NR 500NP Week 7: Incivility and Healthful Environments
Sample Answer for NR 500NP Week 7: Incivility and Healthful Environments Included After Question
NR 500NP Week 7: Incivility and Healthful Environments
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Purpose
The purpose of the graded collaborative discussions is to engage faculty and students in an interactive dialogue to assist the student in organizing, integrating, applying, and critically appraising knowledge regarding advanced nursing practice. Scholarly information obtained from credible sources as well as professional communication are required. Application of information to professional experiences promotes the analysis and use of principles, knowledge, and information learned and related to real-life professional situations. Meaningful dialogue among faculty and students fosters the development of a learning community as ideas, perspectives, and knowledge are shared.
Activity Learning Outcomes
Through this discussion, the student will demonstrate the ability to:
- Examine roles and competencies of advanced practice nurses essential to performing as leaders and advocates of holistic, safe, and quality care (CO1)
- Apply concepts of person-centered care to nursing practice situations (CO2)
- Analyze essential skills needed to lead within the context of complex systems (CO3)
- Explore the process of scholarship engagement to improve health and healthcare outcomes in various settings (CO4)
Due Date
A 10% late penalty will be imposed for discussions posted after the deadline on Wednesday, regardless of the number of days late. NOTHING will be accepted after 11:59pm MT on Sunday (i.e. student will receive an automatic 0 for any portion of the discussion not posted by that time). Week 8 discussion closes on Saturday at 11:59pm MT.
NOTE: To receive credit for a week’s discussion, students may begin posting no earlier than the Sunday immediately before each week opens. Unless otherwise specified, access to most weeks begins on Sunday at 12:01 a.m. MT, and that week’s assignments are due by the next Sunday by 11:59 p.m. MT. Week 8 opens at 12:01 a.m. MT Sunday and closes at 11:59 p.m. MT Saturday.
A zero is the lowest score that a student can be assigned.
Faculty may submit any collaborative discussion posting to Turnitin in order to verify originality.
Total Points Possible: 75
A Sample Answer For the Assignment: NR 500NP Week 7: Incivility and Healthful Environments
Title: NR 500NP Week 7: Incivility and Healthful Environments
Requirements:
Discussion Criteria
I. Application of Course Knowledge: of Course Knowledge:
The student post contributes unique perspectives or insights gleaned from personal experience or examples from the healthcare field. The student must accurately and fully discuss the topic for the week in addition to providing personal or professional examples. The student must completely answer the entire initial question.
II. Engagement in Meaningful Dialogue: I. The student responds to a student peer and course faculty to further dialogue.
- Peer Response: The student responds substantively to at least one topic-related post by a student peer. A substantive post adds content or insights or asks a question that will add to the learning experience and/or generate discussion.
- A post of “I agree” with a repeat of the other student’s post does not count as a substantive post. A collection of shallow posts does not equal a substantive post.
- The peer response must occur on a separate day from the initial posting.
- The peer response must occur before Sunday, 11:59 p.m. MT.
- The peer response does not require a scholarly citation and reference unless the information is paraphrased and/or direct quotes are used, in which APA style standards then apply.
Faculty Response: The student responds substantively to at least one question by course faculty. The faculty question may be directed to the student, to another student, or to the entire class.
- A post of “I agree” with a repeat of the faculty’s post does not count as a substantive post. A collection of shallow posts does not equal a substantive post.
- The faculty response must occur on a separate day from the initial posting.
- Responses to the faculty member must occur by Sunday, 11:59 p.m. MT.
- This response does not require a scholarly citation and reference unless the information is paraphrased and/or direct quotes are used, in which APA style standards then apply.
III. Integration of Evidence: The student post provides support from a minimum of one scholarly in-text citation with a matching reference AND assigned readings OR online lessons, per discussion topic per week.
- What is a scholarly resource? A scholarly resource is one that comes from a professional, peer-reviewed publication (e.g., journals and government reports such as those from the FDA or CDC).
- Contains references for sources cited
- Written by a professional or scholar in the field and indicates credentials of the author(s)
- Is no more than 5 years old for clinical or research article
- What is not considered a scholarly resource?
- Newspaper articles and layperson literature (e.g., Readers Digest, Healthy Life Magazine, Food, and Fitness)
- Information from Wikipedia or any wiki
- Textbooks
- Website homepages
- The weekly lesson
- Articles in healthcare and nursing-oriented trade magazines, such as Nursing Made Incredibly Easy and RNMagazine (Source: What is a scholarly article.docx; Created 06/09 CK/CL Revised: 02/17/11, 09/02/11 nlh/clm)
- Can the lesson for the week be used as a scholarly source?
- Information from the weekly lesson can be cited in a posting; however, it is not to be the sole source used in the post.
- Are resources provided from CU acceptable sources (e.g., the readings for the week)?
- Not as a sole source within the post. The textbook and/or assigned (required) articles for the week can be used, but another outside source must be cited for full credit. Textbooks are not considered scholarly sources for the purpose of discussions.
- Are websites acceptable as scholarly resources for discussions?
- Yes, if they are documents or data cited from credible websites. Credible websites usually end in .gov or .edu; however, some .org sites that belong to professional associations (e.g., American Heart Association, National League for Nursing, American Diabetes Association) are also considered credible websites. Websites ending with .com are not to be used as scholarly resources
IV. Professionalism in Communication: The post presents information in logical, meaningful, and understandable sequence, and is clearly relevant to the discussion topic. Grammar, spelling, and/or punctuation are accurate.
V. Wednesday Participation Requirement: The student provides a substantive response to the graded discussion question(s) or topic(s), posted by the course faculty (not a response to a peer), by Wednesday, 11:59 p.m. MT of each week.
VI. Total Participation Requirement: The student provides at least three substantive posts (one to the initial question or topic, one to a student peer, and one to a faculty question) on two different days during the week.
| DISCUSSION CONTENT | |||
| Category | Points | % | Description |
| Application of Course Knowledge | 20 | 27 | Answers the initial discussion question(s)/topic(s), demonstrating knowledge and understanding of the concepts for the week. |
| Engagement in Meaningful Dialogue With Peers and Faculty | 20 | 27 | Responds to a student peer AND course faculty furthering the dialogue by providing more information and clarification, adding depth to the conversation |
| Integration of Evidence | 20 | 27 | Assigned readings OR online lesson AND at least one outside scholarly source are included. The scholarly source is:
1) evidence-based, 2) scholarly in nature, 3) published within the last 5 years |
| 60 | 81% | Total CONTENT Points= 60 pts | |
| DISCUSSION FORMAT | |||
| Category | Points | % | Description |
| Grammar and Communication | 8 | 10 | Presents information using clear and concise language in an organized manner |
| Reference Citation | 7 | 9 | References have complete information as required by APA
In-text citations included for all references AND references included for all in-text citation |
| 15 | 19% | Total FORMAT Points= 15 pts | |
| DISCUSSION TOTAL=75 points | |||
Preparing the Assignment
Introduction
This graded discussion will explore the impact of systems theory on a practice problem or issue. Please provide an initial response to the discussion question by Wednesday at 11:59pm MT and two interactive dialogue responses no later than Sunday 11:59 PM MT at the end of WEEK 7. The discussion is worth 75 points. Please refer to the discussion grading rubric for additional criteria.
Assignment
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.
**To see view the grading criteria/rubric, please click on the 3 dots in the box at the end of the solid gray bar above the discussion board title and then Show Rubric.
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Dec 5, 2022Dec 5, 2022 at 8:55am
Hello Dr. Cox and Classmates,
One time that I witnessed incivility occurred during a discussion between an intensivist and a critically ill patient’s spouse. The intensivist briefly mentioned planning for a tracheostomy creation to be done in the operating room the next day and when the spouse asked for further clarification on what this procedure was for, the intensivist put his hand up in her face. The physician continued to interrupt the wife and say how the “tracheostomy is necessary, no other options here” and “it’s best for the patient” and left the room. My initial reaction was to support the wife and discuss this surgery with her more in depth. Once she understood the basics of the surgery, we discussed more of her husband’s prognosis and what the tracheostomy would offer for his quality of life. After this discussion, the wife realized that the patient would not want a tracheostomy. I then followed up with the physician and shared my own thoughts and the wife’s thoughts about his behavior in the room. I also updated him that the patient’s wife did not want to consent for the tracheostomy as she believed it was against his wishes. He argued with me regarding what’s “best for the patient” and I offered to consult the ethics committee and palliative care if this would be an issue for the patient’s plan of care. I then discussed this with my manager who consulted ethics and palliative. This was an example of an ethics issue exacerbated by incivility.
Witnessing this incivility made me very uncomfortable yet motivated to appropriately support the decision-maker and advocate for my patient. According to the American Nurses Association, nurses are expected to acknowledge and intervene when unethical situations and incivility occurs by following up with those involved and escalating the issue to administration when necessary (Lachman, 2015). This is significant since studies have shown incivility in the workplace is directly related to higher rates of medication errors and lower job satisfaction amongst nurses (Armstrong, 2018). However, these studies have shown that these situations can be prevented through special trainings for nurses to enhance their confidence to recognize and intervene on these acts of incivility by colleagues (2018). This improvement in confidence in addition to continued support from upper management towards nursing staff will continue to support a healthier work environment (2018).
Thank you,
Alethia Burgau
References
Armstrong N. (2018). Management of Nursing Workplace Incivility in the Health Care Settings: A Systematic Review. Workplace health & safety, 66(8), 403–410. https://doi.org/10.1177/2165079918771106 Links to an external site.
Dec 6, 2022Dec 6, 2022 at 2:03pm
Incivility in the workplace not only affects staff but it also can run over onto the patients which can negatively affect patient outcomes. Behaviors of incivility include criticizing, gossiping, blaming, insulting, sabotaging, refusing to help, making demeaning gestures or facial expressions, and also bullying and intimidating (Croke, 2021). Sadly, many nurses have experienced incivility in the workplace. In fact, Croke (2021) suggests that over 60% of nurses have experienced incivility in the workplace and describes how it can affect work performance and mental wellbeing. Incivility can lead to medical errors, poor patient satisfaction, preventable adverse outcomes, increased cost of care, and cause qualified clinicians to seek new positions (Lachman, 2015). Incivility can also be detrimental to one’s own self-worth and self-confidence and can lead to increased stress, irritability, anxiety and depression (American Nurses Association, 2015).
I, unfortunately, I have both witnessed and experienced workplace incivility. I have worked at two hospitals so far in my nursing career. I have witnessed incivility in each hospital and each hospital dealt with it in very different ways. The first hospital I worked as was a large, reputable, magnet hospital. There were endless opportunities and I was proud to be a part of that organization. Rules and expectations were in place and very clear, there were consequences to negative actions. Although I felt it was a very good place to work, there were still sporadic episodes of incivility. These episodes were taken seriously and dealt with quickly. I unfortunately had to leave this hospital due to moving away, but I know I would still be there, and flourishing had I stayed. The second hospital was a smaller one with a poor reputation. There were very little opportunities. You were either a floor nurse or charge nurse, and then there was the director of the unit. Incivility was very common here with constant gossip, rumor spreading, little to no teamwork, everyone was set in there ways, and there were no consequences when policies or rules were broken. The leadership was very poor, and when someone went to the director when there was a problem with another employee she would ask “Did you say something to that person?”, or she would roll her eyes and change the subject. Everything was made out to be a joke and the director would participate in the gossip. No one was held accountable for neglecting to perform daily nursing duties, nurses were on their phones all shift, ignoring patients or being rude to patients. Nurses were rude to each other. It wasn’t isolated to my unit; it was all over the hospital. When we had to call other units or the emergency room, we were spoken down to and I almost felt as though others in the hospital perceived my unit as incompetent. Even the Medical Chief Officer was condescending and rude. It truly took a mental toll on me. It caused me a great deal of stress and uncertainty. I would dread going to work and although I tried my best not to let it affect my interactions with patients, I’m sure it did. There was a time that I not only reconsidered my workplace, but also my entire nursing career. I am glad I got through it with my career intact and thriving. I learned from my experience and I learned to be more aware of my own actions. I learned to not get sucked into petty gossip, to stand of for what I feel is wrong, and how to better handle these situations, should they ever occur again.
Incivility in nursing occurs in all settings including academic settings (ANA, 2015). The ANA discusses various documents that support civility and a culture or respect in nursing education and practice, such as “Essential VIII: Professionalism and Professional Values” which describes the importance of nurses being responsible and held accountable for their own actions; and the ANA Code of Ethics, which requires nurses to treat others with dignity and respect and state any incivility will not be tolerated.
Leadership is very important in promoting a civil workplace with a culture of respect. Leadership leads by example and assists with problem solving. It is very difficult to change a facility that is set in their ways and resistant to change, such was my experience. When an outsider comes in trying to make improvements, it can be met with hostility and incivility. Leadership, in my case, was not helpful at all and was actually a big part of the problem. No one was held accountable and when boundaries were crossed, there were no consequences, just more gossip. It’s unfortunate that there are hospitals out there like this one. It is not a place I want to be affiliated with, one that I cannot change or improve due to lack of support. In a future place of employment, I know what to look for to ensure I am part of a community that practices a civil culture of respect.
References:
American Nurses Association. (2015). Incivility, bullying, and workplace violence [Position Statement]. https://www.nursingworld.org/~49baac/globalassets/practiceandpolicy/nursing-excellence/official-policy-statements/ana-wvp position-statement-2015.pdfLinks to an external site.
Croke, L. (2021). Preventing and addressing incivility in nursing. AORN Journal, 114(2), P4-P6. https://doi.org/10.1002/aorn.13486Links to an external site.
Lachman, V. D. (2015). Ethical issues in the disruptive behaviors of incivility, bullying, and horizontal/lateral violence. Urologic Nursing, 35(1), 39—42. https://chamberlain-on-worldcat-org.chamberlainuniversity.idm.oclc.org/oclc/5815854891Links to an external site.
Dec 6, 2022Dec 6, 2022 at 2:20pm
NR500NP Discussion: Week 7
Incivility, bullying, and workplace violence are part of a larger complex phenomenon, which includes a “constellation of harmful actions taken and those not taken” in the workplace (Saltzberg, 2011, as cited in American Nurses Association, 2015). Nurses in my opinion are faced with incivility quite often. Especially if dealing with a detoxing patient, for instance with ETOH abuse. Carder (2017) mentions how when nurses see this on their admission, many nurses know they will probably not get a lunch that day, the patient may be very confused, hallucinating, at risk of seizures, and requiring continuous monitoring. This can be exhausting for the nurse and the patient. It’s not uncommon to be spit, vomited on, scratched, or even hit. These patients can become quite aggressive. One sad thing is also that 9 times out of 10 once they get back into the right state of mind, they don’t even remember how they behaved. Additionally, these patients can become restrained because of the harm and risk they provide to the staff as well as to themselves. They may even become a 1 to 1 with the nurse, not because they are S.I watch but because they do not know their own limitations and strengths when they are in this state of mind. Many times, this can make nurses and staff resent taking care of a patient due to their rude behavior and other times can stir up emotions from the past or current. It is important to remember that these patients are not in their right state of mind. Protocols are in place to help ease the detox process such as a CIWA score, that identifies concerns the patient is exhibiting and calls for the administration of lorazepam based on the score the patient presents with. As nurses we need to utilize these protocols for the patient’s safety as well as our own and to know that we are not alone and can ask for back up if needed. Things like this protocol, sitter/ 1 on 1, restraints, moving patient closer to the nurse station, bed alarms, and support from staff are all in place for situations like this. Sometimes having high acuity patients like these can also put strain on other staff and their patient load especially if the DT patient becomes a 1 on 1, as a unit we all need to remember we are all in this together and that we have each other’s back for support if someone needs it. Sometimes it is inevitable that a DT patient will eventually become a 1 on 1. As a nurse leader we can predict this and make sure we have adequate staff for when this does happen around the 72-hour mark and be prepared as a unit to make that transition.
References:
American Nurses Association. (2015). Incqivility, bullying, and workplace violence [Position Statement]Links to an external site.
Carder. (2017). Someoneʼs Son. The American Journal of Nursing, 117(10), 72–72. https://doi.org/10.1097/01.NAJ.0000525884.43091.10Links to an external site.