When Good Nurses Say Bad Things: Fighting Professional Incivility

May 17, 2018

Professional incivility, rudeness, and bullying are not new to the world of nursing. Nurses can see escalated teasing or bullying as “a rite of passage” or “earning our stripes.” However, changes in the workplace have shown that no matter what it’s called, bullying and professional incivility has no place in the working environment. Anne Ireland, MSN, RN, AOCN®, CENP, clinical director of the Solid Tumor Program at City of Hope National Medical Center in Duarte, CA, and Tracy Gosselin, PhD, RN, AOCN®, NEA-BC, chief nursing and patient care services officer at Duke University Hospital in Durham, NC, gave a lecture at the 43rd Annual Congress in Washington, DC, on their work with professional incivility and bullying and ways to teach nurses how to intervene and become powerful bystanders.

According to Gosselin’s and Ireland’s presentation, incivility involves rude and discourteous actions, gossiping and spreading rumors, and/or refusing to assist a coworker, whereas bullying is “repeated, unwanted harmful actions intended to humiliate, offend, and cause distress in the recipient.”

According to data from the American Nurses Association, 50% of RNs report being bullied by a peer, 42% report feeling bullied by a person in a higher level of authority, and 24% report physical assault by a patient or patient’s family member.

More than just ribbing or teasing, bullying involves:

Gosselin and Ireland also explained that bystanders, even though not directly involved, have a responsibility to report bullying and professional incivility; not helping those that are bullied contributes to the problem and is counterproductive to protecting the values of safety, trust, and honor that are central to various communities. However, certain concerns from bystanders can cause them to avoid involvement in these types of situations, including a diffusion of responsibility, ambiguity, any perceived cost (including their own safety), and evaluation apprehension (such as social inhibition).

Gosselin and Ireland encouraged getting involved and helping the situation by using a path to intervention:

Other strategies to lead the way against professional incivility are making sure that your workplace agrees and adheres to a zero tolerance view on bullying, as well as making workplace proclamations against bullying that can be shared with all employees (e.g., through an official employee handbook) so everyone understands their responsibilities to the safety of others.

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