A silent epidemic, a great threat to patient safety, an ugly secret in the most caring of professions,
1these are just a few ways that incivility and bullying have been referred to in the literature over the last 10 years. Incivility and bullying have long existed in society and in health care, yet great strides have recently been made in moving the issue from the background to the forefront for discussion, leading to the beginnings of its prevention. It is known by many names—“eating our young,” “toughening up,” “getting a thick skin”—but at their core, they are the destructive and harming behaviors of disrespect and degradation. Edmonson and Allard
- Edmonson C
- Bolick B
Bullying: changing the conversation with evidence and tools.
Am Nurse Today. 2015; 10(11): 33
2noted that some of the origins of bullying in nursing can be explained using oppression theory. They observed that most incivility in nursing is nurse to nurse, horizontal behaviors, a characteristic of an oppressed group. However, incivility and bullying also occurs within and among professions. They represent a continuum of behaviors that range from disrespect to workplace violence.
- Edmonson C
- Allard J
Finding meaning in civility: creating no bullying zones.
Clin Scholars Rev. 2013; 6: 131-137
3They can occur top down, bottom up, and horizontally within any team or organization. A hierarchal relationship is not required. Worst of all, they may occur between the health care provider and the patient and family. Bullying behaviors can be born out of conflict for resources, authority gradients, gender struggles, generational differences, value differences, power struggles, and learned patterns of behaviors. Health care is a dynamic, complex, and often stressful environment and is primed for bullying behaviors to occur.
- American Nurses Association
Incivility, Bullying, and Workplace Violence.
To read this article in full you will need to make a payment
Purchase one-time access:Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
One-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:Subscribe to Nurse Leader
Already a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
- Bullying: changing the conversation with evidence and tools.Am Nurse Today. 2015; 10(11): 33
- Finding meaning in civility: creating no bullying zones.Clin Scholars Rev. 2013; 6: 131-137
- Incivility, Bullying, and Workplace Violence.http://www.nursingworld.org/MainMenuCategories/WorkplaceSafety/Healthy-Nurse/bullyingworkplaceviolence/Incivility-Bullying-and-Workplace-Violence.html(Accessed July 2, 2016)Date: July 22, 2015
- A phenomenological study of nurse manager interventions related to workplace bullying.J Nurs Adm. 2015; 45: 492-497
- Revisiting nurse turnover costs: adjusting for inflation.J Nurs Adm. 2008; 38: 11-18
- Raging bullies.NurseWeek. 2001; (Feb.12:10.)
- STOPBULLYINGNURSES: A Call for an End to Horizontal Violence and Relational Aggression in Nursing.www.stopbullyingnurses.com(Accessed July 2, 2016.)Date: 2012
- AONE Guiding Principles: Mitigating Violence in the Workplace.Accessed July 2, 2016)
- An ecological perspective on health promotion programs.Health Educ Q. 1998; 15: 351-377
- Civility Matters: What Is Civility?.Accessed July 2, 2016)
- Civility Tool-Kit: Resources to Empower Healthcare Leaders to Identify, Intervene, and Prevent Workplace Bullying: Introduction to the Tool-Kit.www.stopbullyingtoolkit.org(Accessed July 2, 2016.)Date: 2015
- Incivility and Bullying in Healthcare “Overview” Video 1 of 3. [Video]. August 7, 2015. YouTube website.Accessed July 2, 2016)
- Clark Civility Index for Faculty©.Accessed July 2, 2016)
- Cindy's ‘Five RITES’ for Fostering Student-Driven Civility.Reflect Nurs Leadersh. 2014; 39(1) (Accessed July 2, 2016)
- Clark Workplace Civility Index©.Accessed July 2, 2016)
- Civility Index Dashboard.Accessed July 2, 2016)
- ANA Sets ‘Zero Tolerance’ Policy for Workplace, Violence, Bullying.http://www.nursingworld.org/MainMenuCategories/WorkplaceSafety/Healthy-Nurse/bullyingworkplaceviolence/ANA-Sets-Zero-Tolerance-Policy-for-Workplace-Violence-Bullying.html(Accessed July 2, 2016)Date: August 31, 2015
- What you permit, you promote.Nurs Econ. 2009; 27: 245-250
- The Language of Collaboration.Accessed July 2, 2016)
- Perspective: a culture of respect, part 1: the nature and causes of disrespectful behavior by physicians.Acad Med. 2012; 87(7): 1-8
- BE AWARE and Care Mnemonic.Accessed July 2, 2016)
- Incivility and Bullying in Healthcare “Approach to Respectful Conversations” Video 2 of 3. [Video]. August 7, 2015. YouTube website.Accessed July 2, 2016)
- Incivility and Bullying in Healthcare “Practice Vignettes” Video 3 of 3. [Video]. YouTube website.https://www.youtube.com/watch?v5t8XddfSddzU(Accessed July 2, 2016)Date: August 19, 2015
- Respectful Conversations for Difficult Situations: Facilitator Guide.http://stopbullyingtoolkit.org/wp-content/uploads/2015/08/Respecful_Conversations_for_Difficult_Situations_Facilitator_Guide.pdf(Accessed July 2, 2016)Date: 2015
- Incivility and Bullying Code Word.Accessed July 2, 2016)
- (2012). Texas Health Dallas Employee Engagement Survey. Available at.Accessed August 15, 2012)
- Texas Health Dallas: National Database for Nursing Quality Indicators Report. Available at.Accessed November 23, 2015)
© 2016 Elsevier Inc. All rights reserved.
ScienceDirectAccess this article on ScienceDirect
- Letter to the EditorNurse LeaderVol. 15Issue 3
- PreviewI read with great interest the article “A Moral Imperative for Nurse Leaders: Addressing Incivility and Bullying in Health Care”1 in volume 15, issue 1, of Nurse Leader and wish to applaud the authors and Nurse Leader for bringing bullying and incivility to the forefront. As a novice nurse aspiring towards an advanced degree, I find the subject of bullying and incivility a delicate issue that needs to be confronted and addressed. After reading the article, I recognized that there are many effective tools available to use in my career as a nurse leader to combat aggressive and disrespectful behavior.
- Letter to the EditorNurse LeaderVol. 15Issue 3
- PreviewThank you for the excellent discussion that was presented in the article “A Moral Imperative for Nurse Leaders: Addressing Incivility and Bullying in Health Care.”1 In my role as the Director of Perioperative Services, empowering the health care team to address safety concerns is of upmost importance to a patient's safety in the surgical setting. The article presents the nursing aspect of incivility, but I was very disappointed that the disrespectful and demeaning behavior of physicians towards the health care team was not addressed.