How do we, as nurses, accomplish a zero-tolerance stance on incivility? The American Nurses Association released its first official position statement on workplace violence in 2015. The statement has held steadfast and seen some revisions since then, but the premise remains the same: There's zero tolerance for incivility and violence in the workplace. Lateral violence can be avoided through advocacy, engagement, education, legislation, and empowerment. Healthcare professionals should be partnering with their organizations to create work environments that are healthy and nurturing. Environments where acts of aggression are not only prohibited in policy, but culturally unacceptable. What exactly does this mean? I can give a great example of culture versus practice and policy.
Sure, an organization can have a robust, evidence-based policy developed by leadership, prohibiting workplace violence in all forms within its workforce. But let's say this same organization has a certain provider who publicly humiliates the nursing staff in front of families, other providers, associates, and patients. Leadership is aware, yet the behavior is allowed to continue. When the behavior is discussed or reported, the response is merely, "Yes, he can be very difficult to deal with." Or, "We've had many complaints about his behavior, I'm sorry that occurred." There isn't any effort made to curtail the reoccurring behavioral issues. This is bullying; repetitive, unwarranted actions that humiliate, offend, and/or cause distress to the victim. The culture of this organization is that the hierarchy allows for this type of bullying behavior to continue. This isn't only a human resources issue, but a patient safety issue.
The way to manage the culture and break the cycle is to confront the cultural norm through advocacy. Don't be afraid to reach out to those in the organizational hierarchy to advocate for your rights. Don't be afraid to support a coworker who you witness being victimized. Participate in shared governance councils, and empower and support each other. Only through cooperation can a culture be managed, and the ship turned. The other danger is that this provider's allowed behaviors will be mirrored by others. This is applicable to coworkers as well. Speak up when you see this occurring. Retaliation is only effective if we allow it to be. Navigation of a toxic work environment takes commitment and persistence.
Nursing Made Incredibly Easy is dedicated to ending incivility in the workplace and has zero tolerance for workplace violence. You'll find resources located in our archives and educational opportunities to draw inspiration.