Threading Incivility Training Through Nursing Curriculum

Incivility is a well -documented occurrence in the culture of nursing. It has been defined as discourteous, rude, and intimidating behavior which causes psychological and physiological problems for all involved. (Clark et al., 2014). Researchers such as Clark (2014), Luparell (2011) Robertson (2013) Schaffer (2013) and Milesky (2015) proposed that incivility may actually have its root in nursing school. Researcher (Luparell, 2011) in a seminal article, makes a clear connection between academia and incivility in practice. The researcher proposed that today’s students are tomorrow’s colleagues and conversations regarding how to address incivility and bullying should include specific aspects of nursing academia. Schaffer, (2013) suggested that the effects of incivility, whether classified as minor or major may affect the student nurse and impede his or her progress and ability to become an empathic nurse. Academic incivility may contribute to bullying in the workplace, which has been identified as a cause of attrition and contributes to the national nursing shortage. Robertson (2010) also suggested that an uncivil nursing students invites behavior as an uncivil nurse. Finally, Milesky et al. (2015) also concluded that problems from academia spread over to the clinical setting.
With this in mind, the writer surveyed nurses via a professional nursing google network to ask the following question:
"How many of you are required to include an incivility discussion as part of your nursing curriculum or as part of your professional development or orientation training?”
Several nurses, from different geographical regions across the nation responded. Ten responded directly to the question and the results are as follows: Two or (20%) of the respondents formally include incivility training in the curriculum. One of the two (10%) has incorporated a civility contract as part of incivility training. Four (40%) of the respondents informally address incivility in the class room but felt more should be done. Four (40%) requested additional information and assistance from others who have already prepared presentations about incivility. They requested help in beginning the discussion/conversation at their perspective institutions. One respondent is preparing a module about incivility that can be incorporated in any class. Another respondent incorporates incivility training using live scenarios and cognitive rehearsal during orientation.
Based on the survey results and the availability of evidenced based knowledge regarding the global impact of incivility on nursing students and new nurses, the author would recommend the development of detailed modules, toolkits, contracts and other strategies to help educators, administrators and clinical nurses address incivility. Additionally, earlier research by this writer (2016) illustrated that incivility training is not as effective if implemented as a one-time event. New students require repeated exposure and training. Thus, incivility training should be threaded throughout the nursing education curriculum. Utilizing civility contracts in conjunction with evidence based training is one way to hold everyone accountable for professional, civil behavior. The contracts and educational interventions can be revisited throughout the semester as needed or required to articulate or reinforce civil, professional behavior. By threading civility strategies throughout curriculum, students, educators, administrators and clinicians will all benefit as well as the nursing profession as a whole.