NR 500 Week 7 Discussion: Healthful Environments

Chamberlain University NR 500 Week 7 Discussion: Healthful Environments– Step-By-Step Guide

This guide will demonstrate how to complete the Chamberlain University NR 500 Week 7 Discussion: Healthful Environments   assignment based on general principles of academic writing. Here, we will show you the A, B, Cs of completing an academic paper, irrespective of the instructions. After guiding you through what to do, the guide will leave one or two sample essays at the end to highlight the various sections discussed below.

How to Research and Prepare for NR 500 Week 7 Discussion: Healthful Environments              

Whether one passes or fails an academic assignment such as the Chamberlain University NR 500 Week 7 Discussion: Healthful Environments  depends on the preparation done beforehand. The first thing to do once you receive an assignment is to quickly skim through the requirements. Once that is done, start going through the instructions one by one to clearly understand what the instructor wants. The most important thing here is to understand the required format—whether it is APA, MLA, Chicago, etc.

After understanding the requirements of the paper, the next phase is to gather relevant materials. The first place to start the research process is the weekly resources. Go through the resources provided in the instructions to determine which ones fit the assignment. After reviewing the provided resources, use the university library to search for additional resources. After gathering sufficient and necessary resources, you are now ready to start drafting your paper.

How to Write the Introduction for NR 500 Week 7 Discussion: Healthful Environments              

The introduction for the Chamberlain University NR 500 Week 7 Discussion: Healthful Environments  is where you tell the instructor what your paper will encompass. In three to four statements, highlight the important points that will form the basis of your paper. Here, you can include statistics to show the importance of the topic you will be discussing. At the end of the introduction, write a clear purpose statement outlining what exactly will be contained in the paper. This statement will start with “The purpose of this paper…” and then proceed to outline the various sections of the instructions.

How to Write the Body for NR 500 Week 7 Discussion: Healthful Environments              

After the introduction, move into the main part of the NR 500 Week 7 Discussion: Healthful Environments assignment, which is the body. Given that the paper you will be writing is not experimental, the way you organize the headings and subheadings of your paper is critically important. In some cases, you might have to use more subheadings to properly organize the assignment. The organization will depend on the rubric provided. Carefully examine the rubric, as it will contain all the detailed requirements of the assignment. Sometimes, the rubric will have information that the normal instructions lack.

Another important factor to consider at this point is how to do citations. In-text citations are fundamental as they support the arguments and points you make in the paper. At this point, the resources gathered at the beginning will come in handy. Integrating the ideas of the authors with your own will ensure that you produce a comprehensive paper. Also, follow the given citation format. In most cases, APA 7 is the preferred format for nursing assignments.

How to Write the Conclusion for NR 500 Week 7 Discussion: Healthful Environments              

After completing the main sections, write the conclusion of your paper. The conclusion is a summary of the main points you made in your paper. However, you need to rewrite the points and not simply copy and paste them. By restating the points from each subheading, you will provide a nuanced overview of the assignment to the reader.

How to Format the References List for NR 500 Week 7 Discussion: Healthful Environments              

The very last part of your paper involves listing the sources used in your paper. These sources should be listed in alphabetical order and double-spaced. Additionally, use a hanging indent for each source that appears in this list. Lastly, only the sources cited within the body of the paper should appear here.

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Sample Answer for NR 500 Week 7 Discussion: Healthful Environments

Incivility in the workplace can happen in a variety of ways. Sometimes, it can be happening around us without us noticing the effects of it right away. One situation that I can recall involving incivility in the workplace happened with one of our new graduate nurses in the emergency room. This new graduate nurse was one of our own nurse techs who transitioned to a nurse upon obtaining her license. She was overall a great person, but she was very attentive to details and asked many questions, as new nurses should do. This sometimes caused some of the other nurses to be annoyed with her. Some nurses became passive aggressive with her. McNamara (2012) states, “Passive aggressive behaviors are typically more subtle behaviors, but they can be just as disruptive to the work environment. These include failure to support a coworker, setting someone up for failure, treating someone with silence or refusal to communicate, being impatient with another’s inquiry, communicating incomplete information that results in sabotage, and expressing a negative attitude that affects a coworker’s confidence.”

Unfortunately, she caught onto other people’s actions and was afraid to ask questions anymore. I honestly felt bad for the girl. I took her under my wing whenever she needed help and told her that it was okay to ask questions because that’s how you learn. I reminded her that everyone started out as a new nurse in their career. The consequences of the incivility in the workplace caused her to eventually transfer to another department in the hospital. This negatively affected the work environment because we lost a potentially great emergency room nurse who was very knowledgeable. The situation could have easily been prevented if everyone would realize and remember that they once were a new nurse who had to learn by asking questions. “To help prevent lateral violence in nursing, a culture of safety is needed to create and sustain an environment where team members are encouraged to speak up to leaders and peers.” (Stanton, 2015. P8)

McNamara, S. A. (2012). Incivility in nursing: unsafe nurse, unsafe patients. AORN Journal, 95(4), 535-540. doi:10.1016/j.aorn.2012.01.020

Stanton, C. (2015). Action needed to stop lateral violence in the perioperative setting. AORN Journal, 101(5), P7-P9.

Sample Answer 2 for NR 500 Week 7 Discussion: Healthful Environments

Incivility in the workplace is a prevalent concern in nursing and healthcare settings. The knowledge of incivility and lateral violence in nursing is not an uncommon issue. It has been around for decades and remains a strong presence in nursing today. This causes me great sadness for the profession I hold dear. Uncivil workplace behaviors can be characterized as rude and discourteous, with no regard for others (Phillips, Smith, MacKusick, & Whichello, 2018). This repeated act that is essentially bullying, whether verbally or silently, can lead to absenteeism, low job satisfaction and morale, burnout, poor productivity, mental, and physical health problems for the recipient of this poor treatment (Phillips, et al., 2018). The nursing profession must take a continual stand against incivility to assure the safety and well-being of our nurses and ultimately our patients whose care can be affected by work incivility.

As a nurse of many years, I have been witness to and also the target of workplace incivility. As a novice NICU nurse many years ago, I remember the leadership in my department setting an intimidating tone for new employees. There were cliques and gossiping that ultimately led to low morale and fear. This is truly a sad and dangerous place to be when caring for the precious lives of others. In an ICU setting, nurses need to be able to work as a team to deliver effective care. The ability to discuss care situations with colleagues and receive their input in a supportive, non-judgmental way is how nurses grow in their knowledge and expertise, ultimately fine tuning their trade. When intimidation and condescending attitudes are present, nurses will question their ability to provide good care and may eventually leave the department or the profession.

I am currently serving my fourth year as an assistant nurse manager in the pediatric operating room where I am employed. Upon immediate receipt of this promotion, I felt that the staff who were once my colleagues, but now my direct reports started to treat me differently. Suddenly, I became the enemy in some employee’s perspectives as I became responsible for scheduling, assignments, time and attendance tracking, and evaluations. My determination from the start to was model kindness and compassion towards others despite often times not receiving it in return. At the end of the day, I like to reflect upon the questions: Did I do my best? Was I fair to everyone? Was there anything I could have done better?

Unfortunately, even with putting my best efforts forward in communication, organization, and compassion towards others, there are those few in the department that intend on holding grudges and forming untrue opinions about me. We live in a world where very little grace is extended towards others and that is something I intend to provide more of the older I get. Presently, I am dealing with a situation with a particular surgical technologist that refuses to speak to me unless she has too. She talks to everyone around me and is generally well liked by all. She has never taken the time to get to know me personally but became very irritated with me on a few occasions when I assigned her to surgical cases. Instead of immediately coming to me with her frustrations, she would complain to her co-workers.

It would be weeks of the silent treatment before I would figure out that she was upset with me. I have tried repeatedly to rectify the situation, exemplify kindness by asking how she and her family were doing, and have unfortunately gotten nowhere. She complained to our manager that I speak to her like a child and give her unfair assignments. We sat down with our manager to discuss the situation further which led to 30 minutes of her telling me how she has never liked me and does not want me to speak to her and even threatened human resources involvement. During this interaction, I wish that I handled it differently but I did let anger and defensive mechanisms take over, taking the opportunity to call her out on the poor behavior she exhibits towards me on a daily basis. In the end, not much was resolved, my leader advised us to start anew and try to leave negative feelings towards each other in the past. I go to work each day with a desire to provide exemplary care to my patients and support to my team.

Unfortunately, not much has changed with my interactions with this surgical technologist as she refuses to speak to me still unless it is a work-related matter, and then she does it begrudgingly. In a recent attempt to improve this situation, I reached out to my manager and fellow leadership group to let them know that despite efforts, this employee continues to display negativity to me in and out of my presence as has been told me to by other employees. My fellow leadership team did not provide the clarification and support I was seeking, but instead responded that I was just one person and this individual is a ray of sunshine to others.

One fellow leader responded that she expects staff to talk negatively about us and not agree with everything we do. This response has ultimately left me feeling more isolated and alone in this situation. I am currently at a loss as to how to proceed. I have worked many years to reach my current position. Through hard work and dedication, I have been able to advance my nursing practice and hold my professionalism to a high standard. Phillips, Stalter, Winegardner, Wiggs, & Jauch (2018), describe workplace incivility and its consequences such as nursing resignations, mental anguish, and potential patient safety concerns. Personally, I have felt mental anguish over this situation and have indeed considered other positions. As present, I have decided to stick with it and continue to strive for excellence and maintain dignity despite the discomfort I feel when I am around this individual.

Having known earlier how this employee felt about me and addressing the issue upfront could have potentially led to a different outcome. Over time, tension and frustrations tend to build up in individuals which can lead to grudges and long-lasting opinions. Knowing this, I intend to address concerns and disagreements immediately from now on. I also feel that pursuing my MSN and addressing concepts such as incivility through scholarly review is empowering me to look past personal matters and seek out the root cause of incivility, better equipping me with a deeper knowledge base towards the subject. This in turn will help me develop better leadership skills in my current and future positions as a master’s prepared nurse. 

Strategies that support a healthy work environment are education on incivility in the workplace and how to counteract this detrimental behavior. This should be provided upon hire and repeatedly through computer based learning, staff meetings, and educational retreats. If a healthcare system invests in creating a just culture that maintains accountability for behaviors and actions, civil behavior will grow and support a healthy work environment (Phillips, et al., 2018). Leadership should have zero tolerance for incivility and be able to role model appropriate behaviors that promote team cohesiveness and support.

References

Phillips, G., MacKusick, C., & Whichello, R. (2018). Workplace incivility in nursing: A   literature review through the lens of ethics and spirituality. Journal of Christian Nusing, 35(1), 7-12. doi: 10.1097/CNJ.0000000000000467

Phillips, J., Stalter, A., Winegardner, S., Wiggs, C., & Jauch, A. (2018). Systems thinking and incivility in nursing practice: An integrative review. Nursing Forum, 2018, 1-13. doi: 10.111/nur.12250

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Sample Answer 3 for NR 500 Week 7 Discussion: Healthful Environments

Varying forms of incivility have existed in the emergency room since I became a student nurse 16 years ago.  Incivility is a lack of respect for others, and may be psychological in nature.  Display of behavior can be discourteous, condescending, and offensive (Lachman, 2015).  These behaviors still continue today, but the behaviors don’t seem as prominent as they did when I first began.  Unfortunately, I could reflect on a multitude of witnessed or involved episodes of incivility, but the behavior of those in power positions seem to stand out the most.  As McNamara (2012) states, those of hierarchy, direct their incivility toward co-workers having less power.  I have seen Doctors of various positions throughout the hospital display different degrees of incivility and lateral violence, some more aggressive than others. Lateral violence can be defined as condescending and sarcastic comments, in addition to insulting and patronizing behavior (Lachman, 2015).  The issue that I find most concerning is with the Director of Emergency Department, Dr. S.  It is the hospital policy that if a patient presents with chest pain to the emergency department that an EKG be performed and shown to an attending within 10 minutes.   The majority of these EKG’s are performed by the CNAs’.  The CNAs’ try to rotate the EKG’s between attending physicians, so no MD feels  overburden, and they do the best they can at rotating.  However, Dr. S has displayed conducts of incivility, lateral violence, and even bullying.  Lachman (2015) states that bullying can be refusal to assist with duties.  I witnessed a CNA hand Dr. S an EKG, which he then crumbled up and through it to the side.  In addition, a CNA came to me after Dr. S threw an EKG to the side and told the CNA that he wasn’t going to look at one more EKG today.  Needless to say both CNAs’ were extremely intimidated by his behavior, and I as the charge nurse had to intervene in both situations.  I felt bad in both situations, and I was apprehensive as I brought him the EKG’s to sign.  The consequences of this behavior affect the staff and the patient.  The CNAs’ don’t want to approach him, and therefore come to the charge nurse to show him the EKG.  McNamara (2012) states a high stress environment, like the ER, may have a higher occurrence of disruptive behavior leading to increase potential of patient harm.  Dr. S’s behavior caused a delay in a potential abnormal EKG being shown to an attending, including a possible STEMI, which was the rationale for the hospital policy. Also, the charge nurse has to now pull away from promoting flow of the department, which delays patients being placed.  The Director of the Department should have a role model for appropriate behavior.  He should be creating a healthy team environment by setting a tone of respect for all members of the team. Lastly, he should realize that a delay in viewing these EKG’s may cause a delay in care, an ultimately harm the patient.    

Lachman, V. D. (2015). Ethical issues in the disruptive behaviors of incivility, bullying, and horizontal/lateral violence. Urologic Nursing, 35(1), 39–42.

McNamara, S. A. (2012). Incivility in nursing: Unsafe nurse, unsafe patients. AORN Journal, 95(4), 535–540. doi:10.1016/j.aorn.2012.01.020

Sample Answer 4 for NR 500 Week 7 Discussion: Healthful Environments

I recall an experience as a recent graduate nurse in which I was bathing and caring for an eighteen-year-old female patient who had experienced prolonged severe carbon monoxide poisoning. Because of the exposure, she lost her parents and sibling, and she was the sole survivor. She suffered a severe anoxic brain injury that left her mentally devastated. It happened to be my first nursing position straight out of school in the PICU where I had previously worked as a patient care tech. During patient care, the charge nurse came on the overhead speaker in the patient’s room and pretended to talk to the patient. The charge nurse made crude remarks about how the patient was enjoying the bath and needed a boyfriend, would I like to be that man for her? I was in the middle of bathing the patient with another staff nurse when we heard the voice come over the speaker. At the moment that it happened I was not sure how to take the comments. However, I knew enough to know that her actions and comments were inappropriate and far from the standard of care.
As a male nurse, I was still learning how to best care for female patients. Each time I cared for a female patient I was extra intentional in showing respect, dignity, and upholding their privacy whenever possible. This situation caught me off guard and made me feel uncomfortable. My first reaction was to smile, but then the seriousness of the patient’s unfavorable prognosis caught my attention and helped redirect my focus back to the severity of her condition and vulnerability. I was not bothered so much about what the implications of the comment implied towards me as a male nurse but was troubled by the notion that we as health care providers were misbehaving toward the patient and in many ways taking advantage of her mental state and preying on her inability to defend herself. I merely justified the event in my mind and labeled it as the staff just being silly. The charge nurse and other staff members got a real laugh out of the whole thing as the story was retold latter that day. 
Regarding the consequences of the situation, most would argue and say nothing happened because none of the patient’s family or relatives and other neighboring families ever found out. As for implications for the patient, one might think it did not matter since she is incapable of understanding what took place. Had a family member heard about the incident or a member of leadership, the situation could have cost the charge nurse her job or at minimum caused for a movement to re-educate the staff on ethical practice standards of best care.
According to Andersson and Pearson, as cited in (Hunt, & Marini, 2012), the term “incivility” encompasses low-intensity behavior that lacks a clear intent to harm, but violates social norms and can cause harm. According to Lambert, Lambert & Ito, as cited in (Hunt, & Marini, 2012), nurses who have less than satisfactory relationships with their coworkers are more likely to leave their jobs. While I did not have any intentions on leaving my job after the incident, I could have turned this negative situation into a decisive, constructive learning moment in which all staff members could have reflected upon its possible negative implications. I might have gained some resistance from my co-workers, but ultimately an environment conducive to excellence is one worth fighting and advocating for. Unfortunately, I allowed my voice to go unheard, and I failed to support civility. I should have imaged my daughter or loved one laying there in that patient’s bed and treated her with compassion and empathy. 
According to Pearson and Porath, as cited in (Hunt, & Marini, 2012), incivility impacts on inter-professional team function through disruption of relationships and poor cooperation, and grievances. This situation negatively affected the work environment because each nursing provider failed to work towards a basis of civility in which we would love thy neighbor and was unable to demonstrate respect for this precious soul. All parties involved missed the opportunity to stop these rude comments, thoughtless acts, or negative gestures which were a form of aggression just in a less intense form: verbal rather than physical, passive rather than active, indirect rather than direct, and subtle rather than overt. The cycle of negativity continued because we chose to stay nonjudgmental. A charge nurse and every nurse ought to withhold a position of leadership and leadership qualities lacked during that incident. Nursing is a field in which caring is the backbone of all we strive to do, and we failed to uphold that promise. ANA’s Code of Ethics for Nurses states that nurses are required to “create an ethical environment and culture of civility and kindness, treating colleagues, co-workers, employees, students, and others with dignity and respect.” Similarly, nurses must be afforded the same level of respect and dignity as others (ANA, 2015), all these standards were omitted during this occurrence. Strategies that would support a healthy work environment start with continuous self-reflection and self-awareness on our own actions thoughts and perceptions. Confronting negative behavior or perceptions immediately in a nonjudging way with constructive criticism is crucial. ANA defines a healthy nurse as one who actively focuses on creating and maintaining a balance and synergy of physical, intellectual, emotional, social, spiritual, personal and professional wellbeing (ANA 2016). These are the qualities nurse leaders should exemplify so that such crude situations mentioned earlier have no place for acceptance or tolerance and ultimately are prevented altogether.

America Nurses Association. (2016). Healthy nurse, healthy nation. Retrieved from 
http://nursingworld.org/MainMenuCategories/WorkplaceSafety/Healthy-Nurse

American Nurses Association. (2015). Incivility, bullying, and workplace violence [Position 
Statement]. Retrieved from file:///C:/Users/User/Downloads/PosStat-Endorsed-ANA-Incivility-Bullying-Violence.pdf

Hunt, C., & Marini, Z. A. (2012). Incivility in the practice environment: A perspective from 
clinical nursing teachers. Nurse Education in Practice 12(6) pp. 366-370
doi://doi-org.chamberlainuniversity.idm.oclc.org/10.1016/j.nepr.2012.05.001

Week 7: Incivility and Healthful Environments 

Incivility involves workplace violence. Incivility can be harassment or generally lacking respect for others in the workplace (Bambi, 2017). A scenario when this writer witnessed incivility at the work place was an incident involving the day shift and night shift nurses. The issue between the two shifts is that the day shift nurses have been an ongoing battle due to the day shift nurses feeling that the night shift nurses have it easy due to less interactions with the doctors and patients overnight. This has caused a strain between the two shifts because there is a constant attitude within the two shifts and it has led to the day shift nurses dumping most of their work onto the night shift nurses. In example Foley insertions and retiming medications are continuously being dumped on the night shift to be completed on the evening shift. 

The incident that occurred happened at evening on shift change. The night shift came to the unit to begin their shift and the day shift nurses refused to give up their seats to allow the night shift nurses to look up their patients and begin their shift. The situation made this writer feel disrespected and as if the adults were in high school. It honestly was disbelief and saddened to witness behavior like this from adults. The initial response from day shift was that the computers could be used but the night shift nurses would have to seek their own chairs. The response to the situation caused the employees to escalate the issue to upper management which eventually lead to a team meeting. The consequences of the situation led to prolonged patient care. By the nurses spending time bickering over computers and chairs, it took time away from the patients. The other consequences caused more animosity between the two shifts in addition to the night shift nurses not getting a full report prior to assessing their patients. 

An example of how this negatively affected the work environment and outcomes was distrust within the staff. It caused the work environment to have tension amongst the employees. The outcomes have been reports that are not thorough and pertinent information not being relayed due to nurses rushing through reports or having attitudes. The situation could have been prevented by everyone doing what they are scheduled to do on their own shift. Another prevention strategy would have been for the day shift nurses to be courteous to give up their seats if they were done charting and allow the night shift nurses to get settled in (Rawlins, 2017). 

Strategies that would support a healthy work environment includes communication and monthly team meetings. The communication could be to have key points on what is expected from the staff as far as treating one another with respect. The monthly meetings will allow the staff to come together with their own suggestions and develop methods to make the unit run smoother in addition to promoting workplace efforts to come together. Team building exercises could promote collaboration within the staff. For example, the day shift nurse and night shift nurses can collaborate to do handoffs at bedside to discuss the patient in front of them to clarify any misunderstandings that the other party may have. Workplace incivility has negative outcomes on nurses and the healthcare organization. If proactive steps are taken beforehand, communication results could be positive. When reactive actions are taken to manage issues in the own hands of the nurse and not as a unit, outcomes become poor (Bambi, 2017). 

Reference 

Bambi, S. (2017). Bullying, incivility, and workplace violence in nursing: The scope and impact of the problem. (2017). Fast Facts on Combating Nurse Bullying, Incivility, and Workplace Violence. https://doi.org/10.1891/9780826138187.0001Links to an external site. 

Rawlins, L. N. (2017). Incivility in nursing. Fast Facts on Combating Nurse Bullying, Incivility, and Workplace Violence. https://doi.org/10.1891/9780826138187.0003Links to an external site.