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Art of NursingBlog

How to Address Student Incivility and Change the Culture in Your Program

By March 24, 2016 February 1st, 2019 3 Comments

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FREE case study & YouTube videoblog for those who are visual learners!

As a new nurse educator I truly was unprepared for the lack of a “honeymoon” in my new setting. Though I was passionate to do my best to prepare students for practice, I was NOT prepared for the following student behaviors:

  • Aggressively questioned and challenged my ability to write test questions
  • Insist that I “spoon feed” them in lecture and give them what they needed to know to pass the test
  • Insist that I give them back points taken off for deficiencies in performance check-offs
  • Make excuses in clinical for not being able to transfer knowledge to the bedside.

Though I had visions (more like a mirage!) that this was going to be a “beach” experience with students who were eager to learn and hang on my every “pearl” of clinical wisdom derived from my years of clinical practice, it did not take long for this idyllic vision of paradise in nursing education to come crashing down.

There was an elephant in the room, and it needed to be acknowledged for what it was, but this is easier said then done!

One Educator’s Story

Unfortunately these experiences were not isolated to me. I recently received an email from a nurse educator who was lamenting her current struggles with student behavior in her class and clinical.

I had a student raise her voice to me during a test review.  I lowered my voice and spoke directly to her (she was in the front row) and I believe I was able to bring her down to a level of coping versus losing control.  However, she followed that up with an email that essentially put my test writing abilities, my teaching style, and the current state of the notes I provide to the class to question. There was not one “I” statement in that email where she took any responsibility for her learning.

Has this been your experience? If so how has it impacted you personally and professionally?

Does student incivility steal your joy?

If so know you are not alone.

Though both student and faculty incivility is endemic in nursing education, it must first be clearly defined so both students and faculty know when a line has been crossed, acknowledge its impact, and how to respectfully and directly address it! (See my blog How to Help Students ACT Like a Nurse for more info!)

Defining Student Incivility

Entitlement and incivility have become increasingly pervasive in American society and contribute to incivility in nursing education (Clark & Springer, 2010). Unfortunately, students reflect these attitudes as they enter nursing education. Students may come to your program with a sense of entitlement that since they paid for an education, the college “owes” them a degree.

Student “entitlement” is exhibited by those who expect high grades for modest amounts of work, assume a “consumer” mentality toward education, refuse to accept responsibility and make excuses for their failures.

The most common student incivility behaviors are:

  • Disruptive behaviors in class/clinical that include
    • Rude comments, engaging in side conversations, dominating class
    • Cell phone, texting, inappropriate computer use in class
    • Late to class and leaving early
    • Sleeping in class (Clark & Springer, 2010)
  • Anger or excuses for poor performance
  • Inadequate preparation (Clark, 2008)
  • Pressuring faculty until they get what they want (Clark, 2008)
  • Bad-mouthing other students, faculty, and the nursing program (Clark, 2008)

Any of these look familiar to you? I have found that some of this bad behavior can become so common that it becomes the norm; such as bad-mouthing students, faculty, and the program.

Personal Consequences

When incivility is experienced in any context it produces a wide variety of painful emotions to those on the receiving end including:

  • Self-doubt. For new faculty such as myself, this was a biggie!
  • Anger
  • Depression
  • Self-blame…something is wrong with me
  • Burnout
  • Leave academia entirely or worse yet, stay but are checked out and disengaged. Just putting in your time

How to Bring Needed Change

Nursing academia ought to reflect and role model the core values of the profession, which include caring, compassion, nurturing of the other, and RESPECT.

To create a healthy academic culture, there must be a healthy RELATIONSHIP between both faculty and students. The principles that apply to healthy personal relationships are relevant and apply in academia.

This includes the foundation of open/honest communication, working together, and establishing boundaries that are clearly defined and enforced (see blog How to Change an Uncivil Academic Culture)

Faculty Responsibilities

Civility can become normative as a culture of RESPECT is cultivated in your department. The following are practical steps from the literature (Clark & Springer, 2010) that educators can implement to make a goal of civility possible:

  1. Model caring and respect in all that you do so your students can see what true professionalism looks like in practice!
  2. Provide opportunities to dialogue with students in open formats, such as a town hall meeting.. This can provide needed dialogue and understanding.
  3. Establish clearly written policies or place expectations in student codes of conduct that address incivility and consequences. Enforce them consistently.
  4. Listen carefully; give students positive feedback.
  5. Incorporate time management/stress reduction/self-care in the curriculum.

Student Responsibilities

  • Encourage your students to also do their part to create a culture of civility:
  • As a student, hold yourself to the highest standards of professionalism, which includes:
  • Be prepared, respectful, and engaged in your learning (Clark, 2011).
  • Do not speak in a negative, derogatory manner openly about other STUDENTS, FACULTY, or the nursing PROGRAM.
  • Abide consistently by the standards of student conduct of your institution.
  • Communicate your needs, and what you need/expect from faculty (Clark, 2011).
  • Work toward a common goal of civility and RESPECT (Clark, 2011).

High levels of STRESS for both students and educators contribute to the climate that can spark an inferno when incivil behaviors are present or perceived.

That is why it is imperative for both students and educators to live out and practice self-care! (see my blog on Helping Students THRIVE!)

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In Closing

If you are in nursing education, you are there for a reason. It is not just by chance or coincidence. You have a God-given talent to share and use what you have been given to benefit others.

Though incivility has the power to steal your joy or even take you out of the game, don’t stay there!

Remind yourself of what led you to pursue your current path in nursing education and get a resolve to let nothing derail you!

Step back, see the dilemma clearly, and move with empathy, not hostility and anger. Address it directly and respectfully and instead of being a casualty, you will bring needed change to your program that so desperately needs what you have to offer!

What do you think?
What strategies have you found successful to address student incivility?
Comment below and let the conversation begin!

Want More?

  • Cynthia Clark is a hero to me for her extensive and tireless work in the nursing literature on the topic of incivility in nursing education. Be sure to check out each reference from this blog, her website CIVILITY MATTERS as well as her book Creating and Sustaining Civility in Nursing Education.
  • This blog was in part derived from chapter 4 “How to Act Like a Professional” from my new student text THINK Like a Nurse. Click the link and see for yourself why Patricia Benner has endorsed it!

References

  • Clark, C. M. (2008). The dance of incivility in nursing education as described by nursing faculty and students. Advances in Nursing Science, 31, E37–E54.
  • Clark, C. M. (2011). Pursuing a culture of civility: An intervention study of one program of nursing, Nurse Educator, 36(3), 98–102.
  • Clark, C. M. & Springer, P.J. (2010). Academic nurse leaders’ role in fostering a culture of civility in nursing education, Journal of Nursing Education, 49(6), 319–325.

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But God shows his love for us in that while we were still sinners, Christ died for us. For the wages of sin is death, but the free gift of God is eternal life in Christ Jesus our Lord (Romans 5:8. 6:23)

Learn more…

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Join the discussion 3 Comments

  • Valerie Donnelly says:

    This blog is so timely! I teach the last level of Med-Surg in an AD program, and the viciousness of the students last semester caused me to leave a workplace that I love. I was badmouthed openly in the halls, lawyers became involved, and 40 years of being a respected professional in the community was trashed-all because the students did not like my exams, and many did not graduate. I came back, but the behavior of the students continues. Students know that I test on a higher level, and that they have to THINK to pass my exams, but they believe that the tests are “unfair” despite the exams having a high KR value. I am writing exams for another course now, and the same behavior is occurring. It is so disheartening that these students who aspire to be nurses, behave in this manner. faculty has never been treated so disrespectfully.

    • Keith Rischer says:

      Thank you for sharing Valerie. I hope that you are receiving support from your faculty group and holding students accountable for their behavior and working towards cultivating a culture of respect in your program.

  • Barb says:

    I have had experiences similar to Valerie. It is and continues to be very disheartening. I teach in a final year of an ADN program. My tests had questions were/are at a higher level for a medical-surgical course. The students’ greatly disliked these tests, and their viciousness, behaviors, and comments were unrelenting. Negative and disrespectful comments as well as untruths regarding myself were/are out in the community, sent via email and on social networking. Students filed a grievance because they failed the course and ultimately needed to withdraw from the program. I felt as though my character and integrity were on trial…I have never been treated in such a manner by the school’s administration and students. We lost a fair number of students after the first semester…we have never lost this many students in prior years.

    As the next semester started, it was brought to our attention that some of the students who had failed the first semester had obtained tests from a prior year. (It is unknown how they obtained these as we have a protocol we follow to enhance test security.) These students were studying/memorizing those test questions for their test prep; however, I was not using those test questions.

    While we lost approximately 1/3 of our cohort, the remaining students are on tract to graduate and it appears our students will be successful with their first attempt at the NCLEX®.

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