Introduction
The presence of a healthy workplace environment is pivotal in delivering safe, effective patient care. However, nursing environments often face challenges, such as workplace incivility, that affect team cohesion and patient outcomes. Workplace incivility, defined as repeated low-intensity adverse social behaviors, detracts from teamwork, respect, and communication. This assessment evaluates the health and civility of a workplace using the Clark Healthy Workplace Inventory and explores interventions to address uncivil behaviors. It consists of three parts: a summary of the Work Environment Assessment, an analysis of relevant theories or concepts, and evidence-based strategies to build interprofessional teams.
Part 1: Work Environment Assessment (1-2 pages)
Summary of Results – Clark Healthy Workplace Inventory
The Clark Healthy Workplace Inventory revealed a score of 83, indicating a moderately healthy workplace. This score reflects a shared vision and mission among team members grounded in respect, trust, and collaboration. Nurse leaders emphasize teamwork and patient-centered care, establishing a culture that supports evidence-based practice and safe patient outcomes.
Surprising Findings and Confirmation of Prior Beliefs
Two unexpected findings emerged from the assessment. First, while there is a moderate level of civility, covert incivility exists, especially among peers, manifesting as nonverbal cues and subtle disrespect during clinical rounds. Second, the lack of documentation for incivility incidents implies that many cases remain unaddressed. A belief that was confirmed is that the hospital leadership is committed to fostering a healthy workplace, as seen through efforts to involve team members in decision-making and provide competitive compensation.
Implications of Assessment Results
The results suggest that the workplace is moderately healthy but requires interventions to address unspoken tensions and maintain civility. Team dynamics and leadership practices are strong, yet the covert behaviors among colleagues necessitate improvements to foster transparency and mutual respect.
Part 2: Reviewing the Literature (1-2 pages)
Selected Theory or Concept
The concept of cognitive rehearsal, as discussed in Clark (2015) and Clark (2019), forms the foundation for addressing incivility in nursing. Cognitive rehearsal, rooted in Bandura’s social learning theory, involves mentally practicing responses to difficult situations to develop composure and enhance communication. This technique empowers nurses to confront incivility with prepared responses, improving their ability to handle tense situations effectively.
Relevance to the Work Environment Assessment Results
Cognitive rehearsal is directly applicable to the observed workplace challenges, particularly the subtle peer-to-peer incivility that remains unreported. By incorporating cognitive rehearsal, nurses could practice handling incivility in constructive ways, which would mitigate anxiety and build confidence. This process can enable a shift toward open, respectful communication and foster a healthier environment.
Application of Cognitive Rehearsal to Improve Organizational Health
To implement cognitive rehearsal, nurse leaders could conduct role-playing exercises where staff practice responding to incivility. For example, during team meetings, leaders can demonstrate and model respectful responses to common challenges, promoting a culture where respectful discourse is the norm. By establishing structured cognitive rehearsal sessions, the organization can foster a proactive approach to managing incivility.
Part 3: Evidence-Based Strategies to Create High-Performance Interprofessional Teams (1-2 pages)
Recommended Strategies to Address Shortcomings
- TeamSTEPPS Training: Implementing the Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS) program provides structured communication and teamwork training, improving team cohesion and civility. TeamSTEPPS emphasizes clarity, empathy, and respect, which can help reduce miscommunication and interpersonal conflicts in high-stress scenarios.
- Transformational Leadership Development: Leaders should adopt transformational leadership practices, which inspire teamwork, encourage shared governance, and motivate team members to exceed personal and professional expectations. Training nurse leaders in transformational leadership will empower them to foster an environment that discourages incivility, sets a standard for behavior, and supports team members in managing stress.
Strategies to Bolster Successful Practices
- Ongoing Cognitive Rehearsal Training: Continuing cognitive rehearsal sessions, as well as refresher courses, could reinforce respectful communication. By practicing responses to incivility regularly, nurses can build resilience and reinforce the desired behaviors within the workplace culture.
- Implementing the DESC Model: The DESC model (Describe, Express, Specify, and Consequences) could be introduced as a communication tool. This model teaches staff to express concerns without disrespecting others, promoting honest dialogue while preventing conflicts from escalating. Regular training sessions on DESC can solidify effective communication techniques and foster a more civil environment.
Conclusion
The Work Environment Assessment highlighted the importance of addressing covert incivility to strengthen the workplace. Drawing on cognitive rehearsal and evidence-based communication strategies, this assignment proposed solutions for a healthier workplace culture. By implementing TeamSTEPPS, transformational leadership, and DESC communication practices, the organization can reduce incivility, promote teamwork, and ultimately improve patient care quality.
References
Abdollahzadeh, F., Asghari, E., Ebrahimi, H., Rahmani, A., & Vahidi, M. (2017). How to prevent workplace incivility? Nurses’ perspective. Iranian Journal of Nursing and Midwifery Research, 22(2), 157–163.