WORKPLACE ENVIRONMENT ASSESSMENT NURS-6053 Discussion Example

WORKPLACE ENVIRONMENT ASSESSMENT NURS-6053 Discussion Example

BY DAY 3 OF WEEK 7

Post a brief description of the results of your Work Environment Assessment. Based on the results, how civil is your workplace? Explain why your workplace is or is not civil. Then, describe a situation where you have experienced incivility in the workplace. How was this addressed? Be specific and provide examples.

BY DAY 6 OF WEEK 7

Respond to at least two of your colleagues on two different days by sharing ideas for how shortcomings discovered in their evaluations and/or their examples of incivility could have been managed more effectively.

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Accelerated Nursing Programs: How Do They Work?

In the initial assessment of my work environment using Clark’s Work Environment Assessment, it became evident that my current workplace is moderately healthy. Going through the questionnaire and providing answers prompted me to reflect on both my present and former workplaces. I realized that my current work environment is considerably healthier, but it also revealed areas that could benefit from improvement, despite scoring a 70, indicating a moderately healthy environment. According to my assessment, the level of civility at my current hospital also falls within the moderate range. While there is room for improvement, the existence of civility is undoubtedly better than its absence. It is essential to note that incivility in the medical field can lead to perilous working conditions, suboptimal patient care, and increased healthcare expenses (Clark et al., 2011). Although my workplace displays civility in some aspects, I have observed its absence in several others. When it comes to trust between leadership and staff, our environment excels in promoting civility.

My workplace frequently fosters mutual respect, and the leadership team effectively demonstrates the expected behavior and respect they desire from the staff. A civil work environment is a prerequisite for delivering high-quality services, as it encourages nurses and doctors to collaborate more effectively (Hossny & Sabra, 2021). Additionally, my workplace exhibits civility in areas such as joint decision-making, policy change, and governance. Teamwork is a cornerstone of our unit, and our manager actively involves us in decision-making processes, recognizing that we are the ones directly affected by policy changes. The approach is not one-sided; our manager’s belief in trust and collaboration contributes to a healthier workplace. Our manager follows the principles of “Cohesive and Effective Teams,” as mentioned by Broome & Marshall (2021), and exemplifies these concepts through their demonstration of civility and exceptional leadership skills.

However, there are certain areas where civility appears to be lacking, particularly in staff well-being and the equitable distribution of a manageable workload. Recently, the workload has become increasingly burdensome, with each nurse responsible for 6 to 7 patients. This elevated workload and the resulting stress pose risks to our well-being. Working understaffed without proper recognition of our efforts and the expectation of working on days off significantly affects our overall wellness. Our days off are intended for recuperation and recovery from challenging working conditions. As nurses, our responsibilities have a direct impact on people’s lives, and a more civil work environment would result in a more adequately staffed team, ensuring a fair and safe distribution of patient loads. While the issue remains unresolved, there is a consistent reassurance that efforts are being made to address it.

  • Collapse SubdiscussionHannah Timmer 

    Main Post 

     

    My Clark Work Environment Assessment showed that my workplace is mildly healthy. Reading through all the questions and answering them made me think about my current workplace and my old one. I realized that I work at a much healthier place now, but I also learned of some things that could change at my current hospital, even though it scored a 70, which was mildly healthy. Based on my results, my current hospital is mildly civil as well. Although that could be better, it is better than not having any. Incivility in the medical field can result in dangerous working conditions, subpar patient care, and higher medical expenses (Clark et al.,2011). My workplace displays civility in some ways, but I see a lack of it in many other areas. Regarding trust between leadership and staff, we score high in civility.

    Mutual respect often takes place in my workplace, and leadership does a great job showing what they expect by displaying the behavior and respect they want. To deliver high-quality services, a civil workplace environment is required. Nurses and doctors will interact more when they have a greater possibility of working in a civil environment (Hossny & Sabra,2021). My workplace also shows civility regarding joint decision-making, policy change, and governance. We have much teamwork in my unit, and my boss includes us in decision-making as we are the ones who directly work with policy change. It is not one-sided with my boss as she finds that trust and a collaborative approach make a healthy workplace. My boss believes in building “Cohesive and Effective Teams,” just as Broome & Marshall (2021) mention, and she exemplifies this well by showing civility and excellent leadership skills.

    Some areas where civility tends to lack are when it comes to the wellness of staff and when it comes to a reasonable workload that is distributed fairly. The workload has not felt reasonable lately, as we have had 6 to 7 patients per nurse. The workload and stress of that patient load are dangerous and exhausting. They do not respect us nurses and what we do when they continually allow us to work understaffed. That leads to poor staff wellness as we are working extra hours, doing extra work, and are expected to come in on days off. Our days off are meant to recoup and recover from poor working conditions. As nurses, people’s lives depend on us, and if my workplace had more civility, they would have more staff, so the patient load would fairly and safely be distributed. Nothing has been done yet to resolve this issue, but they always say they are working on it.

     

     

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

     

    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.  doi: 10.1097/NNA.0b013e31822509c4.

     

    Hossny, E. K., & Sabra, H. E. (2021). Effect of nurses’ perception to workplace civility climate on nurse-physician collaboration. Nursing open, 8(2), 620–627.    https://doi.org/10.1002/nop2.666Links to an external site.

     

    Reply to Comment

    • Collapse SubdiscussionFatimah Johnson 

      Hi Hannah,

      It is great that you work in a healthier work environment now. A healthy work environment is crucial for patient safety. My organization also has an issue with unsafe staffing conditions; in fact, most healthcare organizations do. According to Dall’Ora et al. (2022), there is a casual relationship between poor nursing staffing and patient mortality. Providing appropriate staffing to meet healthcare demands is essential in creating a healthy environment.

      You also mentioned that a civil workplace with mutual respect is important, especially between nurses and doctors. Mahboube et al. (2019) state, “effective relationship and collaboration between doctor and nurses are considered the main factor in achieving positive medical results” (para. 1). Training healthcare professionals to establish healthy relationships is crucial for efficient patient care.

       

       

      References

      Dall’Ora, C., Saville, C., Rubbo, B., Turner, L., Jones, J., & Griffiths, P. (2022). Nurse staffing levels and patient outcomes: A systematic review of longitudinal studies. International Journal of Nursing Studies134, 104311. https://doi.org/10.1016/j.ijnurstu.2022.104311Links to an external site.

      Mahboube, L., Talebi, E., Porouhan, P., Orak, R., & Farahani, M. A. (2019). Comparing the attitude of doctors and nurses toward factor of collaborative relationships. Journal of Family Medicine and Primary Care8(10), 3263. https://doi.org/10.4103/jfmpc.jfmpc_596_19Links to an external site.

      Reply to Comment

  • Collapse SubdiscussionJeanne Baleng Okuwobi 

    Week 7 Discussion: Main Post 

     

            Based on the Clark workplace assessment, my current workplace is healthy, scoring 90. I’m currently on a new assignment with a hospital about one hour from home. It is an excellent workplace because the manager and staff are very welcoming and supportive. “Nurses have the potential to lead the way in improving health and health care for all, but in order to realize that potential, they must operate in an environment that is safe, empowering, and satisfying” (Healthy work environment for nurses, 2017). The hospital where I’m currently working is a well-known institution highly rated; however, my unit is an orthopedics unit, relatively small, with ten beds. I work at night, and we always have myself, the charge nurse, and a tech. The ratio is 1:5; the charge nurse gets the other half. Techs are highly trained; they can draw blood, insert IVs, insert and remove foley, and straight cath ( which we do a lot on this unit) because some of our patients have post-op anesthesia effect/foley removal difficulties. I never see a hospital where techs do so much; it is impressive. Moreover, the manager is very inclusive, and she acknowledges everyone by their name.  She sends a text message daily  to say thank you for our hard work. I’m pleased to experience this good side of nursing. According to the American association of critical care nurses, Creating a healthy work environment enables nurses to provide the highest quality and compassionate patient care while being fulfilled at work, leading to a high staff retention rate. (Aacn.org, 2022).

     

                                                Uncivil Workplace  

          I have  previously worked in places where the staff was not friendly with contract/travel nurses because of the difference in pay. It often makes the work environment toxic and unsafe because the newcomers get the most patients with complex acuity. In 2021, I was a contractor on a Neuro unit. The place of work was  uncivil, mostly because the charge nurses had poor communication skills, and there were lots of microaggressions  occurring in the unit.  I understand that stress in the workplace can affect people’s behaviors, however, there should be no room for poor behaviors  at work.  According to an article online  “ stressful healthcare workplace, it’s no wonder nurses and other healthcare professionals sometimes fall short of communicating in respectful, considerate way”.  That does not excuse incivility in the workplace.  The patient ratio was 1:5, and our patients on this unit were 90% of the time total care, and we often did not have techs. What made it more challenging was the unfairness that took place. For instance, staff nurses were assigned more stable patients, and if we were lucky to have a tech, staff nurses would get the techs, and contract nurses did not. It was emotionally, physically, and mentally draining to complete my 13 weeks contract at that hospital. The unit manager did nothing to attempt to help despite all the complaints brought to her.  According to Griffin, “workplace incivility can negatively impact employee physical and mental health, job satisfaction, productivity, and commitment to the work environment. In addition, workplace incivility also creates a heavy financial burden for health care organizations”. Most nurses do not renew their contracts in this place; thus, the organization has to hire all the time, which can be costly.

                                                 Reference 

    Aacn.org. (2022).  Accesses  from https://www.aacn.org/nursing-excellence/healthy-work-environments#:~:text=Research%20shows%20that%20a%20healthy,while%20being%20fulfilled%20at%20work

    Conversations more civil workplace – American nurse. (2015).  Accessed from https://www.myamericannurse.com/wp-content/uploads/2015/11/ant11-CE-Civility-1023.pdf

    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. doi:https://doi.org/10.3928/00220124-20141122-02

    Healthy work environment for nurses: Ana enterprise. ANA. (2017, October 14). Retrieved January 9, 2023, from https://www.nursingworld.org/practice-policy/work-environment/ 

     

    Reply to Comment

    • Collapse SubdiscussionDallas Wilcox 

      Week 7 Response #1: Jeanne Baleng Okuwobi

      Jeanne, I thoroughly enjoyed reading about how your current place of employment fosters a civil work environment. It appears as this is so rare nowadays, so I love to hear about the good experiences.

      Unfortunately, I have heard the same complaints you had about contract/travel nurses being treated poorly on more than one occasion. Leadership has a crucial role in advocating, and they need to improve upon these skills to be effective continuously. Walden University (2022) explains that collaboration and assisting in meeting staffing needs ensures retention among staff and better patient outcomes due to happier staff. It sounds like the leadership at your one contract needed to understand and enact more collaboration and assistance in meeting the staff needs. Clark (2015) noted that many times when an organization is going through change, vulnerabilities and power struggles among regular staff could be heightened. Although their treatment is by no means acceptable, it may be that they felt threatened by contract nurses.

      In the situation where you dealt with incivility in the workplace, the suggestions I have for leadership were all based on improving the culture of that environment. Benedictine University (2022) explained that for work environments to be healthy, leaders must demonstrate fairness, show respect, and address workload concerns. A way to accomplish this is to offer educational opportunities to leaders surrounding accountability, collaboration, and positive interactions (St. Catherine University, 2021).

      I hope you continue to have travel nursing experiences as you currently have. This makes all the difference in the world for job satisfaction. Good luck to you!

      References

      Clark, C. (2015). Conversations to Inspire and Promote a More Civil Workplace. American Nurse Today10(11).

      Five ways nurse leaders impact performance. Benedictine University. (2022, March 1). https://online.ben.edu/programs/msn/resources/five-ways-nurse-leaders-impact-performance

      Nurse bullying: Why it happens and how to prevent it. St. Catherine University. (2021, December 17). https://www.stkate.edu/academics/healthcare-degrees/nurse-bullying

      What nurse leaders can do to create a healthy work environment. Walden University. (2022, April 18). https://www.waldenu.edu/online-masters-programs/master-of-science-in-nursing/resource/what-nurse-leaders-can-do-to-create-a-healthy-work-environment

      Reply to Comment

      Collapse SubdiscussionBeth Howell 

      Beth Howell Discussion Response 1

       Hi Jeanne,

           Thank you for sharing your experience. You certainly experienced both ends of the civility spectrum. I find it impressive that your manager sends thank-you messages daily. What a terrific way to show appreciation and recognition. She sounds like an authentic leader expressing appreciation (Morton, 2015).

            It is disheartening to read about the microaggression and inequity in your former work situation especially because you have brought relief to their staffing shortage. I wonder if you had reapproached the unreceptive manager and used the CUS approach if she would have had a different response. CUS is short for concerned, uncomfortable, and safety (Clark, 2018). It might have looked something like this: “I am concerned about the care our patients receive. I am uncomfortable when there is a lack of teamwork and for the patient’s safety, could we talk about more collaboration?”.

           Bullying, incivility, and microaggressions like you experienced range from 25% to 66% when nurses are surveyed (Broome & Marshall, 2021). The resulting unsafe environment affects the quality of care. I applaud you for addressing your concerns with your manager at the time and using your voice which is a good start in addressing incivility (Clark, 2015).

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

      Clark, C. M. (2015). Conversations to inspire and promote a more civil workplace. American Nurse Today, 10(11), 18–23.        https://www.americannursetoday.com/wp-content/uploads/2015/11/ant11-CE-Civility-1023.pdfLinks to an external site.

      Clark, C. (2019). Combining Cognitive Rehearsal, Simulation, and Evidence-Based Scripting to Address Incivility. Nurse Educator, 44 (2), 64-68. doi: 10.1097/NNE.0000000000000563.

      Morton, P. G. (2015). Creating and sustaining healthy work environments. Journal of Professional Nursing31(3), 165–167. https://doi.org/10.1016/j.profnurs.2015.04.002

      Reply to Comment

      • Collapse SubdiscussionFabio Anifrani 

        Response # 1

        Beth,

        Thanks for sharing your thoughts and experiences at your workplace. I was present with the idea that conflict resolution and addressing issues in a safe and open environment can be helpful to the growth of your organization(Broome & Marshall, 2021). I also want to acknowledge your leadership team for being motivated enough to learn how to improve how they relate to the staff improved way of relating to the staff which, as you noted, is not surprising with the current high civility score. I also agree that using “I” statements, as described in the Caspersen model, promotes open communication, especially during uncomfortable situations involving conflict (Clark, 2019). Ultimately, it is safe to claim that a lack of teamwork and the inability to collaborate effectively can lead to breakdowns in communication that contribute to unhealthy work environments and potential medical errors (Walden University Producer, (2018).

        References:

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

        Clark, C. M. (2015). Conversations to inspire and promote a more civil workplace. American Nurse Today, 10 (11), 18–23.

        https://www.americannursetoday.com/wp-content/uploads/2015/11/ant11-CE-Civility-1023.pdf

        Walden University, LLC. (Producer). (2018). Diagnosis: Communication Breakdown [Video file]. Baltimore, MD: Author.

        Reply to Comment

    • Collapse SubdiscussionIvy Dzivenu 

      RESPONSE #2

      Hi Jeanne,

      Great post on your workplace assessment tool. I also did travel nursing and encountered a similar unsafe environment and I will say it was very stressful physically, emotionally, and psychologically. Imbalanced workload and unclear roles contribute to incivility because employees would read mischief (Ogunbote, 2020).

      According to Gibson (2021), the solutions to nursing workplace incivility should focus on enhancing the nurses’ relationships at work and ensuring the nurse’s welfare and fulfillment are achieved. Developing a civil communication culture would increase staff morale, empowerment, and productivity.

      Apart from respect and dignity as the pillars for achieving a civil workplace environment, the best action is for every company to implement good communication skills to encourage a civil workplace environment. Another practical solution to the oppression behaviors is developing a conflict resolution committee where the victims would report the perpetrators for appropriate action.

      References

      Gibson, C. G. (2021). Nursing Workplace Incivility and Mindfulness. https://digitalcommons.gardner-webb.edu/cgi/viewcontent.cgi?article=1039&context=nursing-dnpLinks to an external site.

      Ogunbote, J. (2020). Culturally Diverse Nurse Educators’ Perception of Faculty-To-Faculty Incivility (Doctoral dissertation, Capella University). https://search.proquest.com/openview/fb91c2a597b28898c57a11d4113e4ea8/1?pq-origsite=gscholar&cbl=18750&diss=yLinks to an external site.

       

       

      Reply to Comment

    • Collapse SubdiscussionPaulphielle Mcqueen 

      Response #2:

      Jeanne,

      Great discussion post, I really enjoyed reading your post about your organization! A healthy work environment is something I have learned is especially important and can make or break the success of an organization. Healthy work environments are empowering, healing and safe environments that have been shown to be correlated with employee engagement and organizational commitment (Lee, 2018). Civil communication is so important that the American Nurses Association (ANA) includes fostering a safe, ethical, civil workplace in their code of ethics, to ensure a workplace which is civil and kind (Clark, 2018).

      Reference

      Clark, C. M. (2015). Conversations to inspire and promote a more civil workplace. American Nurse Today, 10(11), 18-23. Retrieved From https://www.americannursetoday.com/wp content/uploLinks to an external site.

      Lee, J. W. (2018). Environmental best practices, it begins with US: Business, local

      governments, and international community should work together. International Journal of Environment and Sustainability,7(2).https://doi.org/10.24102/ijes.v7i2.910Links to an external site.

      Reply to Comment

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