NR 500 Week 7 Graded Assignment: Cultivating Healthful Environments (2 Versions)

NR 500 Week 7 Graded Assignment: Cultivating Healthful Environments (2 Versions)

NR 500 Week 7 Graded Assignment: Cultivating Healthful Environments (2 Versions)

Mosadeghrad (2014) suggest that a variety of factors influence the quality of services provided by nurses in their routine practice. The incidents of incivility could be a major reason in this list. Therefore, it is extremely critical to further assess this issue so that adequate policy measures can be drafted to address this issue. According to Brown and Cummings (2013), there could be different names ad terms but incivility, violence, and bullying is often witnessed by practicing nurses. Therefore, the code of conduct for nursing has seen many revisions in light of this issue, as stated by Simpson (2016). The objective of this paper is to examine the incidents and issue of incivility against nurses and how to deal it effectively without braking the decorum. It also helps the healthcare professionals as well as the management to create a better environment for service delivery.

Issue of Incivility

Several academic researchers have defined the cases of incivility in nursing in different ways. According to American Nurses Association (2015), incivility refers to the act of behaving rudely and without curtesy with the hospital staff. For example, if an individual spreads rumors with the intention to create panic in the hospital complex. In another case, a colleague may refuse to support another to create nuisance in the hospital environment. According to Mosadeghrad (2014), since nurses work in an extremely stressful environment where situations swing between life and death, this incivility becomes an integral part of the business. Even with the best of efforts, the incidents cannot be completely eliminated.

Apart from this, there are many risks and hazards associated with the profession of nursing. Therefore, the nurses as well as patients could be extremely tired and frustrated and lead into behaviors that are classified as incivility. Equipped with these assumptions and knowledge, Lachman (2014) suggests that we need both, primary as well as secondary interventions to address this issue. With the help of primary interventions, the incidents can be prevented while secondary interventions are used to bring down the frequency of such incidents.

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Due to incivility, the relationship between nurses and patients, or fellow nurses may get impacted severely. As a result, there could be many conflicts that hamper the day to day work. The seminal paper by Wood (2016) suggests that due to incivility, the performance of nurses could go down significantly. As a result, the overall healthcare services become of low quality. Having learnt these massive impacts of incivility in the healthcare environment, it is extremely importance to find a solution to this problem so that the healthcare professionals may work in a normal manner.

Importance to Nursing

Lachman (2014) argues that the incidents of incivility in the healthcare environment have been increasing in the last few years, and it has brought down the quality of healthcare services.  The nurses as well as patients, both have to bear the brunt of it. As the situation worsens on day by day basis, the sector would find it hard to maintain the quality, allocate resources intelligently, and maintain the desired level of patient outcomes. Due to the bad behavior that nurses see around them, they often end up either leaving their job or the industry altogether. Therefore, the turnover rate of nurses also becomes higher. Incivility makes the healthcare environment extremely stressful and impacts the psychology of nurses (Chamberlain College of Nursing, 2017). When nurses face constant conflicts, stressed environment, sleep deprivation, or embarrassment at workplace, they lack motivation to work at their full efficiency (Wood, 2016). Due to this increased activity, the nurses may also fall sick and remain absent from work. For a family nursing practitioner, such issues could trigger negative emotions. Brown and Cummings (2013) further elaborate on the ways in which negative emotions could impact the performance of family nurse practitioners.

Due to incivility and the associated poor performance, the nurses often receive bad ratings in performance appraisal. Such ratings often discourage them and the performance level and commitment further reduces. The emotional impact due to incivility could come out in the form of anger, isolation, or fear etc. (American Nurses Association, 2015).

Incivility has other effects also, such as causing damage to the staff nurses. Gradually, increase in the incident of mistreatments provokes the people engaged with the matter and makes the situation intense. Simpson (2016) accepts that there are chances that nurses could get physically injured in the environment of violence. Such conditions take place when one person does not trust another person leading to misunderstandings, arguments and self-interest.


Initially, I had no idea about Incivility and its effects. It is when I started my career in nursing I came to know about Incivility in detail. I faced certain challenges in the start while dealing with the cases of patient’s family incivility. Though the subject of the topic is similar still the cases differ and so the way to handle them. During my job, I realized that the members of nurse team and physicians’ team can coordinate and work closely with each other. They together made a strong team and delivered a recognizable service to the patients admitted at a hospital provision.

I encountered many instants where everything could turn out as a huge fight. But the physicians and the nurses looking after that matter somehow managed to handle it smoothly. The matter was regarding the family patient who was supposed to move to the general ward from the ward of intense precaution. Whereas the one group was confident about the decision, another group was still in doubt. The physicians were sure that the patient is in a condition where he can have cared but the nurses were not sure and needed the help of physicians to deal with it (McCormack & McCance, 2017).

There are some ethics to be followed in Nursing out of which one is to treat with respects to other professionals working with you. There is a major reason behind it. Take an example, if the patient is in a critical condition and professionals tend to have different opinions during operation can lead to the patient into danger. Therefore, professionals need to understand the sensitivity of the situation and act accordingly in the operation theatre. Admiring of each other’s opinion is required for the patients’ safety.  As such, the respect of the ideas from both parties involves ensuring that the patients were well cared for.

Creating a Healthful Environment

The health organizations are regulated effectively through implementing the certain strategy like a flow of effective communication. The first strategy that should be employed for the creation of a healthful environment is ensuring that there is effective communication. On this, Lachman (2014) states that effective communication can be a key to solve any disputes or misunderstandings in a healthcare center or anywhere. opines that communication will help in the resolution of possible issues that may occur in the healthcare profession. Additionally, it also keeps the members concerned informed on activities taking place.

Another strategy explained is coordination. The hospitality is all about caring and goes under manpower. Hence, all the people concerned with each other need to coordinate with each other for smooth operations. Understanding its importance, Brown and Cummings (2013) concludes that if organization aims to achieve the success they should know keep the team spirit allow which is always ready to come front to help each other. Such environment is a boom when it comes to providing training to new employees.

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The third strategy is employees engagement. Though the leaders are tending to know for effective decision making due to the experience they acquired, they show involve other unit members in decision making. Also, everyone differs and so does their thought, one can never know when the great idea can come from. The practice of engaging everyone in the course motivates everyone making them feel important. Hence, they also feel appreciated and give their best in every work they take into account. Through research, Mosadeghrad (2014), stated that engaging everyone is a stepping stone to achieve company’s vision and mission involvement in decision making. Involving others in the process of decision making is filled with advantages like the transparency of activities, exchange of ideas, and elimination of disputes and so on.

Practice Application

My role is the family nurse and my responsibilities at work include managing the illness of the patient taken admission in the healthcare and carrying out the physical tests as per procedure. I have been also honored with the task of specialty diagnosis which is meant to looking after the family members for their health for their entire life. We often get a call for meetings between employers and employees. During the meeting, we discuss the activities, critical condition and everything related to patients. The meetings bring clarity among everyone about tasks, its goal and etc. Also, the feeling of engagement motivates us to work effectively.


Through this paper, we get to know about the role and responsibilities of a practitioner of the family nurse. They have curtained aligned tasks to be performed for maintaining the standards set by hospitals in regard to caring of patients. Additionally, they have to go through certain situations like among the members of the unit. Incivility refers to an offensive and bad-mannered behavior which often give rise to a corrupt culture. It affects the people working in an organization and indirectly affects their working pattern. Hence, healthy environment is very important for smooth working. It can be achieved through various well-defined strategies mainly employee engagement and effective communication. Communicating with each member and asking for their opinion for decision making brings the number of benefits to an organization.


American Nurses Association. (2015). Incivility, bullying, and workplace violence. American Nurses Association.

Brown, P., & Cummings, G. (2013). Factors influencing intentions to stay and retention of nurse managers: a systematic review. Journal of Nursing Management, 21(3), 459-472.

Chamberlain College of Nursing. (2017). Mission, philosophy, program outcomes. Retrieved from

Lachman, V. D. (2014). Ethical issues in the disruptive behaviors of incivility, bullying, and horizontal/lateral violence. Medsurg nursing, 23(1), 56.

McCormack, B. & McCance, T. (2017). Person-centred practice in nursing and health care. Theory and practice (2nd ed.). Oxford: Wiley Blackwell.

Mosadeghrad, A. M. (2014). Factors influencing healthcare service quality. International journal of health policy and management, 3(2), 77.

Simpson, K. R. (2016). Incivility, bullying, and workplace violence: new recommendations for nurses and their employeeers from the American Nurses Association. MCN: The American Journal of Maternal/Child Nursing, 41(1), 68.

Wood, R. M. W. (2016). Workplace bullying between registered nurses: Occurrence and perceived effects on work productivity (Doctoral dissertation, Villanova University).

Master’s-prepared advanced practice nurses participate in and demonstrate fair and unbiased interactions within all workplace settings. As a member of the nursing profession, and a leader, you are encouraged to implement strategies that promote and cultivate cultures of civility, regardless of practice setting. The purpose of this assessment is to analyze the issue of incivility and apply best practices to cultivate healthful environments.

Criteria for your Cultivating Healthful Environments  Content

Reflect on the issue of incivility. Think of an experience in which you were directly …. or witnessed incivility in the workplace. Analyze scholarly literature related to the issue of incivility and strategies for cultivating healthful environments. In a four- to six-page written paper, address the following.

  • Define and explain the issue of incivility. Use scholarly nursing literature.
  • Discuss the importance of this issue to nursing. Address the impact of incivility on individuals, microsystem work environments, and the profession of nursing. In this section, use at least three (3) different scholarly nursing literature in-text citations with matching references.
  • Provide a scenario (real or fictitious) of incivility in a practice setting. What was the impact on the individuals … ? How was the work environment …. ?
  • Describe three strategies for creating a healthful environment. Use scholarly nursing literature to support each strategy.
  • Identify your selected specialty track (education, executive, family nurse practitioner, healthcare policy, or nursing informatics). Provide two examples of strategies you will implement in your master’s-prepared advanced practice role to cultivate a healthful work environment.
  • Provide a conclusion. Include a summary on the issue of incivility, strategies to create healthful environments, specialty track, and how you will contribute to cultivating healthful environments in your future professional practice. Include a self-reflection.

Unfortunately, like you stated many times the acts of incivility in nursing not only impact the individual but the unit and patients as well. Incivility, is a form of bullying that leaves the individual being bullied feeling alone, afraid to ask questions, and helpless. For the nursing unit incivility can cause frustration and division within the unit. Nurses being bullied will move on to other nursing units, find a new organization to work for, or quit the nursing profession all together. Incivility, bullying, and workplace violence are part of a larger complex phenomena, which includes a constellation of harmful actions taken and those not taken in the workplace (ANA, 2015), that needs to be recognized and stopped. Staff nurses and leaders within the environment must build an environment of trust, respect, teamwork, and education to eliminate incivility behaviors that have been long known behavior in nursing practice.


American Nurses Association. (2015). Incivility, bullying, and work place violence [Position Statement]. Retrieve from file:///C:/Users/User/Downloads/PosStat-Endorsed-ANA-Incivility-Bullying-Violence.pdf

Dr. Cox and Class,

Reflect on an experience in which you were directly involved or witnessed incivility in the workplace. Provide a brief synopsis of the situation. How did this make you feel? How did you respond? What were the consequences of this situation? Provide an example of how this negatively affected the work environment and outcomes. How could the situation have been prevented? Discuss strategies that would support a healthy work environment.

Recently I worked a shift at my local hospital.  There was a newly hired health unit coordinator (HUC) working who is good friends with several of the employees who regularly go out and socialize at the local bars.  I have never been invited to these outings. Most of the time when I work with anyone in this clique, I feel like an outsider. This particular day, I could sense the HUC becoming increasingly short and irritable to me. I observed her going out of her way to be kind and friendly to the other nurse and staff, but not to me. I felt a palpable tension in the air.  When I was working with an ER called out to the desk, the HUC would hang up and not respond after I said thank you with the expected professional phone greeting of “you’re welcome” or “bye”. It is so uncomfortable when I feel that someone is going out of their way to be rude to me, but I have no idea why or what I have done to cause it. I find myself worrying about this and being preoccupied while having difficulty concentrating on my job and feeling overwhelmed which is reported to be a common occurrence (Green, 2020). I felt like I was being bullied by this HUC by being ignored and excluded. Then I wonder if it is just me, or in my head.  At the end of the shift, in private, I shared what I was feeling with the other nurse I was working with.  She told me that she did not want to hurt my feelings but that the HUC had rolled her eyes behind my back and the other nurse caught her doing so.  The HUC then smiled at the other nurse. I felt embarrassed and humiliated, but I was glad to have my feelings confirmed that the social signals I felt like I was perceiving were not in my head.

In our rural hospital, staffing usually consists of 2 RNs, 1-2 techs, and 1 HUC who works mostly day hours. To give some back story, when working with others in this clique during the night shift, there may be an entire shift where they do not speak to me while having a conversation, food, and breaks together the entire night. While it is difficult to put how it has felt into words, I have felt awkward, embarrassed, and shunned by a team I wanted desperately to be a part of.

Some of the most frustrating experiences have been when an ER is expected, and the other nurse and team members have been given the patient information about the impending patient, but information has been purposely withheld from me. Sabotaging and excluding nurses have been well-documented in lateral violence behavior (Roberts, 2014). 

The next day after working with this HUC, I stopped by the hospital. She happened to be working again.  I privately approached her and asked if I had done something wrong because I noticed her rolling her eyes at me behind my back.  She responded that she is “just high-strung”.  I also told her but asked that she not address it.  I did not want the nurse that confided in me to be put in the middle.  However, the reality of the situation is, that it would not be addressed anyways.  It is my perception that the working environment is toxic. While the mission at the hospital and new employee orientation call for actions to be guided by Christian values, (Avera, 2022), many staff behaviors are anything but Christian. Any changes will need to come from leaders who will be willing to model and foster positive behaviors.  Leaders will need to educate and promote a zero-tolerance policy that they are willing to enforce and administer consequences if the policy is not followed.

When I work in a different hospital that does not have a toxic environment and the staff is welcoming, it is a breath of fresh air. I feel like I am happy to be at work and ready to face the day and the challenges that it may bring. More importantly, I can focus on my patients instead of being distracted.


American Nurses Association. (2015). Incivility, bullying, and workplace violence [Position statement].

Avera. (2022). Retrieved November 21, 2022, from to an external site.

Green, C. (2020). The hollow: A theory on workplace bullying in nursing practice. Nursing Forum56(2), 433–438. to an external site.

Roberts, S. (2014). Lateral violence in nursing. Nursing Science Quarterly28(1), 36–41. to an external site.

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