Course
NR528 Leading and Managing Evidence-based Change in Nursing
Collaboration Café: Culture of Civility
Incivility in healthcare often begins subtly but can rapidly spread throughout a unit if left unaddressed. When nurse leaders fail to intervene, small behaviors—such as dismissive comments, eye-rolling, gossip, or exclusion—can escalate into a toxic work environment. As an advanced practice nurse (APN) in a leadership role, fostering a culture of civility is both an ethical and professional responsibility.
Creating a Culture of Civility
As an advanced practice nurse in a leadership position, I can promote civility by:
1️⃣ Modeling Professional Behavior
Leadership behavior sets the tone for the unit. Demonstrating respectful communication, active listening, emotional intelligence, and professionalism establishes behavioral expectations.
2️⃣ Establishing Clear Expectations
Developing and reinforcing a code of conduct aligned with organizational policies and the American Nurses Association Code of Ethics promotes accountability and shared standards of behavior.
3️⃣ Encouraging Psychological Safety
Creating an environment where team members feel safe speaking up without fear of retaliation strengthens collaboration and reduces passive-aggressive behaviors.
4️⃣ Promoting Open Communication
Implementing structured communication tools (e.g., SBAR), team huddles, and debriefings encourages transparency and reduces misunderstandings.
5️⃣ Providing Education on Civility
Offering education on conflict resolution, emotional intelligence, and professional communication increases awareness of how subtle behaviors impact team morale and patient safety.
6️⃣ Recognizing Positive Behaviors
Publicly acknowledging teamwork, professionalism, and respectful interactions reinforces desired behaviors.
Addressing Incivility When It Occurs
If incivility is observed, immediate and structured intervention is essential.
1️⃣ Address Behavior Promptly
Incivility should be addressed early before it escalates. Private, direct conversations using a non-confrontational approach can clarify expectations and encourage reflection.
2️⃣ Use a Structured Approach
Applying conflict management frameworks such as those outlined in Crucial Conversations by Kerry Patterson supports constructive dialogue and accountability.
3️⃣ Focus on Behavior, Not Character
Address specific actions rather than labeling the individual. For example, “I noticed the tone used during rounds felt dismissive,” rather than making personal accusations.
4️⃣ Reinforce Organizational Policy
If behaviors persist, progressive discipline aligned with HR policies may be required.
5️⃣ Protect the Team
If incivility impacts psychological safety or patient care, escalation to leadership or human resources may be necessary.
Impact on Patient Outcomes
Research consistently links workplace incivility to:
Increased staff turnover
Burnout
Communication breakdown
Medical errors
Therefore, addressing incivility is not merely a personnel issue—it is a patient safety priority.
Reflection
As an advanced practice nurse, leadership extends beyond clinical expertise. Creating a culture of civility requires proactive modeling, structured communication, accountability, and early intervention. When leaders actively address incivility, they prevent the “single cell problem” from evolving into a multisystem organizational failure and promote a healthier, safer practice environment.
Sample Solution
What are things you can do as an advanced practice nurse in a leadership position to create a culture of civility?
As an advanced practice nurse (APN) in a leadership role, fostering a culture of civility begins with modeling professionalism through respectful communication, empathy, and integrity in every interaction. Establishing clear expectations and policies on professional behavior, paired with regular education on communication, conflict resolution, and emotional intelligence, helps ……..Click below to access the full sample solution (PDF)