Nurses: Enhancing Workplace Safety & Civility for High-Perf Teams

Nurses should uphold safety, ethics, and civility in work environments (Green, 2019). This report captures the work environment assessment of my workplace, a review of the literature surrounding workplace inventory, and the possible evidence-based strategies that can create high-performance interprofessional teams in healthcare.

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Using the Clark Healthy Workplace Inventory (Clark, 2015), my assessment ranks 62. From this score, we can deduce that the organization is barely healthy. The assessment depicts some positive ratings in a few areas. They include the evident promotion of teamwork and collaboration among employees, effective use of conflict resolution skills, among others. The organization performed poorly on other sides. Communication at all ranks of the institution scored poorly with concerns on the transparency, direction, and respectfulness of communications. Additionally, members do not "live" by a shared vision and mission-centered on trust, reverence, and collegiality in the organization. What surprised me about the results is that the organization does not actively support its workers' wellness and self-care. Workers stay at risk of diseases, and thus their productivity can be decreased. Another thing that surprised me is that the organization does not commit to mentoring its health workers. That's why the organization uses the option of outsourcing better-trained health workers instead of strengthening its internal mentorship programs for its workers. These results suggest that the organization has not invested in ensuring a healthy workplace. Its civility standards are low, and this has intent on harming the targets and the norms of workplace behaviors, which has an impact on productivity.

Reviewing the Literature

According to Clark, the quality of safe patient care increases when the nurses develop an ability to manage their emotions effectively, communicate respectfully, and cope positively with stress (2015). Employee interactions, too, can impact the ability to take their responsibilities and organizational loyalty. While nurses strive to establish a moral and polite culture while interacting with coworkers and others, organizational management is mandated to create an environment where nurses feel free to air their views, especially when it comes to a patient's safety matters. To address incivility for challenging conversations, the DESC model framework can be a tool to structure a fruitful talk (Clark, 2015). The DESC model has four elements; D-Describe the specific situation, E-Express your concerns, S-State other alternatives, C-Consequences stated. The model is more valuable and would thus lead to greater nurse satisfaction and improved patient care.

The organization's workplace environment assessment scored barely healthy because communication at all ranks of the hospital is not done with civility. Managers need to establish an environment that would encourage nurses to discuss their concerns regarding the welfare of the patients (Clark, 2019). I noted a scenario of uncivil encounter in the hospital between manager Johnson and nurse Cornell. "Hello Cornell, Noel just reported the rescheduling of his flight back to the city, he will take off tomorrow due to the poor weather conditions, he won't be coming today. We are understaffed at the moment, and you have to stand in for him. I know it's unusual, but that's what we can do." Cornell is disappointed having worked without an off day for two weeks since Noel left for his leave. He had waited to be relieved from duty also for two weeks as they had agreed with the manager on Noel's end of the vacation. Cornell decides to handle this situation at that moment instead of planning a meeting with Johnson. Below is how Cornell uses DESC to address the issue.

Describe: "Johnson, I appreciate the need to cover up because Noel failed to make it to the hospital today. Having adequate staff is very crucial for patients' care."

Explain: "I am exhausted as I have been working for two weeks without a break since Noel left for leave. I'm thus less prepared to offer quality health service."

State: "I agree. It's important to have adequate staff for the oncoming shift, but I would like to offer alternatives since I am unable to work an extra shift today."

Consequence: "Let's put ideas together to resolve for an alternative on Noel's shift cover-up. I must share my views on the issue."

Evidence-Based Strategies to Create High-Performance Interprofessional Teams

It is educating and training the management and other health staff on civility and patient safe care that would create a high-performance team (Woodworth, 2015, p. 196). Such would inspire change to address the shortcomings as the ones evidenced in my work environment assessment. Another strategy to address the gaps is the cognitive rehearsal. This strategy is evidenced-based and addresses incivility immediately when it occurs. Prompt address to incivility can often lead to great success. My organization has never completely developed a shared vision and mission grounded on trust, respect, and collegiality. Developing such a vision and culture would be a great way to foster civility. Weekly and monthly staff meetings can bring the professionals together to evaluate each period's performance. In these meetings, staff questions should be allowed as well as staff concerns regarding patient safety. Additionally, reinforcing positive employee behaviors through rewards would bolster this practice. When employees realize their efforts don't go unnoticed, they will "pride" themselves on providing high-quality healthcare along with living the organization's shared vision and mission.

Conclusion

It can be hard to deal with uncivil behavior in the workplace. However, staying silent increases stress derails work performance, and ultimately endangers a patient's quality of health care. When awkward situations arise, it's wise to address the disrespectful employee through well-prepared conversations, which can be more effective when using the DESC model resolution framework.

References

Clark, C. (2015). Conversations to inspire and promote a more civil workplace. American Nurse Today, 10(11), 18-23. Retrieved 22 April 2020, from https://www.researchgate.net/publication/302941121_Conversations_to_inspire_and_promote_a_more_civil_workplace_Lets_end_the_silence_that_surrounds_incivility.Clark, C. (2019). Fostering a Culture of Civility and Respect in Nursing. Journal of Nursing Regulation, 10(1), 44-52. https://doi.org/10.1016/s2155-8256(19)30082-1Green, C. (2019). Incivility Among Nursing Professionals in Clinical and Academic Environments. Advances in Medical Technologies and Clinical Practice, 1-181. https://doi.org/10.4018/978-1-5225-7341-8Woodworth, J. (2015). Promotion of Nursing Student Civility in Nursing Education: A Concept Analysis. Nursing Forum, 51(3), 196-203. https://doi.org/10.1111/nuf.12138