Incivility is defined by researchers as rude, discourteous, dismissive and belittling behavior which causes physiological and psychological problems for all involved. It may occur on a continuum which ranges from eye rolling to physical stalking or injury. It creates barriers to learning and destroys work relationships. Unfortunately, incivility is so prevalent, it has become the accepted norm in many work environments. Incivility contributes to students leaving the nursing program, clinicians leaving the practice and educators are leaving the class room. Additionally, it contributes to medication errors, poor patient outcomes and satisfaction. Incivility unchecked will contribute to the impending nursing shortage. According to research, incivility costs approximately $12,000 dollars in lost productivity a year. The American Nursing Association as well as the Joint Commission has charged nursing administrators to address incivility and to establish a safe, civil work environment.
Incivility may occur in various forms; It may be descending, ascending or lateral. Horizontal or lateral incivility is also known as nurse to nurse incivility. It is the most commonly reported type of incivility in the nursing profession. Many researchers suggest this phenomenon results because nurses are an oppressed group as illustrated by the Stanley-Martin Model.
According to literature reviews, approximately 86-90 % of all nurses have experienced and or witnessed incivility in the work environment. Ninety percent of the sample in this study reported experiencing incivility in the nursing program while attending clinical or in academic settings. Consequently, there is a need to prepare nursing students with evidenced based strategies to address incivility. Research about incivility in nursing is plentiful, however evidenced based strategies to address the phenomena are scarce.
Evidence supports that cognitive rehearsal is one strategy which provides nurses with a professional and effective means of addressing incivility.
In this qualitative study, 10 senior BSN nursing students were surveyed using six open ended questions following a roleplay using cognitive rehearsal to address incivility. Comparative analysis was used to identify and categorized responses. This study demonstrates the effectiveness of cognitive rehearsal as a strategy to address incivility from a nursing student’s perception.
Incivility in nursing is defined by researchers as rude, discourteous, dismissive and belittling behavior which causes physiological and psychological problems for all involved. Nurses and nursing students therefore need an evidenced based strategy to address this phenomenon. Cognitive rehearsal coupled with role play can effectively impact an uncivil environment.