Effective Strategies to Address Workplace Incivility

Theresa Buxton Ph.D., RN, CNE Penne McPherson Ed.D., RN-BC, OCN

11/2/18

We extend the healing ministry of Christ by caring for those who are ill and by nurturing the health of the people in our communities.

What is Incivility?

“Low-intensity deviant behavior with ambiguous intent to harm the target, in violation of workplace norms for mutual respect. Uncivil behaviors are characteristically rude and discourteous, displaying a lack of regard for others”.

(Andersson & Pearson, 1999)

Workplace Hostility (or bullying) is

“repeated, unwanted harmful actions intended to humiliate,

offend and cause distress”

(Nursing World, 2015, p.1)

5 Scars in the Fence

11/7/2018 6 Scars in the Fence

The story is told of a little boy who had a short temper. His father decided to teach him a lesson by giving him a bag of nails and telling him that every time he lost his temper he was required to hammer one nail into the backyard fence. Over the next several weeks the little boy had driven in 47 nails! However, as the weeks progressed he was driving in fewer and fewer nails as he learned to control his short temper. Eventually the boy had learned how to control his temper most of the time. His father was proud and suggested that he pull out one nail for every day that he had completely controlled his temper.

Many days had passed when the boy went to tell his father that all of the nails were gone. The wise father took his son by the hand and they walked to the fence. He said, “Great job son, you have done really well, and I am very proud of you! But I want you to notice the holes. This fence will never be the same. When you say things in anger, you leave a scar just like you have left in this fence.” Effects of Stress

On the brain- Few days of stress: compromises the effectiveness of neurons in the hippocampus, the area responsible for reasoning and memory

Weeks of stress: reversible damage to brain cells

Months of stress: can permanently destroy brain cells

(Bradberry, 2017)

Chronic stress releases stress hormones Epinephrine (adrenaline) Norepinephrine Cortisol Cortisol causes weight gain, osteoporosis, digestive problems, hormone imbalances, cancer, diabetes, heart disease, negative impact on the adrenal glands

-Patient Safety

-Employee Engagement/ Retention

-Promotion of creativity

-Increased self-esteem/ confidence/ competence

-Workplace Incivility

-Lateral Violence or Hostility

-Behaviors include simple things such as eye-rolling, condescending body language, non-verbal language such as snorts, drumming of fingers, inattention while person is speaking…. texting…..

“Emotional Intelligence is your ability to recognize and understand emotions in yourself and others, and your ability to use this awareness to manage your behavior and relationships”

“Emotional Intelligence is your ability to recognize and understand emotions in yourself and others,….”

How do we recognize our own emotions and understand them? How do we recognize and understand emotions in others?

“….and your ability to use this awareness to manage your behavior and relationships”

Once we do recognize and understand how our emotions and those of others work in relationships, we are able to better manage our behaviors in those relationships

It is not a very advanced part of the brain so processing doesn’t really exist – it is the reptilian brain It takes control of actions when it perceives a threat

The spinal cord will let the brain know we have our hands on the stove and it will send the motor command or reflex to take our hand off the stove before our brain really has time to process it

Fight or flight 16 Second- the Limbic System The amygdala is a gatekeeper and responsible for processing emotions and memories for emotional events – hence it fits with emotional intelligence

It is the most important structure in the limbic system related to EI

17 Third- the Frontal Lobe

The youngest brain structure

Sets us apart from animals and gives us our essential humanness

Responsible for reasoning, planning, parts of speech, movement, some emotions and problem solving

The area in which people spend the majority of their time operating

18 Putting it together: You are on a hike near Boulder. You hear a loud sound and growling…. What happens if the information is processed in the spinal cord and we react with a reflex? • Fight or flight. • Hear sound, know I can’t win against large animals = run.

What happens if the information is processed in the limbic system? • I hear the sound and think, “Oh no, might be a bear, this is terrifying. I’ll never be able to outrun it if it that’s what the sound is. • Frozen in fear.

• Rationally decide what would be the best plan to avoid being mauled by the animal or • Convince myself that it isn’t bear season so it couldn’t be a bear

If the emotional cue that this is a serious situation is missed, I will probably still get mauled by whatever animal it is

Emotions are there for a reason

Note what automatic reflexes we are observing; sweaty palms, heart racing (spinal cord)

Filter them through our emotional memories –how do we normally react during stress and is that effective? Can these emotions be controlled?

Then we can move to the frontal lobe and solve the problem appropriately

is really the last component of EI as it builds on everything that came before it

You are using your own awareness and management and detecting the same of others in order to effectively interact with people

What is a Healthy Environment?

-Supportive

-Safe

-Trust and respect

-Applies learning to daily tasks

-Promotes interdependence, independence and self-motivation

-Considers the associate’s background, education, skills

-Can you remain calm, energized and focused in the face of another’s distress or during an upsetting situation? -Can you defuse conflict with humor or by listening convincingly to another’s point of view?

Increase:

- a climate of safety and healthy communication by role modeling and using as many opportunities as possible to teach interpersonal and care in confrontational skills

(“Leaving a Legacy” toolkit, Colorado Center for Nursing Excellence)

Decrease: - negativity - gossip -culture of blaming- use errors as teaching moments -maintain a zero tolerance for a communication that is unhealthy, disrespectful, or spoken to people other than the persons directly involved (“Leaving a Legacy” toolkit. Colorado Center for Nursing Excellence)

1. Be impeccable with your word.

2. Don’t take anything personally.

3. Don’t make assumptions.

4. Always do your best.

5. Be skeptical and learn to listen. (The Fifth Agreement: A Practical Guide to Self-Mastery (2010) Written by D.M. Ruiz & D.J. Ruiz)

When encountering a situation where you realize you do not want to respond immediately, you may:

-Tell the person that you will answer them in a moment

-Let them know that you need a few minutes before you can answer them

-Take three slow breaths before responding

Questions to ask oneself before responding to a conflict: What part of this issue do I own?

What do I need to apologize for?

If I knew this conversation were being videotaped and then shown to people I respect, how would I change my reaction?

How can I show compassion towards this person?

Proverbs 31 Ministry

Each of us make choices everyday. Healthy choices are made realizing that we are human and make mistakes, we are accountable for those mistakes and that opportunities to grow come from errors

We have the choice to either be the victim or overcome the situation

American Nurses Association (2015). Retrieved from http://www.nursingworld.org\bullying-workplace-violence.

Bradberry, T. (2017). Ten Toxic People You Should Avoid Like the Plague. Retrieved from http://www.talentsmart.com

Cashman, K. (1998). Leadership from the inside out. Provo: Executive Excellence Publishing.

Cornerstone on Demand. (2015). Retrieved from http://www.cornerstoneondemand.org

Davis, K., Middaugh, D., Davis, R. (2008). First down! Keeping your team in the game with great coaching. Med-surg Nursing, 17(6), 434-436. Dickenson-Hazard, N. (2008). Ready, Set, Go Lead. Indianapolis: Sigma Theta Tau.

Dossey, B., Selanders, L., Beck, D., & Attewell, A. (2005). Florence Nightingale Today. Silver Spring, MA.: American Nurses Association.

Karsten, M., Baggot, D., Brown, A., Cahill, M. (2010). Professional Coaching as an Effective Strategy to Retaining Frontline Managers. JONA, 40 (3), 140-144.