NURS 6053 Assignment: Workplace Environment Assessment
NURS 6053 Assignment: Workplace Environment Assessment
The health of a workplace has a significant effect on employee performance and productivity. A work environment assessment was done on my practice site using the Clarks Healthy Workplace Inventory. The organization scored 54, which translates into an unhealthy organization as per Clarks Healthy Workplace Inventory assessment. The organization’s score in of the assessment items were somewhat untrue and neutral.
Some things surprised me about the results of the work environment assessment. One of them is the organization’s score. I believed that most of the staff in the organization perceived it a healthy workplace. The leadership and management pride themselves in implementing staff-centered interventions that contribute to their empowerment and performance. However, it appears that the staff have contrary opinions and experiences about these interventions. The other thing that surprised me from the assessment is that most of the employees reported that they have low level of job satisfaction, morale, and engagement. Employee job satisfaction is a crucial ingredient for the delivery of high-quality, safe, and efficient care in healthcare (Giménez Lozano et al., 2021). However, it was surprising that most employees reported being demotivated yet the organization’s statistics such as turnover rates and adverse events have been low over the past years.
One of the ideas that I believed before conducting the assessment and was confirmed is the lack of transparent and direct communication at all the organization’s level. The communication environment in the organization is one-way. The management makes decisions to be imposed on the staff without the consideration of their views. As a result, most of the staff express dissatisfaction with the manner in which the management undertakes its functions (Hashish, 2020). This was confirmed by most of the staff who reported that the statement on communication being transparent, direct, and respectful being completely untrue. As noted initially, the results of the assessment mean that the organization is not a safe workplace. It does not prioritize the needs of its staff in the implementation of different strategies, hence, having the potential of affecting performance and competitiveness of the organization.
NURS 6053 Assignment: Workplace Environment Assessment References
Giménez Lozano, J. M., Martínez Ramón, J. P., & Morales Rodríguez, F. M. (2021). Doctors and Nurses: A Systematic Review of the Risk and Protective Factors in Workplace Violence and Burnout. International Journal of Environmental Research and Public Health, 18(6), Article 6. https://doi.org/10.3390/ijerph18063280
Hashish, E. A. A. (2020). Nurses’ perception of organizational justice and its relationship to their workplace deviance. Nursing Ethics, 27(1), 273–288. https://doi.org/10.1177/0969733019834978
Clearly, diagnosis is a critical aspect of healthcare. However, the ultimate purpose of a diagnosis is the development and application of a series of treatments or protocols. Isolated recognition of a health issue does little to resolve it.
In this module’s Discussion, you applied the Clark Healthy Workplace Inventory to diagnose potential problems with the civility of your organization. In this Portfolio Assignment, you will continue to analyze the results and apply published research to the development of a proposed treatment for any issues uncovered by the assessment.
To Prepare:
- Review the Resources and examine the Clark Healthy Workplace Inventory, found on page 20 of Clark (2015).
- Review the Work Environment Assessment Template.
- Reflect on the output of your Discussion post regarding your evaluation of workplace civility and the feedback received from colleagues.
- Select and review one or more of the following articles found in the Resources:
- Clark, Olender, Cardoni, and Kenski (2011)
- Clark (2018)
- Clark (2015)
- Griffin and Clark (2014)
The Assignment (3-6 pages total):
Part 1: Work Environment Assessment (1-2 pages)
- Review the Work Environment Assessment Template you completed for this Module’s Discussion.
- Describe the results of the Work Environment Assessment you completed on your workplace.
- Identify two things that surprised you about the results and one idea you believed prior to conducting the Assessment that was confirmed.
- Explain what the results of the Assessment suggest about the health and civility of your workplace.
Summary of Work Environment Assessment
Based on my Work Environment Assessment tool results, my workplace is mildly healthy. I would agree with these findings. Item scoring the lowest in the neutral category included: 1. There is a clear and discernible level of trust between and among formal leadership and other members of the workplace, 2. There is a high level of employee satisfaction, engagement, and morale, and 3. Employees are viewed as assets and valued partners within the organization (Clark, 2015). I believe these results are evidence of several changes in my workplace over the past couple of years, including the COVID-19 pandemic and previous changes. For instance, my workplace used to be a small 4-hospital-based system that merged with a more extensive healthcare system for financial reasons. Contacting management, staffing, or HR suddenly became an impossible process. Our hospital started as a small, holistic facility that patients enjoyed. Merging with the larger healthcare system changed leader roles, made physical changes around campus, expanded our employee workforce, and left many of us feeling lost. Workplace morale has become low throughout the pandemic, with ED nursing staff encountering a lot of system-wide dysfunction with a surge and boarding of inpatients in the ED. Many nurses worked 12 hours without breaks without lunch while the administration strolled by. One of our greatest strengths has been the front-line nursing staff in our department and the ED providers working together to problem-solve these drastic changes on a day-to-day basis. According to Hossny and Sabra (2021), the climate of civility in the workplace impacts collaboration between healthcare professionals, particularly nurses, and doctors.
Civility in the Workplace
Most examples of workplace incivility stem from the common factors of stress and overwork. An example of this I recently encountered as a charge nurse for the department was one of my triage nurses expressing frustration with the lack of patient flow regarding patients being admitted to the hospital but still waiting in the ED for an inpatient room. We had missed our breaks, were stressed, and felt a lack of support from our leaders in problem-solving efforts. Ultimately, we discussed our frustrations and how they were out of our hands and brainstormed how to work with what we had control over. Factors contributing to nursing practice and education stress include work overload, unclear roles and expectations, organizational conditions, and a lack of knowledge and skills. Still, they can be mitigated by leaders who model professionalism and effective communication skills (Clark et al., 2011).
Recently, our admired ED manager left the organization due to disagreements with leadership, further lowering department morale. As a result, we are in the process of welcoming a new leader selected by a group of members from the department’s unit council. “The power of a leader is magnified by an effective team, and the leader who empowers team members expands the capacity of the whole organization at all levels” (Broome & Marshall, 2021, p. 213).
References
Broome, M., & Marshall, E. (2021). Building cohesive and effective teams. In M. Broome & E. Marshall (Eds.), Transformational leadership in nursing: From expert clinician to influential leader (3rd ed., pp. 213–232). Springer Publishing Company.
Clark, C. (2015). Conversations to inspire and promote a more civil workplace. American Nurse Today, 10(11), 18–23. https://www.myamericannurse.com/wp-content/uploads/2015/11/ant11-CE-Civility-1023.pdfLinks to an external site.
Clark, C., Olender, L., Cardoni, C., & Kenski, D. (2011). Fostering civility in nursing education and practice: Nurse leader perspectives. The Journal of Nursing Administration, 41(7/8), 324–330. https://doi.org/10.1097/nna.0b013e31822509c4Links to an external site.
Hossny, E., & Sabra, H. (2021). Effect of nurses’ perception to workplace civility climate on nurse–physician collaboration. Nursing Open, 8(2), 620–627. https://doi.org/10.1002/nop2.666Links to an external site.
Part 2: Reviewing the Literature (1-2 pages)
- Briefly describe the theory or concept presented in the article(s) you selected.
- Explain how the theory or concept presented in the article(s) relates to the results of your Work Environment Assessment.
- Explain how your organization could apply the theory highlighted in your selected article(s) to improve organizational health and/or create stronger work teams. Be specific and provide examples.
Part 3: Evidence-Based Strategies to Create High-Performance Interprofessional Teams (1–2 pages)
- Recommend at least two strategies, supported in the literature, that can be implemented to address any shortcomings revealed in your Work Environment Assessment.
- Recommend at least two strategies that can be implemented to bolster successful practices revealed in your Work Environment Assessment.
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Submit your Workplace Environment Assessment Assignment.
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- Click on the Submit button to complete your submission.A workplace environmental assessment entails touring and understanding the employees
at work, the physical issues at and neighboring the worksite that support or hinder employee
health (Georgakopoulos & Kelly, 2017). Workplace environmental assessment also evaluates the
physical and organizational work environment for health hazards and risks. Workplace civility
helps in promoting collaboration between nurses and physicians to provide high‐quality services
(Hossny & Sabra, 2020). Nurses and physicians working in a civil climate, in addition to early
response to incivility and low intolerance for misconduct, promotes effective collaboration
(Hossny & Sabra, 2020).
It sounds like you have had bad experiences with top-down leadership. I have had similar experiences with a managerial disconnect from clinical consequences during planning, followed by a “too late” response during implementation. Top-down leadership struggles with implementation, but pure bottom-up usually gets unrealistic about resources. Mixing the two has the most success (Stewart et al., 2010). For example, instead of abruptly cutting off the IV team resource you mentioned, leadership could have thought ahead and prepared appropriately by communicating with clinical staff. The designated role might have needed to go for budgetary reasons, but those teams are effective because they have specialized ultrasound equipment. Depending on the size of your facility, it might be feasible to share that equipment. The first time I worked on a floor that had an IV ultrasound machine I was shocked how intuitive it was. Don’t get me wrong, I love having an IV team when it’s available. Anyone specialized like that is going to be more skillful from someone with a more generalized practice. However, in a staffing cut like this, with a top-down bottom-up approach with clinical staff and some planning, the effect of losing a valuable resource like the IV team could have not been so disruptive to workflow and patient care. Nurses are already used to signing out equipment (at least where I have worked), already know how to insert IVs, and as I said the IV ultrasound was pretty intuitive, it would just take practice to get used to inserting an IV while holding the ultrasound equipment. Details aside, the point is, a very practical solution could have been made if leadership had bothered to communicate with clinical staff. A civil workplace requires transparent and direct communication on all levels of the organization, and joint decision making for policy changes (Clark, 2015). Given a little warning, clinical leaders could have made a plan much better than the one I just came up with as an example off the top of my head, and an unfortunate cut might have been more manageable.
NURS 6053 Assignment: Workplace Environment Assessment Grading Criteria
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Workplace Environment Assessment
Healthcare professionals should work in environments that support interprofessional collaboration, protect them from bullying and other uncivil behaviors, and sustain individual development. Due to their critical role in primary care, nurses require guidance, mentorship, and active engagement in decision-making. However, not all workplaces provide nurses with a healthy and safe environment to provide optimal patient care and optimize personal development. Incivility is typical in many institutions, and its magnitude depends on leadership, employee empowerment programs, and behavior management policies, among other factors. A workplace diagnosis helps assess the incivility level and interventions required to promote civility. The purpose of this paper is to describe the workplace environment assessment results, concept/theory, and strategies for creating high-performance interprofessional teams.
Work Environment Assessment
Assessments reveal the health status of an organization. They evaluate many aspects, and the Clark Healthy Workplace Inventory diagnoses potential problems regarding civility in an organization. The organization scored 59 on the inventory and one’s impression. The score demonstrates low performance on critical organizational factors that promote a healthy workplace, including the organizational culture and environment. Multiple factors contribute to such a score, and the chances of interprofessional collaboration and organizational development are usually low.
The facility also lacks appropriate preceptorship plans for new workers. The lack of orientation exposes them to confusion and bullying, among other features of uncivil workplaces. Other contributing factors include the lack of mentorship for current employees’ culture evaluation programs. The situation would have been better if the organization had assessed its culture regularly and responded effectively. The institution also lacks adequate resources to promote career progression, which impedes professional development. Consequently, it is challenging to retain experienced and top nurses. The other factor to blame for the discouraging score is a leadership model that excludes employees in decision-making.
The two surprising outcomes are the organization’s ill state and its unchanged culture. Considering how the organizational environment and workplace relationships profoundly affect patient care, healthcare institutions should avoid uncivil behaviors and invest heavily in positive cultures. Among the dominant organizational perspectives, the institution does not regard employees as valuable participants in decision-making and organizational growth. After checking numerous “totally untrue boxes” scale components, the overall result confirmed the same. This implies ineffective organizational governance. The other major worry was employee appreciation, which was lacking since employees are not regarded as valuable assets. According to Flynn et al. (2021), employee appreciation helps employees feel more secure and satisfied, motivating them to continue their work. Such motivation ensures that employees are more inclined to healthy behaviors and avoid uncivil acts.
The results confirmed the need for transformative change, a view held before conducting the review. A leadership that does not revere employee participation is retrogressive and hampers civility in the workplace. From the findings, current leadership styles are ineffective, and a shift is inevitable for the organization to achieve its vision and goals. A practical way to achieve these goals is to advocate for and practice transformative leadership, whose central tenet is inspiration and working together to achieve the desired vision (Seljemo et al., 2020). The organization, through its leader, must also ensure the satisfaction of both workers and patients.
Generally, the score (59) reveals an unhealthy and uncivil workplace. Incivility hampers nurses’ mental health and reduces overall productivity (Kile et al., 2018). The situation is worse in workplaces where the leadership has not implemented robust policies for preventing incivility and promoting healthy relationships. Unhealthy and uncivil workplaces are also associated with patient safety concerns, implying low patient satisfaction. Due to such outcomes, immediate, practical interventions are necessary. The situation should be addressed before reaching unmanageable levels.
Reviewing the Literature
Nursing literature has explored workplace incivility in-depth and recommended multiple interventions for understanding and addressing the problem. Cognitive rehearsal is among the widely explored concepts. According to Griffin and Clark (2014), cognitive rehearsal is an effective behavioral strategy for addressing incivility and lateral violence in the workplace. It has three interrelated components. The first component is participating in informative instruction regarding incivility and lateral violence. Secondly, those vulnerable to workplace incivility are taught to identify and rehearse specific phrases for addressing incivility. The third component is practicing the phrases to be more familiar with their application in real-life situations.
Cognitive rehearsal empowers nurses to identify and respond effectively to uncivil behaviors. Since their probability is high, organizational management should embrace cognitive rehearsal as a behavioral intervention strategy for current and new nurses. Griffin and Clark (2014) analyzed the effectiveness of cognitive rehearsal for newly licensed nurses. They found that cognitive rehearsal enabled new nurses to stop uncivil behaviors against them completely. Kile et al. (2018) found cognitive rehearsal highly effective in improving nurses’ confidence to defend themselves against incivility. They were also better positioned to recognize workplace incivility and report related behaviors.
Regarding the relationship between the concept (cognitive rehearsal) and the work environment assessment, nurses and other healthcare workers may be trained to overcome workplace incivility through the cognitive rehearsal approach. Currently, it is challenging to achieve the desired vision and purpose without reviewing and changing the organizational culture. A crucial part of the required review is empowering nurses and healthcare workers in recognizing and reacting to distressing behaviors and remarks from leaders or colleagues. Cognitive rehearsal training should be part of the organizational policies for improving its health. The management should also continually measure employee satisfaction and engagement, purposing to empower its workforce and enhance civility.
Cognitive rehearsal can improve the overall organizational health and play a critical role in creating stronger teams. Currently, the organization does not promote a learning culture to help employees advance their careers. Healthcare organizations should consider on-the-job training to strengthen nurses’ interprofessional abilities. Cognitive rehearsal training should be among the central components of on-the-job training. Through cognitive rehearsal, nurses learn what workplace incivility entails and how to promote a civil workplace. They further learn to associate with like-minded colleagues who do not participate in uncivil behaviors. Kile et al. (2018) and Clark (2019) further recommended healthcare facilities invest in education programs that teach cognitive rehearsal to improve their health and staff collaboration. The education team should also provide continuing leadership development programs that include mental tests to assess nurses’ ability to cope with stressful situations.
Evidence-Based Strategies to Create High-Performance Interprofessional Teams
An organization’s progressive growth depends on its strategies to address its shortcomings. Leading causes of incivility, as the workplace assessment revealed, include lack of employee orientation and employee appreciation programs. In response, a robust nurse orientation program is necessary. Such a program introduces new employees to the organizational policies, culture, and workforce. Nurses feel more positive about the organization when they understand its structure and people. Nurse orientation programs are a critical part of the enculturation that helps produce competent nurses ready to provide quality patient care (Church et al., 2020). Besides orientation, employee recognition and reward programs should be part of the interventions for organizational development. The work environment assessment revealed that the leaders rarely appreciate employees and do not consider them in decision-making. Employees’ appreciation is necessary to strengthen the leaders-employees bond. Appreciation also makes employees feel valued and a pivotal part of the organization. Such appreciation encourages them to collaborate and engage positively as crucial members of the healthcare team.
The organization can also implement several strategies to bolster successful practices revealed in the work environment assessment. The focus should be on nurse retention, which the leaders try, but it is not up to the expected levels. Employee recognition through rewards is among the most effective nurse retention programs. Recognition improves the nurses’ mental connection with the facility since it makes them feel more valued (Flynn et al., 2021). The other effective strategy is the leaders to ensure adequate nurse-to-patient staffing ratios. Adequate staffing prevents nurse burnout, a leading cause of nurse turnover in healthcare organizations (Kelly et al., 2021). These strategies can be used independently or interchangeably as situations prompt.
NURS 6053 Assignment: Workplace Environment Assessment Conclusion
The healthcare staff should always be mentally, physically, and emotionally ready to provide patient care and collaborate with colleagues. A practical way of ensuring they are ready is by preventing workplace incivility. The work environment assessment revealed an unhealthy and uncivil workplace where the leaders rarely engage and appreciate employees. Due to the far-reaching effects of such workplaces on patient care, practical interventions are necessary. Cognitive rehearsal is a highly effective approach for empowering nurses to recognize and respond to workplace incivility.
NURS 6053 Assignment: Workplace Environment Assessment References
Church, C. D., White, M., & Cosme, S. (2020). Helping students identify a healthy transition-to-practice work environment. Nurse Educator, 45(4), 174-176. doi: 10.1097/NNE.0000000000000751
Clark, C. M. (2019). Fostering a culture of civility and respect in nursing. Journal of Nursing Regulation, 10(1), 44–52. doi:10.1016/s2155-8256(19)30082-1
Flynn, W. J., Valentine, S. R., & Meglich, P. (2021). Healthcare human resource management. Cengage Learning.
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. doi:10.3928/00220124-20141122-02
Kelly, L. A., Gee, P. M., & Butler, R. J. (2021). Impact of nurse burnout on organizational and position turnover. Nursing outlook, 69(1), 96-102. https://doi.org/10.1016/j.outlook.2020.06.008
Kile, D., Eaton, M., deValpine, M., & Gilbert, R. (2018). The effectiveness of education and cognitive rehearsal in managing nurse‐to‐nurse incivility: A pilot study. Journal of Nursing Management, 27(3), 543–552. doi:10.1111/jonm.12709
Seljemo, C., Viksveen, P., & Ree, E. (2020). The role of transformational leadership, job demands and job resources for patient safety culture in Norwegian nursing homes: A cross-sectional study. BMC Health Services Research, 20(1), 1-8. https://doi.org/10.1186/s12913-020-05671-y
Nurses work in diverse work environments with varying features, including role expectations, support systems, and resources. Despite the differences in these features, nurses must strive to provide the best care possible to patients. Workplace incivility continues to be a significant barrier to achieving high-quality outcomes. According to Zhang et al. (2018), workplace incivility involves discourteous, deviant behaviors intending to harm the target and violating workplace norms. It is pervasive in healthcare settings, and leaders and healthcare staff experience incivility in different magnitudes. Statistics show that more than two-thirds of nurses and three-quarters of physicians have experienced some form of incivility (Keller et al., 2020). Because of its detrimental impacts on patient care, workplace incivility should be identified and addressed accordingly. Nurses should assess their work environment for incivility and work with leaders to de-escalate it using evidence-based interventions. The purpose of this paper is to evaluate the results of the Work Environment Assessment, review literature on incivility, and describe strategies for creating high-performance interprofessional teams.
Part 1: Work Environment Assessment
Understanding the civility of an organization can help healthcare staff and leaders to implement strategies for achieving a healthy work climate. The Work Environment Assessment tool quantifies the organization’s civility status by rating defining aspects like communication, employee satisfaction, shared governance, and teamwork. After completing the Clark Healthy Workplace Inventory, my organization scored 65%, implying that it is barely healthy, but some job aspects help employees empower employees to continue with their everyday roles. Various work-related factors contribute to this score in varying degrees. The first factor is a shared vision between the organizational leaders and employees. A shared vision is a key element of transformational leadership, where leaders create visions and goals and inspire employees to achieve them (Khan et al., 2020). The other contributing factor is employees’ perception of the job; they feel that the management fairly treats them and provide input where necessary. The opportunity to provide input is among the strategies leaders utilize to make employees feel valued and appreciate their contribution to the organization’s success.
The last element critical in attaining an average score is communication. According to Kwame and Petrucka (2020), clear communication allows employees to understand their roles and the organization’s goals. Forward-thinking leaders also understand the importance of communication in preventing workplace conflicts. In the organization, communication is always transparent, respectful, and targeted. As a result, there is no role confusion, and employees can focus on their tasks and achieve the set objectives. Besides improving civility, effective communication is fundamental to high-quality patient care since patients can be treated as nurses tailor care based on patients’ backgrounds and needs.
The workplace inventory helps healthcare professionals to understand their work environment in more detail. However, there are some job characteristics they know and expect to be confirmed before conducting the assessment. One of the things that surprised me about the results is that the civility scores depend mainly on employee-related factors. In this case, the organization must focus more on workplace elements that motivate employees, make them feel valuable, and include them in decision-making as crucial team members. Such elements include promoting teamwork and collaboration, a reasonable workload, and high employee satisfaction (Clark, 2015). Actively involving employees in shared governance and policy development is also important.
The other thing that surprised me about the results was the performance in some areas, such as talent attraction and retention, promotion and career advancement opportunities, and workload. These areas should be addressed to improve performance and contribute more to higher workplace civility. On the things that were confirmed, I expected the organization to score highly on communication and related aspects due to the respectful and transparent nature of communication. To improve performance, employees should be continually trained on effective communication and other areas, such as teamwork, employee wellness strategies, and expressing ideas in a civil manner.
The results (65%) suggest that the organization is vulnerable to workplace incivility and should intensify its efforts to prevent the damaging effects of incivility. According to the Clark Healthy Workplace Inventory, a very healthy workplace has a score of 90-100, while moderately healthy workplaces’ scores range from 80-89 (Clark, 2015). These should be the targets of functional workplaces seeking to achieve the best for their leaders, employees, and stakeholders. The organization can improve performance through employee development, continuous assessment and improvement of organizational culture, employee motivation, and ensuring adequate opportunities for employee wellness and self-care. Such efforts will improve civility and avert the dangers of workplace incivility, such as a decline in performance, anxiety/worries about the incident, and turnover (Wohlever, 2019). These interventions will further help the organization to improve nurse retention and reduce costs associated with skills loss and employee replacement.
Part 2: Reviewing the Literature
Current and past literature has explored workplace incivility and provides numerous concepts useful in addressing the problem. Clark (2015) discussed how workplace incivility could be addressed by holding conversations to inspire and promote a more civil workplace. The article is founded on the principle that a high score could be achieved in nearly every inventory item if healthy communication exists in the organization. However, communication amid incivility is challenging, and healthcare practitioners must understand when to initiate a conversation about incivility and how to sustain it to prevent further conflicts. According to Clark (2015), nurses should first create a safe zone if they decide to engage in a challenging conversation with an uncivil coworker. In this case, both parties should choose an emotionally and physically safe setting to hold the conversation. Such a place should be away from patients, family, and other potential observers.
The concept (crucial conversations) presented in Clark’s article relates to my Work Environment Assessment since it stresses the importance of effective communication. Whether civil or uncivil, healthcare organizations should embrace communication and empower employees to communicate effectively (Clark, 2015). Barriers to communication, such as lack of resources, medical jargon, and the halo effect, should be addressed effectively. Indeed, high performance in the communication aspect improved my organization’s overall score. As a result, it is a critical aspect of civil workplaces, sustained employee productivity, and healthy relationships between employees and other organizational members.
My organization could apply the concept of crucial conversations to improve health and create stronger work teams. According to Clark (2015), addressing uncivil behaviors through open communication can be challenging, but silence increases workplace stress, impairs job performance, and risks patient care. Therefore, my organization should establish a framework for engaging in challenging conversations and ensure employees understand they should address an uncivil encounter when it occurs. To succeed in challenging conversations, nurses should be well prepared for the conversation, speak confidently, and use respectful expressions. Leaders should train nurses to hold such conversations to empower them to face uncivil colleagues. Wohlever (2019) also stressed the importance of organizations and employees having a plan for handling incivility in today’s practice. To optimize safety, organizations should have de-escalations strategies for incivility and teach employees how to implement them. Employees should also know the type of help available to them in the organization so that they can engage in what is permissible and manageable.
Part 3: Evidence-Based Strategies to Create High-Performance Interprofessional Teams
Addressing Shortcomings in the Work Environment Assessment
A score of 65% implies that intensive efforts are needed to maximize civility in the organization. To improve communication, decision-making, and teamwork, the organization can implement routine huddles to address incivility-related safety risks and other issues. In the context of healthcare, huddles are brief interdisciplinary meetings for improving team communication and coordination by addressing issues affecting patients, staff, and the environment (Pimentel et al., 2021). Nurses and leaders can use huddles to share their experiences of incivility and how it should be addressed. The other area that requires massive improvement is employee retention through attracting and retaining the best talent. High employee retention could be achieved by increased motivation and assigning manageable workloads to prevent nurse turnover. Always, the guiding principle should be higher patient outcomes.
Bolstering Successful Practices
Teamwork is crucial for sustained performance and interprofessional collaboration. An effective way of improving teamwork and communication is by creating diverse healthcare teams. Such teams include members of different races, cultures, and ages who work together for a common goal. Stanford (2020) stressed the importance of diverse, inclusive teams in healthcare for high coordination and a shared perspective. Team members learn from each other and learn effective communication skills such as emotional intelligence, tolerance, and attentive listening. The other important practice for bolstering performance is wellness and self-care since they help to create nursing teams that are optimally healthy (Hofmeyer et al., 2020). Prioritizing wellness and self-care helps nurses to be mentally, physically, and emotionally healthy. Such wellness is crucial for sustained performance and low incivility in the workplace.
NURS 6053 Assignment: Workplace Environment Assessment Conclusion
Healthcare organizations should be highly civil for employees’ optimal performance. Issues contributing to workplace incivilities, such as poor communication, a lack of employee engagement, and a high workload, should be prevented as much as possible. My organization’s score of 65/100 shows that multiple interventions should be implemented to improve the civility score. Focus areas include communication, teamwork, shared decision-making, wellness, and self-care. It is also crucial to empower employees to engage in challenging conversations with uncivil colleagues.
NURS 6053 Assignment: Workplace Environment Assessment References
Clark, C. M. (2015). Conversations to inspire and promote a more civil workplace. American Nurse Today, 10(11), 18-23.
Hofmeyer, A., Taylor, R., & Kennedy, K. (2020). Knowledge for nurses to better care for themselves so they can better care for others during the Covid-19 pandemic and beyond. Nurse Education Today, 94, 104503. https://doi.org/10.1016/j.nedt.2020.104503
Keller, S., Yule, S., Zagarese, V., & Parker, S. H. (2020). Predictors and triggers of incivility within healthcare teams: a systematic review of the literature. BMJ Open, 10(6), e035471. http://dx.doi.org/10.1136/bmjopen-2019-035471
Khan, H., Rehmat, M., Butt, T. H., Farooqi, S., & Asim, J. (2020). Impact of transformational leadership on work performance, burnout and social loafing: A mediation model. Future Business Journal, 6, 1-13. https://doi.org/10.1186/s43093-020-00043-8
Kwame, A., & Petrucka, P. M. (2020). Communication in nurse-patient interaction in healthcare settings in sub-Saharan Africa: a scoping review. International journal of Africa nursing sciences, 12, 100198. https://doi.org/10.1016/j.ijans.2020.100198
Pimentel, C. B., Snow, A. L., Carnes, S. L., Shah, N. R., Loup, J. R., Vallejo-Luces, T. M., Madrigal, C., & Hartmann, C. W. (2021). Huddles and their effectiveness at the frontlines of clinical care: a scoping review. Journal of General Internal Medicine, 36(9), 2772–2783. https://doi.org/10.1007/s11606-021-06632-9
Stanford, F. C. (2020). The importance of diversity and inclusion in the healthcare workforce. Journal of the National Medical Association, 112(3), 247–249. https://doi.org/10.1016/j.jnma.2020.03.014
Wohlever, A. S. (2019). Incivility in health care: Strategies for de-escalating troubling encounters. Family Practice Management, 26(5), 8-12. https://www.aafp.org/pubs/fpm/issues/2019/0900/p8.html
Zhang, S., Ma, C., Meng, D., Shi, Y., Xie, F., Wang, J., Dong, X., Liu, J., Cang, S., & Sun, T. (2018). Impact of workplace incivility in hospitals on the work ability, career expectations and job performance of Chinese nurses: a cross-sectional survey. BMJ Open, 8(12), e021874. https://doi.org/10.1136/bmjopen-2018-021874
A civil workplace is an environment where employees are treated with respect and dignity and feel safe and comfortable expressing their opinions and ideas. In a civil workplace, healthy communication and respectful behavior are important qualities to promote among employees.
According to Clark Healthy Workplace Inventory, my current workplace got 89 points, making it a relatively healthy environment. I agree with the findings as I can find things that could be improved, but I still see a lot of improvements already made. Most points were deducted from the questions related to communication, the presence of mentoring programs, conflict resolution techniques, and employee satisfaction. As part of a small company, the management tends to be personal to their employees, lacking more structure. There were many instances where my opinion was not taken into account, or when a conflict arose, no one was available to take care of it.
According to Marshall and Broome (2021), creating a safe environment for employees is critical to building a culture of excellence. Specifically, a safe environment refers to creating space for the employee’s culture, promoting inclusion, managing power inequities, and eliminating incivility. An example of where my workplace managers did not manage power inequities was when I struggled with another female worker who had been with the company for more than ten years and completely refused to consider another way of resolving an issue. The management, instead of verifying what option was the best, refused to consider my opinion. They advised me not to force my idea because of how new I was compared to the other employee. When management does not take suggestions into consideration, the employee feels undervalued and unappreciated, and their lack of motivation can decrease the company’s main goals.
An unhealthy work environment will not only reduce patient outcomes but will also reduce nurse satisfaction and produce emotional strains. (Wei et al., 2018) An unhealthy work environment can be characterized by a lack of support from management, poor communication, a lack of resources, and unsafe working conditions. These factors can lead to increased stress, frustration, and burnout among nurses, which can affect the quality of patient care. Nurses who work in unhealthy environments are more likely to make errors, experience job dissatisfaction, and leave their jobs.
Broome, M., & Marshall, E. S. (2021). Transformational leadership in nursing: From expert clinician to influential leader (3rd ed.). New York, NY: Springer.
Wei, H., Sewell, K. A., Woody, G., & Rose, M. A. (2018). The state of the science of nurse work environments in the United States: A systematic review. International journal of nursing sciences, 5(3), 287–300. https://doi.org/10.1016/j.ijnss.2018.04.010
Response #1 to Precious
It sounds like you have had bad experiences with top-down leadership. I have had similar experiences with a managerial disconnect from clinical consequences during planning, followed by a “too late” response during implementation. Top-down leadership struggles with implementation, but pure bottom-up usually gets unrealistic about resources. Mixing the two has the most success (Stewart et al., 2010). For example, instead of abruptly cutting off the IV team resource you mentioned, leadership could have thought ahead and prepared appropriately by communicating with clinical staff. The designated role might have needed to go for budgetary reasons, but those teams are effective because they have specialized ultrasound equipment. Depending on the size of your facility, it might be feasible to share that equipment. The first time I worked on a floor that had an IV ultrasound machine I was shocked how intuitive it was. Don’t get me wrong, I love having an IV team when it’s available. Anyone specialized like that is going to be more skillful from someone with a more generalized practice. However, in a staffing cut like this, with a top-down bottom-up approach with clinical staff and some planning, the effect of losing a valuable resource like the IV team could have not been so disruptive to workflow and patient care. Nurses are already used to signing out equipment (at least where I have worked), already know how to insert IVs, and as I said the IV ultrasound was pretty intuitive, it would just take practice to get used to inserting an IV while holding the ultrasound equipment. Details aside, the point is, a very practical solution could have been made if leadership had bothered to communicate with clinical staff. A civil workplace requires transparent and direct communication on all levels of the organization, and joint decision making for policy changes (Clark, 2015). Given a little warning, clinical leaders could have made a plan much better than the one I just came up with as an example off the top of my head, and an unfortunate cut might have been more manageable.
Resources
Clark, C. M. (2015). Conversations to inspire and promote a more civil workplace. American Nurse Today, 10
Links to an external site.(11), 18–23. Retrieved from https://www.americannursetoday.com/wp-content/uploads/2015/11/ant11-CE-Civility-1023.pdf
Stewart, G. L., Manges, K. A., & Ward, M. M. (2015). Empowering sustained patient safety: the benefits of combining top-down and bottom-up approaches. Journal of nursing care quality, 30(3), 240-246.
A civil workplace is an environment where employees are treated with respect and dignity and feel safe and comfortable expressing their opinions and ideas. In a civil workplace, healthy communication and respectful behavior are important qualities to promote among employees.
According to Clark Healthy Workplace Inventory, my current workplace got 89 points, making it a relatively healthy environment. I agree with the findings as I can find things that could be improved, but I still see a lot of improvements already made. Most points were deducted from the questions related to communication, the presence of mentoring programs, conflict resolution techniques, and employee satisfaction. As part of a small company, the management tends to be personal to their employees, lacking more structure. There were many instances where my opinion was not taken into account, or when a conflict arose, no one was available to take care of it.
According to Marshall and Broome (2021), creating a safe environment for employees is critical to building a culture of excellence. Specifically, a safe environment refers to creating space for the employee’s culture, promoting inclusion, managing power inequities, and eliminating incivility. An example of where my workplace managers did not manage power inequities was when I struggled with another female worker who had been with the company for more than ten years and completely refused to consider another way of resolving an issue. The management, instead of verifying what option was the best, refused to consider my opinion. They advised me not to force my idea because of how new I was compared to the other employee. When management does not take suggestions into consideration, the employee feels undervalued and unappreciated, and their lack of motivation can decrease the company’s main goals.
An unhealthy work environment will not only reduce patient outcomes but will also reduce nurse satisfaction and produce emotional strains. (Wei et al., 2018) An unhealthy work environment can be characterized by a lack of support from management, poor communication, a lack of resources, and unsafe working conditions. These factors can lead to increased stress, frustration, and burnout among nurses, which can affect the quality of patient care. Nurses who work in unhealthy environments are more likely to make errors, experience job dissatisfaction, and leave their jobs.
NURS 6053 Assignment: Workplace Environment Assessment Grading Rubric
| Performance Category | 100% or highest level of performance
100% 16 points |
Very good or high level of performance
88% 14 points |
Acceptable level of performance
81% 13 points |
Inadequate demonstration of expectations
68% 11 points |
Deficient level of performance
56% 9 points
|
Failing level
of performance 55% or less 0 points |
| Total Points Possible= 50 | 16 Points | 14 Points | 13 Points | 11 Points | 9 Points | 0 Points |
| Scholarliness
Demonstrates achievement of scholarly inquiry for professional and academic topics. |
Presentation of information was exceptional and included all of the following elements:
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Presentation of information was good, but was superficial in places and included all of the following elements:
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Presentation of information was minimally demonstrated in all of the following elements:
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Presentation of information is unsatisfactory in one of the following elements:
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Presentation of information is unsatisfactory in two of the following elements:
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Presentation of information is unsatisfactory in three or more of the following elements
|
| 16 Points | 14 Points | 13 Points | 11 Points | 9 Points | 0 Points | |
| Application of Course Knowledge
Demonstrate the ability to analyze and apply principles, knowledge and information learned in the outside readings and relate them to real-life professional situations |
Presentation of information was exceptional and included all of the following elements:
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Presentation of information was good, but was superficial in places and included all of the following elements:
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Presentation of information was minimally demonstrated in the all of the following elements:
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Presentation of information is unsatisfactory in one of the following elements:
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Presentation of information is unsatisfactory in two of the following elements:
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Presentation of information is unsatisfactory in three of the following elements
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| 10 Points | 9 Points | 6 Points | 0 Points | |||
| Interactive Dialogue
Initial post should be a minimum of 300 words (references do not count toward word count) The peer and instructor responses must be a minimum of 150 words each (references do not count toward word count) Responses are substantive and relate to the topic. |
Demonstrated all of the following:
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Demonstrated 3 of the following:
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Demonstrated 2 of the following:
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Demonstrated 1 or less of the following:
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||
| 8 Points | 7 Points | 6 Points | 5 Points | 4 Points | 0 Points | |
| Grammar, Syntax, APA
Points deducted for improper grammar, syntax and APA style of writing. The source of information is the APA Manual 6th Edition Error is defined to be a unique APA error. Same type of error is only counted as one error. |
The following was present:
AND
AND
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The following was present:
AND/OR
AND/OR
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The following was present:
AND/OR
AND/OR
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The following was present:
AND/OR
AND/OR
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The following was present:
AND/OR
AND/OR
AND/OR
|
The following was present:
AND/OR
AND/OR
|
| 0 Points Deducted | 5 Points Lost | |||||
| Participation
Requirements |
Demonstrated the following:
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Failed to demonstrate the following:
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| 0 Points Lost | 5 Points Lost | |||||
| Due Date Requirements | Demonstrated all of the following:
A minimum of one peer and one instructor responses are to be posted within the course no later than Sunday, 11:59 pm MT. |
Demonstrates one or less of the following.
A minimum of one peer and one instructor responses are to be posted within the course no later than Sunday, 11:59 pm MT. |