GIVEN the stressful healthcare workplace, it’s no wonder nurses and other healthcare professionals sometimes fall short of communicating in respectful, considerate ways. Nonetheless, safe patient care hinges on our ability to cope with stress effectively, manage our emotions, and communicate respectfully. Interactions among employees can affect their ability to do their jobs, their loyalty to the organization, and most important, the delivery of safe, high-quality patient care.
The American Nurses Association (ANA) Code of Ethics for Nurses with Interpretive Statements clearly articulates the nurse’s obligation to foster safe, ethical, civil workplaces. It requires nurses “to create an ethical environment and culture of civility and kindness, treating colleagues, coworkers, employees, students, and others with
dignity and respect” and states that “any form of bullying, harassment, intimidation, manipulation, threats, or violence will not be tolerated.” However, while nurses need to learn and practice skills to address
uncivil encounters, organization leaders and managers must create an environment where nurses feel free and empowered to speak up, especially regarding patient safety issues.
All of us must strive to create and sustain civil, healthy work environments where we
communicate clearly and effectively and manage conflict in a respectful, responsible way. The alternative— incivility—can have serious and lasting repercussions. An organization’s culture is linked closely with employee recruitment, retention, and job satisfaction. Engaging in clear, courteous communication fosters a civil work environment, improves teamwork, and ultimately enhances patient care.
In many cases, addressing incivility by speaking up when it hap- pens can be the most effective way to stop it. Of course, meaningful dialogue and effective communication require practice. Like bowel sound auscultation and nasogastric tube insertion, communication skills can’t be mastered overnight. Gaining competence in civil communication takes time, training, experience, practice, and feedback.
LEARNING OBJECTIVES
1. Identify components of a healthy workplace.
2. Discuss how to prepare for a challenging conversation. 3. Describe models for conducting a
challenging conversation.