Unmasking Incivility in Nursing: The Hidden Cost to Patient Care

Abstract

Nursing is a respected and noble profession. Nurses are considered compassionate, skillful, and highly ethical. Once again for the 21st consecutive year, nurses are ranked the most trusted profession. Despite the positive accolades that the nursing profession has received over the years, there is pervasive plague which diminishes the reputation of the profession; incivility. Incivility in the nursing profession is associated with decreased job satisfaction, staff shortages, and alterations in physical well-being and mental anguish. Nursing incivility has a negative impact on healthcare organizations. The results can be seen in decreased productivity, increased absenteeism, increased turnover, and overall job dissatisfaction. These can cause strains on other staff and healthcare administration. Besides issues with morale and employee satisfaction, there are real financial costs associated with lost productivity and employee turnover. Uncivil actions and behaviors among nurses are delivered in many different forms from subtle to very aggressive and overt. While the literature is abundant with evidence to substantiate the existence of incivility in the nursing profession, it is imperative to raise awareness to the current culture and climate in nursing as it poses great risk to patient safety. A hostile work environment fractures interpersonal relationships thus contributing to the breakdown of essential communication methods needed to maintain safe delivery of care. Attempting to deliver nursing care in an environment where there is intimidation, violence, and bullying increases the risk of nurses making errors such as with medication administration. Over 100,000 reports of medication errors a year are reported and the estimated cost of these errors is $42 billion annually. The repercussions associated with incivility are massive as the effects are felt on an individual, the profession, health care agencies, nursing academia, and consumer (the patient.