1. Purpora, Christina PhD, RN

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FOR MANY NURSES, determining how to respond to a coworker's unkind words and/or actions is challenging. I've faced these uncomfortable and intimidating situations many times in my 30 years of nursing. During a recent shift report, I decided to speak up to one of my colleagues about the uncivil way she communicated with me. Her conduct change after our conversation taught me something about improving these difficult exchanges.

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Nurse, interrupted

In this particular situation, I approached my coworker (we'll call her Pat) to give her my end-of-shift report. I said, "Hello, Pat. I had Mr. D this evening. Are you ready for report?" Without looking up from what she was reading, Pat replied, "Um hum." I believed her answer meant she was ready, so I started report. "Mr. D is a 52-year-old male, admitted on the twe..."


Interrupting me, she said in an irritated tone, "I know that! I took care of him last night! Just tell me what's new!" Pat's disruption surprised me. Feeling apprehensive, I continued with handoff, but I worried I'd forget to report something important about Mr. D's care. I paused briefly to mentally review whether my report was complete before asking Pat, "Do you have any questions for me?"


Pat rolled her eyes, sighed, and sounded very annoyed when she replied, "I would've asked you if I did." Feeling a bit less surprised, I was ready to respond to her outburst. I wanted to tell Pat about the impact her words and actions had on me, but also potentially on Mr. D's care.


I decided to use "I" language, as suggested in an article I'd read.1 The authors maintain that the best way to address a coworker's uncivil conduct is to talk with him or her directly. "I felt surprised when you interrupted me and, just now, when you rolled your eyes and answered my question abruptly. I don't know what you know about Mr. D; I thought it was important to ask if you had any questions to make sure we communicated all necessary information for his care."


I braced myself, unsure of how Pat would react to my assertion. Then, looking down at her paper, she answered, "Right. No questions." Hearing this, I walked away to give report to another nurse.


Owning up

As I left the unit to go home that evening, Pat approached me in the hallway. She said she was dealing with a problem at home and realized she wasn't being as respectful toward her colleagues as she could be. I thanked her for telling me and said I hoped things at home would improve soon. She walked away saying, "Me, too." Although her difficulty at home wasn't an excuse for her incivility, I understood and took what she said as an apology.


The following evening, I approached Pat to hand off Ms. C. First, Pat told me what she already knew about the patient. Clear about what to include, I gave her report. This time, when I was done, Pat smiled and said to me, "No questions, thanks. Have a good night."


Turning it around

Driving home that night, I wondered what it was that helped turn the contentious situation between Pat and me into a respectful, productive one. My first thought was that Pat had considered what I said regarding her outburst during report and decided to make a change. I reflected on times when I myself could have been kinder toward my coworkers. I'm more mindful now, because I know that what I say and do can negatively impact a peer and possibly the quality of our patient care. Ending incivility may take speaking up and talking with a coworker about the effect of his or her words and actions. Equally important, it requires us to reflect on our own conduct and be willing to change.




1. Gessler R, Rosenstein A, Ferron L. How to handle disruptive physician behaviors: Find out the best way to respond if you're the target. Am Nurse Today. 2012;7(11):8-10. [Context Link]