Incivility and Professionalism in Nursing

Incivility and Professionalism in Nursing


Incivility refers to a disruptive, intimidating and undesirable conducts that a person directs to another. Incivility in nursing is therefore disruptive and undesirable conducts that nursing officers directs either to their patients or fellow health practitioners during health care process.  Incivility entails a conduct that is unacceptable and hostile within a hospital environment. Incivility in nursing may lead to physical as well as psychological challenge to patients. Various researches have indicated that people who experiences incivility often develops some undesirable traits like stress, depression, anxiety, sleeplessness as well as exhaustion.

In nursing process, incivility may occur either in clusters or at individual level of interactions. For instance, there may be some cases where health care providers or administrators harasses a nurse, nurses harassing a fellow nurse, patients bullying a nurse or individuals in from nursing faculties bullying a learner. Nursing professionalism on the other hand is a vital ingredient in attainment of a favorable working environment in health care system. Professionalism in nursing is enabled by both exercises and experience. It aids in promoting the results of nurses, healthcare organizations and healthcare seekers. The purpose of this paper is to outline how incivility in nursing and professionalism affects nursing outcome by providing key concepts of both. In addition, the paper explains how these two concepts related and contrasts in nursing field. The Sentinel Event Alert of Joint Commission on July 2008 highlighted that healthcare is one of the high stakes and a pressure-packed environment.




Table of Content

  • Introduction…………………………………………………………………………..4
  • Incivility in Nursing…………………………………………………………………..4
  • Nursing Professionalism……………………………………………………………….6
  • How to Deal with Incivility…………………………………………………………….7
  • Conclusion………………………………………………………………………………8
  • References……………………………………………………………………………….9














  • Introduction

Incivility has been ranked among the most disruptive behaviors that causes disruptions and intimidations in nursing care in health care systems. Incivility is increasingly becoming a major challenge in healthcare setting especially among the nurses. It has been a major cause of psychological and physiological distress to those affected therefore affected service delivery. There are numerous forms of incivility in nursing and they include; cases whereby, a nurse harasses a fellow nurse, an individual from the faculty of nursing harasses a student, nurses harasses a patient and an individual from the hospital management harasses a nurse.

2.0 Impacts of Incivility

Incivility has been a major cause of reduced havoc on nurses, workplaces and connections. It has also led to serious effects on safety of patients. Incivility has been widespread than most people thinks. Notably, there are devastating impacts due to incivility in healthcare systems. A healthcare organization incurs high costs when there are cases of incivility. This is due to some reasons that include, little efforts by nurses, low quality services by nurses and poor handling of patients by nurses. Leister and Maslach (2005) argues that, United States healthcare sector incurs a total of 300billion dollars as a result of incivility.

On the basis of shielded individual categories like race, gender, religion and disability, incivility in healthcare is against United States nursing and general healthcare legislations.  Nevertheless, there are no legislations that averts incivility in other work categories unless it is interpreted as mental or physical abuse. Zolby (2007) raises some claims that most of areas that have been affected by workplace bullying indicates that 37% of United States task labourers experienced direct forms of bullying, 12% were bullying witnesses, 45% had their health impacted as a result of stress after they were bullied, 3% files a lawsuit as a result of bullying related cases and 40% were faced by bullying but they never raised any forms of complaints.

According to Forni (2008), incivility is often experienced when nurses are stressed, rushed or are unhappy. Anything can occur when all these factors coincide. There is erosion of individual self-motivation, erosion of relationships, contaminated work place environment and rising cases of stress. At some occasions, incivility results in violence. Most importantly, individuals who escalate incivility are often aware of the effects their conducts will have on other people. Clark explains that uncivil conduct are present along a continuous disruptive conduct on the end to cause some threat on other peoples’ conducts (Anselmi, et al. 2014).  Over incivility expressions like; bullying, taunting as well as various forms of intimidating behaviors, there have been increased case in the media. In most cases, incivility in nursing starts in simple forms that ranges from benign manner to conducts like sarcastic comments or comments that dominated in a cluster.  It is important for any health organization to identify to identify any form of disruptive behaviors in within their premises in order to take necessary measures before they have resulted into incivility.

Most importantly, it is essential to understand the forms in which incivility occurs. To start with, incivility may occur in form of a silent treatment, sabotaging a project, verbal abuse(Del Prato, 2013). Failure to offer support to a co-worker, eroding reputation of an individual and using intimidating and humiliating language while addressing an individual.

Impacts of incivility affects all individuals. To start with, it lowers individual self-esteem by wearing out individual mental defenses. Anxiety often tends to increase when people feels vulnerable and this could result in anger and resentment(Anselmi, et al. 2014). There is eroded connections that brings workmates and other people together due to arousal of failure feelings.  Incivility in nursing makes people to develop a strange feeling of isolation leading to increased stress. This may result in weakened immune system. Incivility have been perceived as a major cause of lowered morale among nursing officers.

Acceptance of incivility behaviors by healthcare administrators makes it a challenge for other people to report similar forms of behaviors.(Del Prato, 2013)  A nurse may develop a feeling that healthcare leadership accepts and tolerates incivility conducts such conducts should be brought to nursing leaders in order to ensure that they have taken actions against individuals who depicts them.

Incivility is has also been reported among student nurses and is mainly carried out by nursing officers in practice as well as those in nursing faculty(Anselmi, et al. 2014). This makes students’ confidence to diminish, there is increased anxiety among nursing students affected, sleeplessness, frustrations and stress. Development of nursing professionalism conduct is each nurses’ responsibility.

3.0 Nursing Professionalism

According to the Baccalaureate essentials in relation to Nursing Education for Professionalism in Practice (2008), inherent in professionalism is entirely a responsibility as well as accountability for a person’s conduct, actions and civility. In order to have professionalism, there must be civility.  According to American Nursing Organization (ANA), nursing ethical codes denotes that nurses have an obligation to maintain high level of professional standards in relation to individual behaviors which are well reflected on profession and promotes the confidence of entire public(Del Prato, 2013).  According to nursing code of ethics, the provisions of 1.5 indicates some requirements by nurses to handle their workmates, learners and their patients with both dignity as well as respect.

Moreover, provisions 1.5 denotes that any form of  bullying, disrespect and any form of actions that seems to threaten the workmates, patients or nursing students will not be condoned. Joint commission considers incivility to be a safety issue. There were cited concerns by joint commission on the rising cases of incivility in nursing whereby it undermined the nursing ethical standards(Del Prato, 2013). There are some reported cases of intimidations and disruptive behaviors due to incivility and this hence creates high level of concerns. Also, the joint commission expressed its concerns on the rising medical errors, poor satisfaction of patients, increased costs, adverse results and loss of experienced nursing staff (Ibrahim& Qalawa, 2016).

The Sentinel Event Alert of Joint Commission on July 2008 highlighted that healthcare is one of the high stakes and a pressure-packed environment. This provision also denote that healthcare is capable of testing incivility limits in healthcare workplace. Rude and disruptive conduct depicted by health care professionals could have potential impacts as they are have serious risks to the overall safety of patients as well as overall care quality (Del Prato, 2013). Therefore, there is a need for all healthcare settings to establish a behavioral ethical code as well as creation of a formal process that will promote management of unacceptable conduct by nursing professionals.

4.0 How to Deal with Incivility

Incivility can be dealt with at individual level as well as in the organizational level. At the individual level, one has to create a resolution between him or her and the person that causes incivility. One can start by describing how incivility affects them. In case were an individual is unable to reach to a resolution directly with the other person, it is important to engage a third party. Documentation of incidents is also necessary as evidence that these occasions took effect. This process should continue until one is able to identify some changes(Anselmi, et al. 2014). On the other hand, solving the problem at organizational level will involve organizational leadership. This will incorporate various policies that have been used to avert and promote incivility. More importantly, ethical codes are applied to describe any form of conduct that could be described as disruptive or intimidating.

5.0 Conclusion

It is when the nurses shows maximum care that they are able to confront incivility among themselves and even towards their patients. Enhancement of respectful conduct among the nurses plays a significant role in ensuring that incivility conducts have been rectified in health care systems. Most importantly, it is important to acknowledge the effects of incivility not only to nurse but also to the entire system including the society. Incivility has potential impacts that include lowering the level of confidences among the community members on the quality of health care services that receives. Moreover, incivility is a behavior that lowers personal-self-esteem and could lead to poor quality and reduced work magnitude by affected nurses. In addition, incivility is a behavior that goes contrary to ethical standards in nursing care as have been outlined in provisions of Joint commission. Therefore, all stakeholders must join hard to uphold professionalism in nursing and fight against incivility as a way of upholding overall performance of health care system in United States and even across the globe.



  • References

Anselmi, K. K., Glasgow, M. E. S., & Gambescia, S. F. (2014). Using a nursing student conduct committee to foster professionalism among nursing students. Journal of Professional Nursing30(6), 481-485.

Del Prato, D. (2013). Students’ voices: The lived experience of faculty incivility as a barrier to professional formation in associate degree nursing education. Nurse Education Today33(3), 286-290.

Ibrahim, S. A. E. A., & Qalawa, S. A. (2016). Factors affecting nursing students’ incivility: As perceived by students and faculty staff. Nurse Education Today36, 118-123.



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