INCIVILITY Essentials Bundle


New nurses are at highest risk to experience incivility. Cognitive rehearsal is a best-practice strategy that will prepare them. This bundle includes Incivility PowerPoint w/notes, practice based scenarios, and faculty guide and FREE bonus to effectively present and practice this essential content!


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Get a buffet of clinical reasoning case studies to get your students nurse thinking and practice ready with access to everything on KeithRN, exclusive webinars, and two new case studies each month.

Get started for only $1, PLUS…receive a FREE copy of TEACH Students to Think Like a Nurse and student textbook THINK Like a Nurse ($100 value!).

Better yet, get your department on board at a discount. Contact Keith for an estimate!


The Problem.

Health care occupations such as nursing have the highest rates of incivility and bullying (Johnson & Rea, 2009). Surveys have shown that 93 percent of nurses have witnessed bullying and 85 percent reported that they were victims of bullying (Coursey, Rodriguez, Dieckmann, & Austin, 2013).

Incivility & Bullying Defined

Incivility is defined as a disregard for others that creates an atmosphere of disrespect, conflict, and stress that results in rude speech that can progress to more threatening situations (Clark, 2013).

The most common overt bullying behaviors in nursing include:

  • Patterns of faultfinding
  • Intimidation
  • Gossip
  • Put-downs
  • Nonverbal innuendo such as raising eyebrows or sighing.
  • More subtle bullying behaviors include isolation, exclusion, ignoring/refusing to help, and unfair assignments (Bartholomew, 2006)

 The Consequences

Sixty-four percent of nurses cited this as the primary reason for leaving their current job (Stagg, Sheridan, Jones, & Gabel Speroni, 2011). NEW NURSES as well as men (Dellasega, 2009) are more likely to experience incivility most often from other more experienced or senior nurses (Griffin, 2004).

For those that experience incivility, the following are commonly experienced:

  • Feelings of failure
  • Decreased self-esteem
  • Self-doubt
  • Anger
  • Depression
  • Burnout
  • Post-traumatic stress disorder (PTSD) are common (Bartholomew, 2006) which often leads to decreased morale, low job satisfaction, increased absenteeism, and ultimately leaving the unit or even nursing entirely (Murray, 2008)

Don’t let your students be a tragic statistic!

 The Solution.

The article Teaching Cognitive Rehearsal as a Shield for Lateral Violence: An Intervention for Newly Licensed Nurses” is a must-read for every student or new nurse (CLICK the link to download!). It defines professional behaviors as well as the most common uncivil behaviors. But more importantly, “cognitive rehearsal” teaches nurses to have a prepared plan to respond respectfully when specific uncivil behaviors are directed toward them.

Because incivility thrives in an environment of passivity, incivility can often be stopped in its tracks when it is directly addressed in an assertive, direct, and respectful way (Griffin, 2004).

I am passionate to see the cancer of incivility addressed head on in nursing education so every student is empowered to not only address it respectfully and directly, but have a high standard of professional behavior lived out so that they also embody what it means to be a healthcare professional.

 How to Practically Prepare Every Student
(it’s all about CONTENT & PRACTICE!)

To accomplish this vision I have created a special educators packet of essential resources that I have created inspired by the nursing literature and the groundbreaking work of Martha Griffin. Nursing theory and best practice is effectively taught when it is APPLIED and PRACTICED through ACTIVE learning.

Take 30″ in your next post-conference clinical to prepare your students for professional practice.

I have created the following resources to save HOURS of prep time and facilitate any educator to prepare and empower students to be the needed change:

  1. CONTENT-PowerPoint file (PPT) containing TWO presentations. The first addresses nursing incivility, the behaviors, consequences, and why it exists in a “caring” profession. The second PPT captures the essence of Griffin’s article on cognitive rehearsal to strengthen student understanding of this essential concept. I have taken my presentation I have shared on this topic across the country and adapted it for students! I even included my notes so you can present with confidence!
  2. PRACTICE-FOUR incivility scenarios (PDF) to APPLY cognitive rehearsal to clinical practice. These capture the essence of the most common uncivil behaviors and can be role played by students as well as one including a rude physician who is called for an update. Each scenario provides three reflection questions to go deeper and provoke needed discussion.
  3. ANSWER KEY to scenarios. I have used Griffin’s article to label the uncivil behavior as well as provide a practical response using cognitive rehearsal to guide this needed discussion and application!
  4. Instruction guide (PDF). Practical resource that provides step-by-step guidance and additional resources from the nursing literature to strengthen any educators knowledge of incivility in academia as well as clinical practice!

Complementary Bonus!

“How to Act Like a Professional”-chapter 4 from my book THINK Like a Nurse (PDF). This chapter has excellent background and needed depth to discuss professionalism and what it looks like in clinical practice. This chapter was reviewed and edited by Cindy Clark, the foremost authority on incivility in the nursing literature! Check out her website Civility Matters.

Closing Thoughts…

Many of your students are just about ready to graduate. You have done your best to help them pass the NCLEX and think like a nurse. But are your students well prepared to address and protect themselves from incivility?

It’s not too late. My hours of research and practical tools can save you hours of prep time.

There is no risk for you if you check out my latest tool for nurse educators. If for any reason you are not 100% satisfied, simply contact me and I will refund your purchase. No questions asked.

Thank you for all that you are doing to strengthen student learning and be part of the needed change in nursing education! It is a pleasure to partner with you!

Keith, RN


  • Bartholomew, K., (2006), Ending nurse to nurse hostility: Why nurses eat their young and each other. Marblehead, MA: HCPro Incorporated.
  • Coursey, J. H., Rodriguez, R.E., Dieckmann, L.S., & Austin, P.N. (2013). Successful implementation of policies addressing lateral violence. AORN Journal, 97(3), 101–109.
  • Dellasega, C. A. (2009). Bullying among nurses. American Journal of Nursing, 109, 52–58.
  • Griffin, M. (2004). Teaching cognitive rehearsal as a shield for lateral violence: An intervention for newly licensed nurses. The Journal of Continuing Education in Nursing, 35, 257–263.
  • Johnson, S. J. & Rea, R. E. (2009). Workplace bullying: Concerns for nurse leaders. The Journal of Nursing Administration, 39(2), 84–90.
  • Murray, J. S. (2008). No more nurse abuse. American Nurse Today, 17–19.
  • Stagg, S. J., Sheridan, D., Jones, R., & Gabel Speroni, K. (2011). Evaluation of a workplace bullying cognitive rehearsal program in a hospital setting. The Journal of Continuing Education, 12(9), 395–401.