Discussion on Civility in Nursing

In Annie's story, there is a potential for incivility to occur between those who oppose palliative sedation and those who are asking for it (Annie) or participating in it's treatment (Karen and other healthcare providers).

I guess the most important thing I have learned from discussing ways to confront incivility is that it is necessary to do something about it. We cannot sit idly by while disrespectful assaults are taken against us personally, or us as a group. Even though I have experienced incivility or bullying, I did not identify the behavior as this until discussing this topic this week. Once I was able to recognize my own experiences as well as witnessed behaviors of others as incivility, I was relieved that I could put a name to it. I truly believe that once we have a proper “diagnosis,” we can finally focus our attention on proper treatment. In the case of incivility, it is relieving to understand that there are ways to preserve integrity and counter attacks in the midst of it. I love that Cynthia Clark has really brought this matter to attention in her nursing research. She emphasizes the need for practice and application of civility activities to be a priority in nursing environments (Clark & Ahten, 2011). One of my favorite ideas presented by Clark & Ahten (2011) is the need for nursing leaders to be the “guide on the side.” Instead of just preaching to staff nurses about civility, give them instruction on how to do it and then allow them to discuss and role play scenarios. I love Clark’s simple suggestions on how to work through situations of incivility (Clark, 2013). We should begin by stepping back and reflecting on the issues at hand. In this we should also plan how to approach the person of interest. Next comes the hardest part: the conversation. Clark (2013) breaks down this process into a simple mneumonic: DESC. D tells us to describe the issue we are having, E has us explain how this issue impacts us, S prompts us to state what we want the outcome to be, and C urges us to give a consequence or explain what our next action will be if things do not resolve. This is an easy tool to remember when faced with an uncomfortable situation. A great pamphlet outlining Clark’s recommendations can be accessed here.

References:
Clark, C.M. (2013). Stress, coping, healing and the quest for civility. NSNA Imprint, 34-39. Retrieved from http://hs.boisestate.edu/civilitymatters/docs/Stress-coping-healing-Imprint-Clark-2013.pdf.
Clark, C.M. & Ahten, S.M. (2011). Nurses: Resetting the civility conversation. Retrieved from http://www.medscape.com/viewarticle/748104_4.