Assignment: Workplace Environment Assessment
Clearly, diagnosis is a critical aspect of healthcare. However, the ultimate purpose of a diagnosis is the development and application of a series of treatments or protocols. Isolated recognition of a health issue does little to resolve it.
In this module’s Discussion, you applied the Clark Healthy Workplace Inventory to diagnose potential problems with the civility of your organization. In this Portfolio Assignment, you will continue to analyze the results and apply published research to the development of a proposed treatment for any issues uncovered by the assessment.
- Review the Resources and examine the Clark Healthy Workplace Inventory, found on page 20 of Clark (2015).
- Review the Work Environment Assessment Template.
- Reflect on the output of your Discussion post regarding your evaluation of workplace civility and the feedback received from colleagues.
- Select and review one or more of the following articles found in the Resources:
- Clark, Olender, Cardoni, and Kenski (2011)
- Clark (2018)
- Clark (2015)
- Griffin and Clark (2014)
The Assignment (3-6 pages total):
Part 1: Work Environment Assessment (1-2 pages)
- Review the Work Environment Assessment Template you completed for this Module’s Discussion.
- Describe the results of the Work Environment Assessment you completed on your workplace.
- Identify two things that surprised you about the results and one idea you believed prior to conducting the Assessment that was confirmed.
- Explain what the results of the Assessment suggest about the health and civility of your workplace.
Part 2: Reviewing the Literature (1-2 pages)
- Briefly describe the theory or concept presented in the article(s) you selected.
- Explain how the theory or concept presented in the article(s) relates to the results of your Work Environment Assessment.
- Explain how your organization could apply the theory highlighted in your selected article(s) to improve organizational health and/or create stronger work teams. Be specific and provide examples.
Part 3: Evidence-Based Strategies to Create High-Performance Interprofessional Teams (1–2 pages)
- Recommend at least two strategies, supported in the literature, that can be implemented to address any shortcomings revealed in your Work Environment Assessment.
- Recommend at least two strategies that can be implemented to bolster successful practices revealed in your Work Environment Assessment.
Sample Paper – Week 9 Assignment
NURS 6053 – Workplace Environment Assessment
Workplace Environment Assessment
Name of the Student
Interprofessional Organization & System Leadership
Workplace Environment Assessment
Incivility is a well-recognized and common issue in clinical practice as well as nursing education. As a contrast to civility, which involves considerate and respectful participation, incivility is referred to as low-intensity behavior characterized by various behaviors like being rude, impolite, or discourteous. It can be bidirectional and take many forms. It can occur between nurses, subordinates, and those in positions of leadership as well as from leaders to nurses in lower-ranking positions. Incivility in the healthcare workplace can involve repeated disrespectful, offensive, or discouraging behavior, unfair punishments, and misuse of power that can discourage and distress receivers. It ultimately creates strain and decreases the satisfaction and confidence of employees (Raheem & Cosby, 2016). This paper aims to describe the results of the Work Environment Assessment completed for my workplace and explain what they suggest about the civility and health of the workplace. It will also reveal a theory relating to the results and how the organization can apply it to create stronger work teams and improve organizational health. Strategies from the literature that can be implemented to bolster successful practices and address shortcomings revealed in the assessment will also be recommended.
Work Environment Assessment
The overall civility score of the workplace was 56, which falls in the unhealthy score range from 50 to 59 (Clark, 2015). Two surprising things were the statements; “communication at all levels of the organization is transparent, direct, and respectful.” and “teamwork and collaboration are promoted and evident,” which had deficient scores. It can be the cause of the exceptionally high turnover, especially among registered nurses within the department, as well as decreased job satisfaction scores and retention rates. An unhealthy and uncivil work environment can negatively influence staff commitment to the organization as well as their productivity. While working on the floor, there have been experiences of miscommunication, especially in changes in shifts. One scenario that portrays the issue involved hurrying up to get patient reports and stabilize another one as an intensive care unit (ICU) patient was waiting to transfer to the floor. My work phone was frequently ringing as the ICU nurse tried to give me a report. She eventually rolled the new patient to my level and expected a report right away as she had to go home. She was uncivil as I tried to apologize, and she responded, saying, “whatever, I don’t have time for this. I want to go home.” I respectfully acknowledged her incontinence that I might have caused, but my patient’s safety was my priority. Additionally, I explained to her that she needed to address me respectfully as we are both professionals, and the wellbeing of our patients comes first. One prior belief that was confirmed by the results is that the only thing helping the organization retain staff is the benefits and competitive salaries. The statement “the organization provides competitive salaries, benefits, compensations…” had the highest score in the assessment.
The results of the assessment suggest that the workplace is unhealthy and uncivil. Communication is lacking, and this impacts the health of the organization while the lack of teamwork harms the work environment. Broome and Marshall (2017) point out that communication and teamwork are among the critically essential core values for successful collaboration that shapes the quality of care for patients and families. Effective collaboration is not only personally and professionally satisfying to those involved, but also contributes to a unified and holistic approach to patients and clients, facilitates faster internal decision making, reduces cost through shared resources and promotes innovation. Healthcare professionals are socialized and educated in discipline-specific frameworks. They must move out of such habits for them to work together, and this requires sensitivity to other theoretical foundations as well as ways of thinking and knowing.
Review of Literature
Many studies have been conducted to establish the best evidence that can guide practice to decrease and address incivility in the workplace. One of the articles reviewed was titled “Revisiting cognitive rehearsal as an intervention against incivility and lateral violence in nursing: 10 years later” by Martha Griffin, and Cynthia Clark (2014). The authors had the aim of conducting a literature update on cognitive rehearsal, and they undertook reviews on the utilization of cognitive rehearsal as a strategy that is based on evidence for addressing bullying behaviors as well as incivility in nursing. Griffin and Clark (2014) point out that different kinds of negative interactions and behaviors occur between and among nurses and other care providers, including workplace mobbing, bullying, lateral violence, and incivility. Those in a higher power and authoritarian positions, including experienced nurses, managers, and physicians often present such behaviors. Many times the receiver’s or those impacted by incivility fail to address the offenders and often wish they could.
The authors describe the cognitive rehearsal concept as productive communication activities that can be utilized by individuals in addressing lateral violence and incivility by delivering the message that it is not okay to act in an uncivil or violent manner. Examples of disrespectful behavior are provided in the study as well as the cognitive rehearsal responses that can be utilized by healthcare professionals like nurses to practice rehearsing. They argue that even though the technique can be challenging to practice, it can effectively eliminate or reduce lateral violence and incivility. According to the authors, when incivility victims implement strategies from cognitive rehearsal, such behaviors can be removed. Clark (2015) supports this view by noting that the most effective way of addressing incivility is through speaking up when it happens. The author also advocates for the use of cognitive rehearsal in challenging conversations that aim to address incivility through three process steps. They include interactive and didactic instruction and learning, repetition of particular phrases to utilize in uncivil encounters, and sessions of practice for reinforcing instructions and rehearsal.
The concept of cognitive rehearsal relates to the results of the workplace assessment as it addresses the issues of communication and teamwork. The workplace scored very low on these domains, meaning it is unhealthy and uncivil. Clark (2015) points out that utilization of cognitive rehearsal can enable improved communications, greater nurse satisfaction, and a workforce that is more conflict-capable as well as improved patient care. One model proposed to address incivility under this concept is the DESC model. It stands for Describe, Express, State, and Consequences. The organization can apply it to create a healthier organization as well as stronger working teams. The model is part of an evidence-based teamwork system for improving communication and teamwork skills, which in turn improves on the quality of care and safety. The model will help professionally address uncivil behavior to help relieve stress and conflict within the work environment. That means, respectfully confronting and having a conversation with the uncivil coworker.
An example can include the uncivil ICU nurse in a hurry to get home during shift changing. Describing can involve explaining that you understand she is in a hurry and apologizing for delaying, although you feel she is not giving enough information. Explaining can involve telling her she is disrespectful to a colleague. Stating can include providing an alternative like giving more information or talking with respect and decency. At the same time, consequences can involve explaining how her behavior can result in information breakdown that can harm the patient’s safety.
Evidence-Based Strategies to Create High-Performance Inter-professional Teams
Strategies to Address Shortcomings
Strategies that can be applied in addressing the shortcomings of poor communication and teamwork involve reflection, probing, and commitment. Clark (2015) points out that reflection on our workplace cultures, as well as the interactions and relationships we have with others is a vital step toward the improvement of team, individual, and organization success. Fundamental questions have to be asked when one is faced with the prospect of having a challenging conversation. They include inquiring about what would happen if one engages in a difficult conversation as well as what would happen if they did not. It also includes asking oneself what would happen to the patient if they stayed silent. Not speaking up during disrespectful situations has been identified as a severe breakdown of communication among care providers, and it has been asserted that such failures can have severe consequences for patient care. Creating commitment to a practice of speaking up can involve multifaceted organization approaches which foster a culture where individuals can effectively speak up when they have concerns.
Various sources of influence, as well as recommendations, can be utilized, such as improving the ability of everyone to speak and hold their colleagues accountable to safe practices. Such skills can be acquired through training and education, development of scripts, role-playing, as well as the increased practice of communication skills in situations involving high stakes. Also, the DESC framework can be applied in uncivil scenarios to structure conversations that are based on civility. Clark (2015) notes that utilizing the cognitive rehearsal strategies in combination with the DESC model is an effective means of addressing particular incidents of incivility.
Strategies to Bolster Successful Practices
The workplace assessment revealed one successful practice where the organization provides competitive compensations, benefits and salaries. It can be boosted further through the involvement of all stakeholders in the decision making processes of the organization. It involves incorporating team members from all care levels in creating and sharing the goals, values, and mission of the organization. Happy employees have been described as those whose personal values or visions align with those of the organization (Black and Venture, 2017). The goal, value, and mission of respect and civility should be embraced and shared by everyone in the organization to ensure its success. Employees at all levels need to be part of what the organization seeks to achieve so they can align their behavior towards the shared objectives. The second strategy involves effectively clarifying expectations about the clinical practice to enhance workplace autonomy. Such an approach can enable nurses to organize their work and communicate more effectively to promote sound clinical decisions (Griffin & Clark, 2014). Effective communication is necessary to ensure clarity, especially between leaders and subordinates. Every employee needs to know what they are expected to achieve or do and how they can accomplish it, and this includes the type of behavior that should be practiced in the organization.
Workplace incivility negatively influences employees as well as the health of the organization with communication and inter-professional teamwork being greatly affected. Literature points to various evidence-based strategies for reducing and eliminating incivility including reflection on our workplace cultures, as well as the interactions and relationships. It also points to the involvement of all stakeholders in the decision making processes of the organization to bolster successful practices.
Black, J., & Venture, K. L. (2017). The human factor to profitability: People-centered cultures as meaningful organizations. Journal of Organizational Psychology, 17(2), 24-34.
Broome, M. E., & Marshall, E. S. (2017). Collaborative Leadership Contexts: Networks, Communication, Decision Making, and Motivation. Transformational Leadership in Nursing: From Expert Clinician to Influential Leader, 86.
Clark, C. M. (2015). Conversations to inspire and promote a more civil workplace. American Nurse Today, 10(11), 18-23.
Griffin, M., & Clark, C. M. (2014). Revisiting cognitive rehearsal as an intervention against incivility and lateral violence in nursing: 10 years later. The Journal of Continuing Education in Nursing, 45(12), 535-542.
Rahim, A. and Cosby, D. (2016), “A model of workplace incivility, job burnout, turnover intentions, and job performance”, Journal of Management Development, Vol. 35 No. 10, pp. 1255-1265. https://doi.org/10.1108/JMD-09-2015-0138