Creating a Civil Work Environment

Purpose: Many studies report that incivility, workplace bullying, and lateral/horizontal violence in the clinical setting is common. Working in a high stress environment, such as an acute behavioral health unit, is one factor that is thought to increase the level of incivility in the workplace. The literature demonstrates significant physical and psychological distress, diminished clinical decision making ability, and reduced organizational commitment to those involved (Spence-Laschinger, 2014). Consequences of uncivil behaviors lead to an increased risk of patient injury, a high rate of nursing turnover, and a financial drain on healthcare institutions (Ceravolo, Schwartz, Foltz-Ramos, & Castner, 2012). Based upon the current research, implementing several civility initiatives in tandem will decrease the incidence of workplace bullying and create a healthier workplace (Griffin & Clark, 2014).

Design: The study is a pre/post intervention design. A pre-intervention evaluation tool, Clark's Workplace Civility Index, will allow all participants to take an introspective look at his or her own level of civility. An education on the use of cognitive rehearsal strategies and mentoring will be given via the e-learning platform. It will include a lecture on the use of cognitive rehearsal as a primary intervention for acts of incivility and how mentoring will be used as a supportive role. A virtual simulation was included to demonstrate a common form of incivility and how the use of the pre-planned cognitive rehearsal statements can be effective. Several scenes were included to reinforce the education provided. Laminated index cards or "badge buddies" were included in the participant packet that list all cognitive rehearsal statements. Additionally, the primary researcher will be on the practicum unit to serve as a mentor. The mentoring role is an evidence-based strategy to increase confidence in addressing incivility directly and reduce the psychological consequences of such encounters. This can be achieved by providing presence, active listening, demonstrating professional communication, and facilitating the use of the suggested interventions. The unit leadership were included as participants in the study to ensure that the micro level and mesa level staff was covered with the same evidence-based strategies.