, 2014, p. 536). My organization, in the quest to avoid creating more financial burden on itself and to prevent further staff grievances. That is, problems that could result in staff shortage or employee dissatisfaction carried out an environmental assessment which led to removing the extra incentives designated to some specific units during the COVID-19 Pandemic, thereby creating a level ground for all employees.