Where Do You Think You Are? A Grounded Theory Study on Incivility in Nursing

Friday, 22 February 2019: 3:50 PM

Roselle Ann Samson-Mojares, PhD, RN
College of Nursing and Health Sciences, Barry University, Miami, FL, USA

Title: Where do you think you are? A Grounded Theory Study of Incivility in Nursing

Background: Incivility in health care settings had been identified in 1976. In 2000 the Institute of Medicine sent a challenge for a safer health care environment and in 2008 the Joint Commission emphasized that disruptive behavior continued to compromise patient safety. Incivility in nursing has quickly become a topic of interest yet it had not been studied from a qualitative approach by looking at it as a social process.

Purpose: To adopt an abductive process to acquire an in-depth understanding of the critical factors that trigger the existence and fuel the persistence of incivility in nursing and to develop a substantive theory to address the concept of incivility.

Methodology: A constructionist grounded theory approach by Charmaz was utilized. A total of 29 Registered Nurses voluntarily participated. Phase I included twenty-five 60-minute individual face-to-face interviews and phase II was a 90-minute face-to-face focus group interview with four nurses. Data analysis involved initial, focused, axial, and theoretical coding alongside memo-writing and reflexive journaling.

Results: The four main categories that emerged from the voices of twenty-nine Registered Nurses were neglecting (institution), alienating (profession), relinquishing (society), and finding oneself. The theory of self-positioning developed from these four categories. There are three possible positions that every nurse consciously or subconsciously takes on: self-doubt triggers the existence of incivility, self-indulgence fuels the persistence of incivility, and self-awareness diminishes the occurrence of incivility.

Conclusion: To understand incivility as a social process, one must, immersed within the institution, profession, and society find and position the self.

Implications: The four categories and the theory of self-positioning may serve as a guideline to nursing education, nursing practice, nursing research, and health/public policy in setting realistic and attainable goals and implementing specific action plans to diminish the incidence of incivility, address the health and well-being of Registered Nurses, contain healthcare costs, and ensure patient/public safety.

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