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Workplace Environment Assessment Results & Civility

            According to Clark (2015) and Clark (2018), one of the requirements of building healthy work environments involves engaging in civility conversations at different organizational levels. Such engaging communications enhance states of wellbeing among healthcare providers (Clark et al., 2011; Marshall & Broome, 2021). Based on the Clark Healthy Inventory, the health score of my workplace environment was 85. The overall score indicates that the workplace is moderately healthy. Based on the inventory results, the organization performed poorly on having lack of comprehensive mentorship program for all healthcare professionals in the workforce. The organization further obtains a low score on not providing competitive remuneration, salaries, and compensations to its workforce.

            The inventory outcomes show that the organization upholds integrity, presents a discernible trust between leaders and colleagues, and reinforces and encourages direct, transparent, and respectful communication. The organization further presents a shared mission and vision, which has its foundation on respect, trust, and collegiality. Based on these outcomes, the organization can be said to be moderately civil. The inventory results mirror the day-to-day occurrences in the psychiatric mental hospital that I work in. I’ve faced nurse-patient violence encounters, hostile exchanges among colleagues, and disagreements. However, these instances are resolved in a logical, coherent, and respectful manner.  My colleagues engage in respectful and healthy interactions. I extent respect to all my workmates and patients, and others reciprocate high levels of respect as well. Each nurse and physician seem excited to be part of the team and works towards meeting the daily quality indicators and targets—building a harmonious clinical environment.

Incivility Incident & Address

            Last year during the COVID-19 outbreak, I observed an altercation between the clinical nursing officer, a physician, and one of the new nurses on the neurology floor. Hours before this incident, a young teen boy had been admitted to the neurology department to obtain brain scans following head injuries after a prolonged seizure. The patient was impulsive and had a declining range of focus. The new nurse had prescribed Adderall to suppress his impulsivity. Studies by Thomas and Upadhyaya (2018) show that Adderall is effective in facilitating a calming effect among patients exhibiting hyperactivity and seizures. The physician was yelling at the new nurse, demanding answers on why the nurse prescribed Adderall without his supervisory watch. The physician went so far as to call the new nurse insulting names, including mentioning that she is rigid and unruly. The outbursts were calmed when the nurse made verbal and written apologies and affirmed to abide by the organizational protocols requiring nurses to prescribe medications under a supervisory watch of a licensed physician.

References

Clark, C. M. (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.pdf

Clark, C. M., Olender, L., Cardoni, C., & Kenski, D. (2011). Fostering civility in nursing education and practice. JONA: The Journal of Nursing Administration, 41(7/8), 324–330. https://doi.org/10.1097/nna.0b013e31822509c4

Clark, M. (2018). Combining cognitive rehearsal, simulation, and evidence-based scripting to address incivility. Nurse Educator. https://www.10.1097/NNE.0000000000000563

Marshall, E. S., & Broome, M. (2021). Transformational leadership in nursing : From expert clinician to influential leader (3rd ed.). Springer Publishing Company, Llc.

Thomas, S., & Upadhyaya, H. (2018). Adderall and seizures. Journal of the American Academy of Child & Adolescent Psychiatry, 41(4), 365. https://doi.org/10.1097/00004583-200204000-00005