Walden NURS 6053 Week 7 Discussion Workplace Environment Assessment

Walden NURS 6053 Week 7 Discussion Workplace Environment Assessment

Walden NURS 6053 Week 7 Discussion Workplace Environment Assessment

Incivility refers to a milder form of uncivil behavior conducted with the aim of harming the target.  All forms of incivility entail dysfunctional interpersonal relationships attributed to high employee turnover and low quality of care (Kisner et al., 2018). Nurses have a responsibility to establish and promote healthy interpersonal relationships with one another. They need to know how their communication and behavior or failure to act can cause incivility (Abdollahzadeh et al., 2017). This essay will analyze the results from the Work Environment Assessment, review literature on incivility, and explore evidence-based strategies to create high-performance interprofessional teams.

Work Environment Assessment

Results of the Clark Healthy Workplace Inventory

My workplace scored 67/100 on the Clark Healthy Workplace Inventory. The result suggests that the workplace environment is Barely Healthy (Clark, 2015). This was an unexpected score, as I expected to have at least a score in the moderately healthy range.  I was surprised that we only scored 5 points in only four items. It is somewhat surprising that our organization could only score the maximum points in only four items, which means that we have a long way to promote a healthier workplace. The four items include: Promotion of Teamwork and collaboration, Treating employees fairly and respectfully, using effective conflict-resolution skills, and Providing competitive salaries, benefits, compensations, and other rewards.

I was also surprised that my workplace scored 1 point in two items in the Clark Inventory. This was surprising because our organization belongs to a caliber that should not have very low scores on matters associated with healthy workplaces.  The two items that had the lowest score were: The workload being reasonable, manageable, and fairly distributed and Organization attracting and retaining the best and the brightest.

Before completing the Clark Inventory, I assumed that unreasonable and unmanageable workload is a primary cause of failing to retain the organization’s best staff. I believed that unbearable nursing workloads and nurses shortages are interconnected, in that each leads to the other. This was confirmed by the assessment, where I established that the high unmanageable nursing workload in our workplace is the primary reason for failing to retain staff.

What the Results Suggest About the Health and Civility of My Workplace

The assessment results indicate a stressful work environment that can be attributed to an unreasonable, unmanageable, and unfairly distributed workload.  A Barely Healthy workplace suggests a problem with the organization’s leadership; in that, the leaders are more goal-oriented than people-oriented. This results in the management focusing more on meeting its clients’ needs at the expense of the staff needs (Abdollahzadeh et al., 2017).  The results also mean that the staff’s needs may be overlooked, and their voice is not often considered during policy-making. Furthermore, they suggest that the staff may not be adequately engaged in making decisions that affect them, and the leadership does not recognize shared governance.

Despite the average results, the organization scored highly in items that indicate high civility in the workplace. These items include: Promotion of Teamwork and collaboration, Treatment of employees fairly and respectfully, and Use of effective conflict-resolution skills (Clark, 2015). The high scores in these items suggest that a culture of civility has been developed in the workplace.  It also means that the employees have strived to create and maintain civil, healthy work environments by communicating clearly and effectively, despite the harsh working environment. Besides, it shows that the staff manages conflict in the workplace respectfully and responsibly.

Reviewing the Literature

The article by Clark (2015) presents the concept of healthy work environments. The article mentions the six standards by AACN that are vital in establishing and sustaining healthy work environments, namely, skilled communication, effective decision-making, true collaboration, appropriate staffing, meaningful recognition, and authentic leadership (Clark, 2015). Clark also presents other standards from her research, crucial in promoting healthy work environments, which include: A common organizational vision, values, and team norms; Emphasis on both formal and informal leadership; Creation and sustenance of a high level of the individual, team, and organizational civility; and Civility conversations at all organizational levels.

Clark argues that when an uncivil encounter occurs, we may require to address it by having a critical conversation with the uncivil person. One needs to be well-prepared for this critical conversation, speak with confidence, and use respectful expressions (Clark, 2015). Critical conversations are often stressful. Thus, while taking a direct approach to resolving a conflict, it requires courage, know-how, and lots of practice. By having this conversation, one can end the silence that surrounds incivility. The article presents the DESC model, which can be used to address incivility in the workplace. The DESC model has four elements: D-Describe the specific situation, E-Express your concerns, S-State other alternatives; and C-Consequences stated (Clark, 2015). The critical conversations can occur more effectively when one is well-equipped with tools like this DESC model.

How the Concept Presented In the Article Relates To the Results of the Work Environment Assessment

The concept on the standards of sustaining a healthy work environment relates to the assessment results, in that ineffective decision-making, lack of appropriate staffing, and lack of authentic leadership in the organization has resulted in a less healthy environment. Lack of authentic leadership is evident in the workplace environment, which suggests that the organization’s leaders have not put much effort into ensuring the staff work in a healthy work environment. The leaders at my organization do not initiate or encourage open discussions and dialogues on promoting a healthy workplace. If they do so, they could have identified key factors that create a harsh working environment, such as inadequate staffing.

Ineffective decision-making by failing to engage the employees has contributed to a less healthy workplace. This is because the staff’s opinions on enhancing the workplace environment are not incorporated in policy-making. The low assessment results can be related to the employees’ failure to initiate a critical conversation with the management on issues that affect them. Perhaps, if we expressed their concerns to the leaders, we could be heard, and the various issues that negatively impact the workplace could be addressed. The tense relationship between the employees and the management can be attributed to the lack of conversations between the two groups, which is critical in ending the silence surrounding incivility.

How My Organization Could Apply the Concept to Improve Organizational Health

My organization can apply the identified standards to enhance organizational health by having direct and transparent communication at all organizational levels to promote respect among the staff and between the staff and the supervisors. The management can actively engage the staff by consulting or involving them in decision-making and developing organizational policies (Griffin & Clark, 2014). Additionally, the organization’s employees can apply the concept of critical conversation to discuss with the management on issues affecting them, such as inadequate staffing (Clark, 2015). Critical conversations can be started among the employees to help solve conflicts, especially between different professions, to help create strong intra- and interprofessional health teams.

Evidence-Based Strategies to Create High-Performance Interprofessional Teams

Strategies That Can Be Implemented To Address Any Shortcomings

The article by Clark (2019) discusses the use of Cognitive Rehearsal to address incivility that threatens patient safety.  Cognitive rehearsal (CR) is a technique employed in behavioral science whereby people work with a skilled facilitator to identify and rehearse effective methods of addressing a problem or social situation (Clark, 2019). It is intended to lessen anxiety, enhance confidence, and increase impulse control by practicing effective methods to solve potentially stressful situations. CR has been established to be an effective strategy to solve incivility in clinical practice and educational settings (Clark, 2019). A planned, rehearsed response presents a chance to convey expectations for appropriate behaviors and future interactions.

The article by Kisner et al. (2018) discusses the Mixed-intervention strategy, which effectively addresses incivility. The strategy entails the following steps: Providing personal support, education, and mediation between the perpetrator and the target. Using corrective action to discipline the perpetrator and educating the target to handle aggression (Kisner et al., 2018). The strategy also involves imposing policies and penalties to deal with aggressive behaviors. The last step is encouraging social interaction and interventions that promote collective responsibility in creating a safe and supportive culture.

Strategies That Can Be Implemented To Bolster Successful Practices

Successful practices in the workplace environment can be enhanced by holding Team-building sessions in organizations. The team-building sessions should build trust, engage staff in decision-making, clarify roles, and role-model positive interactions. Simulation can be employed in these sessions to promote better teamwork and collaboration. For instance, the simulation activity can involve a nurse role-modeling positive interactions with other nurses. The role-modeling can be useful in demonstrating to the staff the power of positivity in employees’ communication.

Organizations can develop and impose a zero-tolerance policy for incivility, which clearly outlines uncivil behaviors. The policy should be clear that incivility will not be tolerated in the organization, and if it happens, consequences will result. For instance, the policy can indicate that a staff who displays uncivil conduct will be given a verbal and written warning for each violation, and after three violations, they will be terminated. A policy is a very effective strategy as it outs employees conducting incivility on notice. Once the policy is developed, the management can conduct staff development programs for staff and managers about the zero- incivility tolerance policy. The programs can include enhancing communication skills, challenging culprits, and using silence to facilitate thinking.

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. https://doi.org/10.4103/1735-9066.205966

Clark, C. M. (2019). Combining cognitive rehearsal, simulation, and evidence-based scripting to address incivility. Research in Nursing Education| Nurse Educator, 44(2), 64-68. http://doi.org/10.1097/NNE.0000000000000563

Clark, C. M. (2015). Conversations to inspire and promote a more civil workplace. American Nurse Today, 10(11), 18-23.

Griffin, M., & Clark, C. M. (2014). Revisiting cognitive rehearsal as an intervention against incivility and lateral violence in nursing: 10 years later. The Journal of Continuing Education in Nursing, 45(12), 535-542. http://doi.org/10.3928/00220124-20141122-02

Kisner, T. (2018). Workplace incivility: How do you address it?. Nursing2019, 48(6), 36-40. http://doi.org/10.1097/01.NURSE.0000532746.88129.e9

Walden NURS6053 Week 7 Discussion Workplace Environment Assessment

You must proofread your paper. But do not strictly rely on your computer’s spell-checker and grammar-checker; failure to do so indicates a lack of effort on your part and you can expect your grade to suffer accordingly. Papers with numerous misspelled words and grammatical mistakes will be penalized. Read over your paper – in silence and then aloud – before handing it in and make corrections as necessary. Often it is advantageous to have a friend proofread your paper for obvious errors. Handwritten corrections are preferable to uncorrected mistakes.

Use a standard 10 to 12 point (10 to 12 characters per inch) typeface. Smaller or compressed type and papers with small margins or single-spacing are hard to read. It is better to let your essay run over the recommended number of pages than to try to compress it into fewer pages.

Likewise, large type, large margins, large indentations, triple-spacing, increased leading (space between lines), increased kerning (space between letters), and any other such attempts at “padding” to increase the length of a paper are unacceptable, wasteful of trees, and will not fool your professor.

The paper must be neatly formatted, double-spaced with a one-inch margin on the top, bottom, and sides of each page. When submitting hard copy, be sure to use white paper and print out using dark ink. If it is hard to read your essay, it will also be hard to follow your argument.

ADDITIONAL INSTRUCTIONS FOR THE CLASS

Discussion Questions (DQ)

Initial responses to the DQ should address all components of the questions asked, include a minimum of one scholarly source, and be at least 250 words.
Successful responses are substantive (i.e., add something new to the discussion, engage others in the discussion, well-developed idea) and include at least one scholarly source.
One or two sentence responses, simple statements of agreement or “good post,” and responses that are off-topic will not count as substantive. Substantive responses should be at least 150 words.
I encourage you to incorporate the readings from the week (as applicable) into your responses.

Weekly Participation

Your initial responses to the mandatory DQ do not count toward participation and are graded separately.
In addition to the DQ responses, you must post at least one reply to peers (or me) on three separate days, for a total of three replies.
Participation posts do not require a scholarly source/citation (unless you cite someone else’s work).
Part of your weekly participation includes viewing the weekly announcement and attesting to watching it in the comments. These announcements are made to ensure you understand everything that is due during the week.

APA Format and Writing Quality

Familiarize yourself with APA format and practice using it correctly. It is used for most writing assignments for your degree. Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for APA paper templates, citation examples, tips, etc. Points will be deducted for poor use of APA format or absence of APA format (if required).
Cite all sources of information! When in doubt, cite the source. Paraphrasing also requires a citation.
I highly recommend using the APA Publication Manual, 6th edition.

Use of Direct Quotes

I discourage overutilization of direct quotes in DQs and assignments at the Masters’ level and deduct points accordingly.
As Masters’ level students, it is important that you be able to critically analyze and interpret information from journal articles and other resources. Simply restating someone else’s words does not demonstrate an understanding of the content or critical analysis of the content.
It is best to paraphrase content and cite your source.

LopesWrite Policy

For assignments that need to be submitted to LopesWrite, please be sure you have received your report and Similarity Index (SI) percentage BEFORE you do a “final submit” to me.
Once you have received your report, please review it. This report will show you grammatical, punctuation, and spelling errors that can easily be fixed. Take the extra few minutes to review instead of getting counted off for these mistakes.
Review your similarities. Did you forget to cite something? Did you not paraphrase well enough? Is your paper made up of someone else’s thoughts more than your own?
Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for tips on improving your paper and SI score.

Late Policy

The university’s policy on late assignments is 10% penalty PER DAY LATE. This also applies to late DQ replies.
Please communicate with me if you anticipate having to submit an assignment late. I am happy to be flexible, with advance notice. We may be able to work out an extension based on extenuating circumstances.
If you do not communicate with me before submitting an assignment late, the GCU late policy will be in effect.
I do not accept assignments that are two or more weeks late unless we have worked out an extension.
As per policy, no assignments are accepted after the last day of class. Any assignment submitted after midnight on the last day of class will not be accepted for grading.

Communication

Communication is so very important. There are multiple ways to communicate with me:
Questions to Instructor Forum: This is a great place to ask course content or assignment questions. If you have a question, there is a good chance one of your peers does as well. This is a public forum for the class.
Individual Forum: This is a private forum to ask me questions or send me messages. This will be checked at least once every 24 hours.

Incivility is a reoccurring problem in the healthcare system. According to Clark (2018), uncivil work environments lead to self-doubt, weakened self-confidence, and compromised clinical judgment skills. Therefore, uncivil working environments lead to less safe conditions for patients and staff working in the environment. About 20% of workers report that they experience or witness incivility daily (Di Fabio & Duradoni, 2019). I believe it is important to feel valued and respected in the workplace. Uncivil work environments can cause a quick turnover and poor morale.

How Civil is my Work Environment?

After taking the Work Environment Assessment, I was sad to find out that my current place of work is in the “Barely Healthy” category. Following the prompts, my place of work scored 68 out of 100. My organization was missing many categories that create a healthy work environment, such as shared values, emphasis on leadership, and civility conversations (Clark, 2015). My current organization scored a few 4’s, many 3’s, and even a few 2’s when completing the survey. Something I feel my organization needs to work on is room for growth. There are often no raises and next to no opportunities for promotions and growth. Tuition is not reimbursed, and there is no support for furthering your education. Another area where my organization did not score high is that although a small organization, nurses are often left out of decision-making even when the decision directly involves floor nurses. This creates a low employee satisfaction rate and mistrust in organizational leaders.

A Time I Experienced Incivility

Unfortunately, I think we have experienced incivility more than once in our nursing career. Recently I had an experience where a coworker was rude and unhelpful. We did not have enough Certified Nursing Assistants (CNAs) on our unit for the day, and I had multiple entirely dependent patients. I asked my coworker, another RN, to assist in helping me get my patient back into bed and change their diaper. My coworker responded, “I am not a CNA; that is CNA work .”I was frustrated because I tried to go above and beyond to help out my coworkers and CNAs, and also annoyed because all CNA work falls under nursing care. However, I did not have time to argue with her, so instead, I asked another coworker who was willing to help me. When my director heard about the confrontation, I was upset because she asked me why I did not ask the CNA for help before asking the other nurse. However, the CNA was in another room, and the nurse was sitting at the nurses’ station. I felt unsupported and annoyed because I always help out my coworkers. At my organization, many nurses understand that we have to support each other because we often do not have extra support. The nurse unwilling to help me was new to the organization; the charge nurse that day heard what occurred and reeducated the new employee that CNA work is still considered nursing care and must be completed by nurses if there are not enough CNAs on the shift. I hope that in the future, she will be willing to help so that the patients do not suffer.

Conclusion

Incivility can negatively impact your work life and cause self-esteem issues in your home life (Di Fabio & Duradoni, 2019). Understanding the impact of incivility on your employees when in a leadership position and on your coworkers is essential. As nurses, we should understand how to acknowledge and address incivility to protect ourselves and our patients best. Organizations should survey their employees to determine where there is room for improvement to create a safer and happier working environment.

References

Clark, C. M. (2015). Conversations to inspire and promote a more civil workplace. American Nurse Today, 10(11), 18-23 Retrieved from https://www.myamericannurse.com/wp-content/uploads/2015/11/ant11-CE-Civility-1023.pdf

Clark, C. M. (2018). Combining cognitive rehearsal, simulation, and evidence-based scripting to address incivility. Nurse Educator, 44(2), 64–68. https://doi.org/10.1097/nne.0000000000000563

Di Fabio, A., & Duradoni, M. (2019). Fighting incivility in the workplace for women and all workers: The challenge of primary prevention. Frontiers in Psychology, 10. https://doi.org/10.3389/fpsyg.2019.01805

Workplace environments such as patient care settings should be supportive to ensure that the staff has good working environments to help enhance patient outcomes. The implication is that the environment significantly affects patient and nursing outcomes. Therefore, organizations should strive to cultivate positive cultures, such as interprofessional collaboration and patient safety culture (O’Donovan et al.,2019). Respect for diversity and civil behaviors to help support a positive work environment and lower the chances of incivility. As such, the purpose of this assignment is to examine the results of the work environment assessment, review relevant literature, and present evidence-based strategies for creating high-performance interprofessional teams.

The Work Environment Assessment

            From the responses, our workplace is moderately healthy, with a score of 85. There is a high level of employee satisfaction, engagement, and morale. There are sufficient resources for professional growth and development. There is an emphasis on employees’ wellness and self-care. The score, therefore, indicates that our organization is civil. Various aspects were supervised from the assessment. For example, the organization has been known to value efficient, safe, and high-quality patient care, and it has also consistently achieved a high ranking based on quality and safe patient care and patient satisfaction. However, the facility has been having complications with retaining the staff, an indication which could be a reflection that the staff is not that satisfied. As such, I expected a lower score. The next aspect which surprised me was the score obtained regarding the application of teamwork in the organization. It has been evident that nurses use teamwork when offering care to patients. They also have been using multidisciplinary teams in care assessment, planning, implementation, and monitoring. Nonetheless, the scores related to teamwork were low, which was a surprise to me.

There are also other ideas that I believed and got confirmed by the workplace assessment. For example, the organization obtained lower scores connected to conflict resolution. The organization has operated for a long time without putting in place a formal structure for conflict resolution. Hence a considerable number of conflicts remain unresolved. This was confirmed by lower scores. The assessment of the organizations showed that my workplace is moderately healthy. The high scores were obtained since the organization values the use of effective strategies that promote patient care. Therefore, there is a need to integrate strategies that would help the organization work on the areas of weakness.

Reviewing of Literature

 The theory presented in the chosen article highlights how heightened levels of student stress and nursing faculty, workload,  faculty superiority, and the attitudes of student entitlement all lead to incivility. Therefore, this concept is a reflection of how stressors can lead to incivility in nursing practice as well as nursing education. The article highlights various stressors, such as lack of skills and knowledge, organizational conditions, unclear expectations and roles, and work overload. According to the theory presented in the article, it is important to model effective communication to help address incivility since it has been shown that effective communication helps in lowering the incidences and impacts of civility (Clark et al.,2011).

The theory presented in this article is related to the results of the work environment assessment. For example, it is important to note that the organization has been using effective communication to help drive forward patient safety and efficiency forward, which saw the organization obtain high scores in this regard. Therefore, it helped the organization to obtain a moderately healthy status. On the other hand, a lack of effective communication has been observed in conflict resolution times, where the organization lacks a formal model of communication that can help resolve conflicts. As such, the organization had low scores in the area. The organization can apply this theory to create stronger work teams by using effective communication as part of conflict resolution (Griffin et al.,2014). This will help the workers to solve their conflicts better and create stronger teams by working together.

Evidence-Based Strategies to Created High-Performance Interprofessional Teams

            The workplace assessment revealed that the organization is moderately healthy. However, various strategies can still be applied to address the shortcomings revealed in the assessment to improve the organization. One of the strategies that can be used is to enhance employee engagement in organizational issues. One aspect that was found to lead to lower retention rates is the minimal involvement of the staff in organizational issues. Therefore, their engagement on organizational issues should be enhanced. The use of staff engagement has been supported by literature (Huang & Pun, 2022). Another strategy is rewarding employees who perform well. Such a strategy will lead to motivating the staff and increasing their job satisfaction, productivity, and retention. The strategy will also likely reduce conflicts as employees will be rewarded based on their performance (Seitovirta et al.,2018). Various strategies can also be implemented to bolster successful practice. For example, the organization can use open communication, an effective reward system as well as an appropriate conflict resolution mechanism.

Conclusion

            Workplace incivility negatively impacts both patient outcomes and the nursing activities performed to improve patient outcomes. Workplace assessment can be key to revealing how civil the work environment is. The workplace assessment performed revealed that the organization is moderately civil; as such, various strategies can be used to help improve the organization.

References

Clark, C. M., Olender, L., Cardoni, C., & Kenski, D. (2011). Fostering civility in nursing education and practice: Nurse leader perspectives. JONA: The Journal of Nursing Administration, 41(7/8), 324-330. 10.1097/NNA.0b013e31822509c4

Griffin, M., & Clark, C. M. (2014). Revisiting cognitive rehearsal as an intervention against incivility and lateral violence in nursing: 10 years later. The Journal of Continuing Education in Nursing, 45(12), 535–542. https://doi.org/10.3928/00220124-20141122-02

Huang, Q., & Pun, J. (2022). Views of Hospital Nurses and Nursing Students on Nursing Engagement—Bridging the Gap Through Communication Courses. Frontiers in Psychology, 13, 915147. https://doi.org/10.3389/fpsyg.2022.915147

Seitovirta, J., Lehtimäki, A.-V., Vehviläinen-Julkunen, K., Mitronen, L., & Kvist, T. (2018). Registered nurses’ perceptions of rewarding and its significance. Journal of Nursing Management, 26(4), 457–466. https://doi.org/10.1111/jonm.12571

O’Donovan, R., Ward, M., De Brún, A., & McAuliffe, E. (2019). Safety culture in health care teams: A narrative review of the literature. Journal of Nursing Management, 27(5), 871–883. https://doi.org/10.1111/jonm.12740