WK4 NRSG 232 Fundamentals of Nursing

Is Effective Communication Imperative for Health Professionals?

Learning Outcomes

• Explain why effective communication is imperative among health professionals.
• Describe disruptive behaviors (incivility, horizontal violence, bullying) and their effects on the healthcare environment and client safety.
• Demonstrate effective communication as a professional and improve civility when disruptive behaviors and workplace violence occur.
• Differentiate the major characteristics of assertive and non-assertive communication.

Civility

• Civility is defined as courtesy and politeness, as well as a polite action or expression.

Disruptive Behaviors

• Incivility
• Horizontal violence
• Bullying

Incivility

• Definition: Rude, disruptive, intimidating, and undesirable behavior directed at another person.
• Consequences: Psychological or physiological distress, potential escalation to threatening situations (Taylor et al., 2023, pp. 200, 1777).

Incivility in the Classroom

• Using cell phones/computers during class for non-class related activities
• Harsh or cruel feedback
• Gossip
• Undermining
• Discrimination/lack of inclusiveness

Examples of Incivility

• A nurse threatening another nurse in a rude, belittling way.
• A nurse being rude and disrespectful to another nurse.
• A nurse bullying other nurses.
• Negative actions or body language (verbal or nonverbal).
• Stalking or physical assault.
• Impact: Can affect patient care.

Horizontal Violence

• Definition: Physical, verbal, or emotional abuse, anger, or aggression directed at RN coworkers at the same organizational level.
• Examples:
  • Gossiping
  • Verbal abuse (speech intended to humiliate or embarrass)
  • Withholding information
  • Snide remarks
  • Abrupt responses
  • Sabotage
  • Scapegoating
  • Not available to help
  • Eye-rolling
  • Complaining to others about an individual
  • Ostracism
  • Failure to respect privacy (Taylor et al., 2023, p. 200).

Bullying

• Definition: Persistent intimidating actions by individuals (or a group) directed towards an individual (or a group) intended to intimidate, degrade, humiliate, undermine, or create a risk to health or safety.
• Consequences:
  • Health problems for the target.
  • Hostile work environment hindering effective communication.
  • Nurse retention problems (Taylor et al., 2023, pp. 200, 1777).

Why Civility/Effective Communication is Imperative

• Patient Safety
• Vulnerability
• Nurse Attrition

Individual Actions to Promote Civility

• Be respectful of others.
• Raise awareness of disruptive behaviors in self and others.
• Increase communication skills to intervene when others display disruptive behaviors (Taylor et al., 2023, pp. 201 & 202).

Suggestions for Dealing with Incivility

• Cognitive Rehearsal
• SBAR or I-SBAR or I-SBAR-R or I-SBAR-Q
• Emotional Intelligence (EQ)
• DESC
• CUS
• Assertive Communication
• TeamSTEPPS

Cognitive Rehearsal Responses to Uncivil Behaviors (Griffin & Clark, 2014)

• Uncivil Behavior: Using nonverbal innuendo (e.g., eye-rolling, making faces, deep sighing)
  • Verbal Response: “I sense/see from your facial expression that there may be something you wish to say to me. It’s okay to speak to me directly.”
• Uncivil Behavior: Name-calling, verbal affronts, demeaning comments, put-downs, sarcastic remarks
  • Verbal Response: “I learn best from individuals who address me with respect and value me as a member of the team. Is there some way we can structure this type of interaction?