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Fostering a Culture of Civility in Nursing Education and Practice

By March 31, 2021No Comments

Why do incivility and bullying remain a problem in nursing education and practice settings when nursing is predicated on caring and compassion towards others?

Dr. Cynthia Clark joined me on Facebook and YouTube Live for a discussion about how students, nurse educators, and nurses in practice can foster a culture of civility and be a  part of the needed change.

Dr. Clark is an award-winning tenured professor, professor emeritus at Boise State University, and the Founder of Civility Matters. She is a licensed registered nurse with more than 30 years of experience in health care practice and academic settings.

She is a leading expert in fostering civility and healthy work environments around the globe. Her groundbreaking work on fostering civility has brought national and international attention to the controversial issues of incivility in academic and work environments. Her theory-driven interventions, empirical measurements, theoretical models, and reflective assessments provide “best practices” to ­­prevent, measure, and address uncivil behavior and to create healthy workplaces. 

Her book, Creating & Sustaining Civility in Nursing Education, Second Edition, explores the problem of incivility within nursing academe and provides practical solutions that range from ready-to-use teaching tools to principles for broad-based institutional change.

Dr. Clark started her career as a behavioral health nurse working with adolescents with mental health issues. She noticed how the young people she worked with heard so many damaging words over and over, and realized that what was important for transformation in their lives was focusing on what we could do to give these kids strength.

The essence of what it means to be a nurse is seeing the dignity in every human being. We need to recapture our compassion in nursing to foster a culture of civility.

What are the behaviors that are hurtful to students, other nurse educators, and fellow nurses?

  • Incivility: A range of lower intensity acts of aggression. A person might roll their eyes, slam a door, act with disdain, spread rumors, gossip, or put others down based on their weight, religion, ethnicity, etc. They might post damaging things on social media, withhold information, or fail to acknowledge a person. There are many ways we can ignore or marginalize people, and lower intensity acts of incivility can easily escalate. 
  • Bullying: A persistent pattern of abusive behavior of someone asserting their power over another person. Bullying is especially problematic around promotion and tenure in academia. Often, others fear speaking up because they fear losing advancement opportunities.  
  • Mobbing: Bullying on steroids. A group coalesces or colludes to socially pile on and target an individual to ridicule, marginalize, and humiliate. The physical, emotional, psychological, and spiritual damage is very difficult to recover from.

In academia, incivility plays out between the following groups or individuals:

  • Student(s) to faculty: Students may mob faculty without them knowing about it. We may see it on ratemyprofessors.com, and there are many other ways it can happen. During COVID, many faculty are noticing incivility play out in online classes.
  • Faculty to student(s): Faculty might treat students as if they are expecting them to fail. Students just want some words of encouragement. 
  • Faculty to faculty: Some things that faculty do is set up faculty to fail and belittle them in faculty meetings. Many faculty avoid addressing incivility in their department for fear of personal and professional retaliation, because they don’t have the skillset to address it, or they are worried about evaluations.

What is the solution to incivility? Civility.

  • Civility is making a choice to engage or not to engage. Being merely “civil” doesn’t cut it. Civility is about finding ways to connect, fostering equity and belonging, and bringing people together, treating one another with respect and dignity. Ultimately we are trying to create a joyful culture in our workplaces. 
  • Martha Griffin’s cognitive rehearsal technique is a useful intervention for incivility. Many people don’t understand how to speak up for others. Cognitive rehearsal uses an evidence-based framework to create your own scripts. For example, if a colleague comes to you to complain about another colleague, you have a choice in how you engage with them. You can ask the colleague to talk with the other colleague about their problem rather than trashing them.
  • In higher education, how are we supporting each other? Are we collaborating? Are we fostering equity and belonging? Are we treating each other with dignity and respect? Does everyone feel valued? 
  • Co-create a class charter and class expectations and norms with your students. Students and faculty then hold each other accountable. When student incivility happens, have a conversation about expectations. “Remember when we co-created norms and respect was part of that? Can you tell me what your issue is in a professional manner?” Remind them that every nurse has an ethical and moral obligation to create a culture of civility and respect. 
  • Name the values we seek in nursing education—Professional Identity Formation clearly intersects with this work.
  • Increasing diversity in nursing education is an opportunity to see how we are accepting of all members of the educational setting. Civility and respect has to be a part of equity and diversity. We need to come together, not silence opinions or voices that need to be heard. How do we take our learning to the next level together? We have to show respect to everyone’s pathway and journey.

Closing Thoughts

For educators who may want to give up, you need a plan in place to take care of yourself. One of the most important lessons learned during the 1918 pandemic was the vital need for collaboration and relationship building. The same is true today. Reach out and celebrate your accomplishments. Be empathetic in every encounter you have. You never know what someone else’s experience or journey might be. It changes our mindset to act with goodwill. 

We get to choose who we want to be, and we get to consider our role and place in this world. What do you want your legacy to be? How we act today reveals our character and our grit. We need you as nurse educators. 

Contact Dr. Cindy Clark at cclark@boisestate.edu.

To learn more, watch the video of this conversation: