Messages from the Nursing Department
Excerpt from Paper #1—The Importance of Civility in Nursing Practice
Incivility and bullying are most rampant and prevalent in nursing. Bullying can range from employers to employees, employees against employers, or employees against employees (Deans, 2004a). When superiors bully their inferiors, they project the idea that such acts are tolerated and acceptable. Novice nurses may be subjected to harassment by their superiors and not speak out against it due to fear and intimidation. In 2009, a study on workplace bullying revealed 20 percent of 249 emergency room nurses admitted to experiencing bullying at work, with 50 percent of them identifying managers and directors as the bullies (Johnson, Rea). In 2012, an online survey with a sample of 197 novice nurses revealed 73 percent of the participating nurses experiencing workplace bullying at least once in the previous month (Berry, Gillespie, Gates, Schafer). In 2014, the American Nurse Association (ANA) surveyed 3,765 nurses and revealed 43 percent of the participants were verbally and/or physically threatened by a patient or family member of a patient (LCWA Research Group). In 2015, the ANA published a code of ethics dictating the requirement for nurses to “create an ethical environment” (p. 4). It is the nurse’s responsibility to prevent incivility in their workplace. Incivility includes any action that may be disrespectful towards coworkers, whether it is direct or indirect. It comprises the partaking in active violent and/or discriminatory actions and failing to intervene when such actions are present. According to the World Health Organization (WHO), some actions may be more obvious—such as using intimidation tactics, gossiping, or belittlement of coworkers—while other actions may be more inconspicuous—withholding information or ignoring blatant harassment (2015).
Excerpt from Rewrite—The Importance of Incivility in Nursing Practice
In 2015, the ANA published a code of ethics in their position statement on incivility, bullying, and workplace violence, dictating the requirement for nurses to “create an ethical environment.” It is the nurse’s responsibility to prevent incivility in their workplace. Incivility includes any action that may be disrespectful towards coworkers, whether it is direct or indirect. It constitutes participating in active violent and/or discriminatory actions and failing to intervene when such actions are present. Some actions may be more obvious—such as using intimidation tactics, gossiping, or belittlement of coworkers—while other actions may be more inconspicuous—withholding information or ignoring blatant harassment (ANA, 2015). Nurses can protest incivility practices by promoting communication, speaking up to superiors, and advocating against bullying at work through posters or seminars. More experienced nurses should also take on the responsibility of setting a positive role model by punishing bullies or preventing any occasions where bullying may originate. This includes not allowing an experienced nurse to diminish the capabilities of a novice nurse through intimidation or any other means. By allowing incivil treatment of staff to occur, it not only interferes with the nurse’s ability to work efficiently and drains resources, but also discredits the profession as a whole. How are nurses supposed to be respected if they cannot respect each other? This behavior also gives the nursing profession a bad reputation and deters future nurses from entering the profession.
Incivility must be stopped because it contributes to the shortage of nurses, decreases productivity, and is financially consuming. No one would willingly work in an environment where they were constantly belittled or depreciated, especially if they were exposed to highly stressful situations as in the health profession. Nurses are tasked with a heavy workload: having to care for individual patients and their families, filing patient paperwork, making sure that all health professionals are well informed on each and every patient’s records, as well as many more responsibilities. In such a stressful environment, it is easy for tempers to shorten and for bullying among the staff to flourish. However, bullying among the nursing staff prevents the victims of bullying from efficiently providing care to the patients, like distracting the nurse from placing his or her full attention on the patient, and stymying the cooperation of professionals, causing a decrease in quality of patient treatment. Working in such an atmosphere can deplete the confidence and teamwork of the staff (Danza, 2018)
Nursing is a profession that constantly undergoes changes, always aiming to improve the quality of care for patients. I am currently in my first clinical rotation as a nursing student and I previously took a writing intensive course dedicated to developing a nurse’s way of thinking. The course focused on the analysis of weekly readings composed of various articles, case studies, and guidelines intended to introduce nursing as a professional and scholarly field. This writing class greatly improved my scholarly writing skills and furthered my appreciation for nurses.
My experience in taking this writing class was overall positive but challenging, because I had to learn how to write in an analytical and scholarly fashion. Prior to taking this course, I thought of myself as a pretty good writer. I have always received scores in the high 90’s in other classes; thus I was relatively confident when I submitted my first analysis paper focusing on incivility in nursing. I received an 84 on that paper. Granted, it wasn’t a bad grade but I knew I was capable of doing better and I wanted to improve my writing skills. The difference between my past writing experiences and this writing intensive course was analysis. A majority of my writing experience pertained to research papers, focusing more on using studies and statistics as the foundation for my writing. I was not prepared to read a text and synthesize my own inferences using said text. I did not know what to focus on when writing an analysis paper in the American Psychological Association (APA) format. Furthermore, I was not familiar with the proper technique for in-text and/or parenthetical citations. The first papers I submitted had a substantial amount of errors due to incorrect in-text and parenthetical citations.
The biggest challenge I had, something I still struggle with, was putting my thoughts into words. Having to convey my thoughts in clear and concise words was and is still the most difficult part for me when writing analysis papers. Many of my “arguments” that seemed logical to me were actually very unclear and unspecific to my professor. The arguments were just summaries of my articles or definitions. I was simply restating what I had read in my resources. My professor would often comment, “Why? Explain more,” and I didn’t know how to expand on my thoughts. This is something I still struggle with, but I’ve gradually gotten better at it.
The start of the course was challenging and it took many trials and errors to finally improve my analysis skills. As I previously stated, a majority of my writing skills were centered around research papers. So it was very difficult to switch gears and take a step back from using only the evidence in my resources. In my excerpts, you can see how little analyzing I actually did in my first paper. In my rewrite there is a noticeable increase of my own ideas synthesized with the authors’ thoughts. It took a bit of time before I realized that the assignment was not just summarizing articles but, instead, actually understanding them and making my own meaningful connections. A critique from my professor I always think about is to be specific and opinionated. That enables me to be able to argue and support my ideas with the readings or statistics from other sources. Another tip I learned was to always try and explain my theories in a clear and straightforward format. While it is great to sound sophisticated and professional, you never want that to get in the way of potential readers understanding what you are writing about. As you will see in my excerpts, the rewrite has much more elaboration which provides the context necessary to further understand the topic that I am writing about.
Thoughts on the Writing Expectations
My overall expectations in taking a nursing writing intensive course was positive and enlightening. The course really helped me improve my writing and analyzing skills. I’ve learned how to analyze articles and use the author’s reasoning to support my own ideas and thoughts. Aside from helping me expand on my scholarly writing abilities, this course also prepared me for the reality of working in a clinical setting. The topics discussed in class include empirical knowledge, ethics, compassion/empathy, professionalism, and sociopolitical concerns. It was greatly beneficial for me to take this class before entering a clinical setting because it prepared me for what to expect. While I have not personally experienced workplace incivility, I have seen and heard it with other medical professionals. Nursing is an amazing profession, and with every semester that I progress with my studies, I find a new appreciation for nurses.
These two excerpts are from the first analysis paper I submitted for a writing intensive course called “Developing Nurse’s Ways of Knowing.” The topic was incivility in nursing. Many of my articles were sourced from the American Nurses Association (ANA) Code of Ethics and peer-reviewed studies composed of case studies on incidents of bullying and/or incivility in the nursing profession.
American Nurses Association. (2015). American Nurses Association Position Statement on Incivility, Bullying, and Workplace Violence. American Nurses Association. https://www.nursingworld.org/~49d6e3/globalassets/practiceandpolicy/nursing-excellence/incivility-bullying-and-workplace-violence–ana-position-statement.pdf.
Danza, P. (2018). Confronting isolation and bullying in the workplace. Nursing, 48(11), 48-53.
Etienne,. (2014). Exploring workplace bullying in nursing. Workplace Health & Safety, 62(1), 6-11. https://doi.org/10.1177/216507991406200102
Sellars, et al., (2012). The Degree of Horizontal Violence in RNs Practicing in New York State. JONA, 42(10), 483-487. https://doi.org/10.1097/NNA.0b013e31826a208f