Incivility in the practice environment: A perspective from clinical nursing teachers

This paper advances a notion of incivility as a precursor to a continuum of antisocial acts culminating in bullying behaviour. Clinical teachers (CTs), working with undergraduate nursing students in a variety of clinical settings from a large urban centre, were studied. Using a mixed method design, CTs were asked to define and describe the nature, type and frequency of uncivil encounters. Data was collected across four practice settings, which included, acute care, maternal child, community and mental health. To unpack the complex nature of incivility we applied a conceptual model based on bullying behaviour which permitted us to analyze CTs narratives for both form (i.e., direct vs. indirect incivility) and function (i.e., reactive vs. proactive). The results suggest that indirect incivility was the most prevalent subtype narrative reported. One of the implications of this study is that nurse educators can help new clinical students recognize the different subtypes of in/civility in the practice environment as an essential first step before targeted intervention programs can be developed and implemented to create civil learning and safer working environments.     

Incivility in nursing education: A review of the literature

This literature review defines incivility in nursing, describes different methodologies used to study incivility in nursing, synthesizes perceptions of uncivil behaviors in nursing students and faculty, and discusses gaps in the literature and needs for future research. Nurse educators' awareness of incivility in nursing education and the need for additional research will aid in curtailing the problem of incivility in nursing education.     

Incivility in nursing: the connection between academia and clinical settings

Incivility and bullying in nursing are complex problems that have garnered much attention in recent years. Emerging evidence suggests that incivility in the workplace has significant implications for nurses, patients, and health care organizations. Because today's students are tomorrow's colleagues, conversations regarding how to address incivility and bullying should include specific aspects of nursing academia and the preparation of new nurses.     

Incivility in nursing practice education in the operating room

BackgroundIncivility toward nursing students has been identified as a contributor to negative experiences in clinical education and may cause a weakened learning environment, anxiety, depression and workplace violence. However, few data with regard to uncivilized behavior toward nursing students in the operating room are available. The operation room is a special place where the tempo is fast and the risk is high. Nursing students may have to face pressure from different people, such as anesthesiologists, surgeons, clinical instructors, and staff nurses.ObjectivesTo explore uncivilized behavior toward nursing students in the operating room and to discuss the source of uncivilized behavior and the attitude of clinical instructors when it occurs.MethodA total of 215 nursing students in the operating room of the Second XiangYa Hospital from January to December 2018 were investigated. The uncivilized behavior in clinical nursing education tool and self-designed questionnaire were used.ResultsThe incivility mean score was (4.6 ± 6.7). In all, 122 (56.7%) participants had experienced various degrees of uncivilized behavior in the operating room. There were significant differences in incivility toward students according to degree of education and age. The most frequent uncivilized behavior toward students was raising of the voice when speaking to students (41.9%), followed by inappropriate tone (36.7%), being embarrassed in front of others (36.3%), and snide remarks (34.4%). Surgeons (59%) were considered as the most important source of uncivil behaviors, followed by staff nurses (46.7%). When students experienced uncivilized behavior, 61.5% clinical instructors defended and comforted them, 23% comforted them privately, 13.1% ignored them, and 2.5% even criticized them together with the uncivil behavior actor.ConclusionNursing managers and instructors should pay more attention to the incivility toward students and take actions to foster a healthy, civilized and respectful work environment in the operating room for students.     

Incivility in nursing education: a descriptive study of definitions and prevalence

Evidence suggests that incivility on American college campuses, ranging from insulting remarks and verbal abuse to violence, is a serious and growing concern. Faculty and students are often unsure how to address these behaviors. Therefore, 32 (88.9%) nursing faculty and 324 (69.4%) nursing students at one university completed a survey to gather their perceptions of student and faculty behaviors that may be considered uncivil. Student behaviors most frequently reported as uncivil by faculty included making disapproving groans, making sarcastic remarks or gestures, not paying attention in class, dominating class discussions, using cell phones during class, and cheating on examinations. The majority of faculty reported that uncivil student behaviors occurred rarely or sometimes. Examples of faculty behaviors considered uncivil by students included canceling class without warning, being unprepared for class, not allowing open discussion, being disinterested or cold, belittling or taunting students, delivering fast-paced lectures, and not being available outside of class. Students perceived incivility as a moderate problem in the nursing academic environment. It is imperative that nurse educators help students and faculty cope effectively with these behaviors; the authors discuss strategies to do so.     

Social mission in nursing: Reaffirming our roots

The Organization of Associate Degree Nursing has declared Advancing the Social Mission of Nursing as the major theme for the year (Meyer, 2020). Nursing's historic roots are embedded in social mission. Social mission encompasses the social determinants of health, which are a major factor impacting health outcomes. In order to effectively prepare associate degree nursing graduates to address issues related to health equity, nurse educators should re-examine the core purpose of nursing education to ensure inclusion of social mission.     

Incivility in Nursing Education: Generational Differences

The purpose of this study was to investigate differences in the experiences of incivility of 2 generations of associate degree nursing faculty. A quantitative study was conducted using the Incivility in Nursing Education Survey to determine whether a difference exists between Baby Boomer (n = 50) and Generation X (n = 21) faculty's experience of incivility. Results indicate significant difference in reported student disruption, frequency of disruptive student behaviors, and number of student threats reported by the 2 generations.     

Revisiting our roots: caring in nursing curriculum design

It is widely accepted that a caring curriculum is integral to nursing education. Caring as a concept is extensively cited in the literature as a core value in nursing education and nursing practice. What is not evident is the curricular designs used by nurse educators to enable students to internalize caring behaviors. The literature supports the internalization of affective learning through hierarchically structured learning objectives, and the movement from emotional to reflexive responses through critical reflection. Krathwohl, Bloom, and Masia’s (1964) taxonomy of affective objectives and concepts from Mezirow’s (2000) transformational learning theory were used to synthesize the integration of caring affective objectives into the design of the nursing curricula. The expected outcome of such integration is a nursing curriculum that progressively supports the development of nursing students’ caring behaviors that are consistent with the ideals of the profession. Examples of hierarchically leveled caring objectives are provided.     

Hypospadias repair: the nursing contribution

The role of the urology nurse in the care of 50 boys undergoing hypospadias surgery was prospectively evaluated using semi‐structured interviews and data retrieved from hospital notes. Four nursing‐related areas of interest were identified: Firstly, that nurses were instrumental in preparing the families for surgery by assessing the boys and providing information to the families. This enabled the early discharge of the children. Secondly, that nurses also dealt with any problems arising from pain or the wound as well as from the catheter or stent. Thirdly, that named nurses provided seamless care to the families enabling a development of familiarity and trust. Finally, nurses provided routine back‐up and a 24‐h emergency call facility for the families at home. These were valued by the parents for their reassuring and confidence giving effect as well as the quality of the advice given. Based on the results of this evaluation it was recommended to establish and introduce a care pathway for day‐case hypospadias repairs and to upgrade the urology nurses' role towards advanced nursing practice.     

Historical roots and future perspectives related to nursing ethics

This article traces the evolution of the development and the refinement of the professional code from concerns about the ethical conduct of nurses to its present state as a professional code for all nurses. The importance and the relationship of the Ethics Committee of the American Nurses' Association (ANA) to the development of the code and other ANA programs and structural units is also presented. The recognized need for a code of ethics to establish nursing as a profession has been present throughout the evolution of the professional nursing organization. A distinction between ethical conduct of nurses and a code of ethics for professional nurses has been made by nursing leaders. The code has been refined to reflect nursing's changing relationship to society and the societal concerns of the times.     

Returning to our roots: 25 years of maternal/child nursing in the community

In many ways the past 25 years in maternal/child nursing have brought us back to community roots. Components of community care in maternal/child nursing include self-care; prevention; family, culture, and community; and collaboration. These components are reviewed through a retrospective look at community maternal/child nursing activities during the past 25 years. In addition, maternal/child nursing for the future is examined by thinking expansively in five areas: childbirth education, community-based interventions for better health behavior, community-based interventions to meet 2010 objectives, family forms, and definitions of women's health in the United States and beyond. We are birthing a new vision of maternal/child health and wellness. Central to that birthing is an awakening of the still, small, wise intuitive voice in all of us.     

Left-ventricular aneurysms: from disease to repair

Myocardial infarction may be complicated by the formation of a left-ventricular aneurysm that distorts the normal elliptical geometry of the ventricle to produce a dilated spherical ventricle with limited contractile and filling capacities. One of the consequences is congestive heart failure, which may be refractory to medical therapy and require surgical treatment. Surgical methods to restore the volume and shape of the left ventricle have evolved over the years. Nevertheless, although surgery for left-ventricular aneurysms has been performed for almost 50 years, the most appropriate approach is still controversial. This review gives an overview of the postinfarction left-ventricular aneurysm, tackling issues from the disease itself to surgical and other techniques of ventricular remodeling.