Workplace civility and staff retention

Nephrology Nursing Journal, Nov-Dec, 2004 by Mary Rau-Foster

"We must become the change we want to see"

(Mahatma Gandhi)

It is becoming increasingly difficult for some dialysis units to recruit and to maintain staff. The focus of this article is the effect that workplace incivility and bullying can have on employee retention.

The dialysis work environment itself is a fertile breeding ground for conflict. The noisy environment, the close and crowded quarters, difficult patient situations, and interdependent relationships can all lead to conflict. However, the lack of civility by and between staff members and patients can be counted as one of the biggest culprits of conflict creating a working environment filled with strife. This lack of civility is also a reason frequently given by employees who resign their positions with the dialysis facility.

What is Workplace Incivility?

Workplace incivility is subtle rude or disrespectful behavior that demonstrates lack of regard for others. It includes:

* Speaking in a condescending manner

* Demeaning, belittling, or harassing others

* Having emotional tirades, displays of temper, tantrums

* Unnecessarily or rudely interrupting others

* Not listening when another person is speaking directly or indirectly to you or others

* Rumor mongering and gossiping

* Acting in an impatient manner

* Being unable or unwilling to empathize with others

* Staff splitting and polarizing some staff members against others

* Exclusionary behavior, especially excluding new employees

One of the destructive behaviors that can be seen in any workplace or social environment is the exclusion of a newcomer. As groups form there is a natural tendency to form boundaries and protect or preserve that group (even if there are dysfunctional behaviors within that group). Newcomers may undergo a period of scrutiny by the group. The group is looking for evidence of common beliefs, values, practices, and whether the new employee will fit in. Often it appears that any mistake by a new employee is intolerable (though we make mistakes everyday). The new employee may be perceived as being too bright (and therefore is threatening) or not intelligent or capable enough.

What Causes Workplace Incivility?

Workplace stress, disrespectful treatment of employees, difficult working conditions, and conflict that is not addressed thus remaining unresolved, can lead to incivility. In addition, the "in your face" attitude portrayed in the media as acceptable behaviors and the failure to use good manners can also lead to strife, which if not addressed and corrected, can become the workplace norm. There must be conscious efforts made to use the tools that will build good working relations (including having a code of civil conduct). Proactive behavior will eliminate the bridge burning actions that have negative impacts on good workplace relationships.

What Can Be Done About Workplace Incivility?

The workplace culture must reflect a civil environment where the employees are and feel respected and where civil behaviors are expected in all interactions. Managers and employees must have a common understanding of what constitutes workplace incivility. Its consequences in terms of impact on patient care, staff retention, and productivity, and the financial costs flowing from the rude behaviors must be acknowledged. There must also be promotion of the use of good conflict resolution and communication skills, both of which will require training and constant reinforcement.

On a personal level, employees should listen, pay attention, be inclusive and empathetic. In addition, it is important to accept and give praise, speak kindly and respect other people's time and space. We must learn to assist and not just criticize others, especially new employees.

To change an environment, we have the responsibility to hold ourselves accountable for being proactive in changing bad habits. We must create an inclusive community and model the behaviors that will lead to a happier, more productive and stable workplace.

Readers are invited to contribute opinion essays for the Professional Issues department. Articles should cover topics of current interest to nephrology nurses. The Nephrology Nursing Journal encourages candid opinions. For specific guidelines, contact Paula Dutka, Department Editor, through the ANNA National Office; East Holly Avenue/Box 56; Pitman, NJ 08071-0056. The opinions and assertions contained herein are the private views of the contributors and do not necessarily reflect the views of the American Nephrology Nurses' Association.

Mary Rau-Foster, JD, MBA, BS, RN, is founder and president of Foster Seminars and Communications LLC (Web site www.workplaceissues.com), Brentwood, TN; and a member of ANNA's Music City Chapter.