Discussion reply (with 2 references)1

 
Work Environment Assessment
            In summarizing the results of the Clark Healthy Workplace Inventory, my current organization’s overall score was a 93%, which indicates “a very healthy workplace” (Clark, 2015). Most statements were rated as “Completely true,” and none were rated as either “Somewhat untrue” or “Completely untrue.” Although almost all answers were positive, the most positive answers were related to trust, team work, individual value, respect, organization transparency, equality, collaboration, growth and development, fairness, free expression, and a workplace culture which promotes a high level of employee involvement and worker self-determination. As one of the members of the leadership team at my organization, I was actually not surprised by any of the results, as I am one of the architects of the workplace culture, and we have strived to rid it as best we can of the toxic personalities and petty squabbles that can plague a work setting.
            However, there were several instances where the assessment results highlighted some of the areas where, unfortunately more work is needed. The area in which my organization scored the lowest (“neutral”) was in regards to opportunities for promotion and advancement. This is due to the fact that, although a national organization, each facility is fairly small (35-40 beds) and the leadership team and levels of management are firmly in place. Because we agree with Berg et al. (2017) when the researchers cited that professional growth and development were lifetime endeavors, the leadership team at Vogue Recovery are constantly training and educating our nurses, behavioral health technicians, and clinicians on the latest evidence-based treatment practices for the complicated area of substance abuse and addiction. The other areas in which my organization scored less than optimal (“Somewhat true”) had to do with staff retention, comprehensive mentoring, shared governance, and recruitment efforts. All of these areas need work because of the smaller size of the company, as well as the fact that it is currently under new ownership, so improvements in these areas are coming, but at a glacial pace. 
Civility in Current Organization
            One area which deserves and demands attention is conflict resolution at the workplace, and I and the rest of the leadership team are very aware of this. If the resolving of conflicts is neglected, it could result in a toxic, uncivil work environment, and the American Nurses Association (ANA) recommends implementing evidence-based strategies to immediately mitigate incivility and bullying at work (Crawford et al., 2019), and our leadership team agrees. The maintaining of personnel civility, a spirit of teamwork, and a collaborative work environment are topics of daily and weekly meetings, and we often talk about how we, as leadership, are affecting how out staff treat each other. Kaiser (2017) wrote that “leadership style is not a definitive factor of incivility, but leader behaviors impact the level of incivility between staff…” and that “the relationship between leaders and staff and the empowerment of staff have the strongest impact on [personnel] incivility.” I can say with certainty that, although some minor issues have popped up here and there during my tenure, the fact that management confronts them as quickly as possible decreases their escalation. Alshehry et al. (2019) cited that “administrators and nurses should be pro-active in recognizing, preventing, approaching, reporting and intervening with uncivil acts [in an effort to] avoid their negative impacts on patient care.”
Experience with Incivility in the Workplace
            Unfortunately, as both a floor nurse and a nurse supervisor, I have witnessed many instances of incivility in work settings. During nursing school, we were warned that “nurses eat their young,” and I found this notion to be preposterous, because I thought, with the nursing shortage causing so much burnout in practicing nurses, existing staff would welcome new graduates to the profession. Sadly, this is just not the case. Edmonson and Zelonka (2019) wrote that “nurse bullying is a systemic, pervasive problem that begins well before nursing school and continues throughout a nurse’s career,” and that a significant number of nurses “leave their first job due to the negative behaviors of their coworkers,” and these types of situations are “likely to exacerbate the growing nurse shortage.”
            Thankfully, I have not witnessed incivility in the form of violence, but more often on display is a lack of respect and support. Due to the highly collaborative nature of addiction nursing and patient care, the lack of teamwork and support from one’s peers can cause the typical stressors of the job to seem insurmountable. This lack of civility comes in the form of a seasoned nurse not being a resource for new nurses on the floor who are unfamiliar with the accepted practice protocols or how to best utilize the electronic medical record (EMR). These passive aggressive behaviors are not necessarily direct, but can heighten stress so much that people leave the organization. Although the situation seems to be getting better just due to the wider acknowledgement of the incivility problem and intervention being implemented to combat it, it is quite unfortunate that it still exists to such a high degree, and seems especially bad among people who have pledged to provide quality, compassionate care to others.

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