Nurses: Resetting the Civility Conversation

Cynthia M. Clark, PhD, RN; Sara M. Ahten, MSN, RN


August 19, 2011

In This Article

Nurses Choosing Civility

Creating a civil environment belongs to all of us, not just leaders, managers, and teachers. Dealing with incivility takes personal courage and requires each of us to "name the problem" and take action to stop uncivil behavior. Some actions involve direct communication with uncivil coworkers, whereas others are indirect yet effective ways to deal with the problem.

  • A direct approach is to acknowledge the offensive behavior head-on without offering excuses or opinions. For example, if you as a new graduate nurse are repeatedly criticized by another nurse for not "pulling your weight," you can say, "You criticize me a lot about the pace of my work, and it distracts me from caring for my patients. I want you to stop making these comments so that I can focus on my patients." Confronting an uncivil coworker can be challenging, but it often puts an end to the problem by directly addressing the offensive behavior.

  • If a direct approach is too difficult or you have tried to work directly with the other person without success, you can write a letter of complaint to the nurse manager asking him or her to explore the situation and assist you in reconciling the problem. Be sure to include the date, time, and details of the encounter. If your coworkers are also targeted by the uncivil employee, ask them to provide additional documentation to strengthen your position.

  • If the other person is your manager, supervisor, or teacher, then you need to rely on the organizational policy for dealing with incivility and disruptive behaviors. We won't pretend this is an easy or stress-free decision to make. However, those policies exist to protect you from unacceptable behaviors and your employer from costly litigation. Use them. If creating a civil workplace is a passion for you, then we strongly encourage you to join the teams in your organization that develop those policies.

  • Examine your own behavior. When we have role-played incivility scenarios with our students, they have responded with 2 interesting types of feedback. First, they frequently report that they have been a victim of, or an observer of, uncivil behaviors in school or clinical settings. Second, they report that it made them reflect on their own behaviors in similar situations in the past, and they recognize that they have initiated, participated in, or encouraged incivility themselves. They often report that they didn't recognize the behaviors as uncivil but merely the "normal" way things were done. This supports research findings that calmly and directly telling people to stop unwanted behavior can be effective.

  • Step up and speak up. There is power in numbers.

You need to agree as a group on what is acceptable behavior and what is not. If you see someone being bullied, don't stand by quietly or pretend you don't see it. Unless each nurse names uncivil behavior when it occurs, it continues without any consequences. If someone is gossiping and "tearing down" your colleague, don't join in or give approval by saying nothing. Unless you speak up and say, "I don't feel right talking about this behind his/her back. Have you talked with him/her?" then that behavior will likely continue, regardless of what your manager does. Support each other to hold each another accountable.

Stop making excuses. Quit saying, "That's just Mike. He does that to everyone." No, he doesn't. He has learned where his behavior is tolerated and where it isn’t, and up until now, your department may have tolerated it. Unless all of you refuse to excuse it any longer, it will continue.

Acting civilly and respectfully isn't always easy, especially in a stressful environment of high patient acuity and demanding workloads, where lives often hang in the balance. Yet, we must make civility a priority for our patients and colleagues. Incivility takes a tremendous toll on staff, patients, and organizations. Choosing civility is important and the right thing to do.


Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.