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Dr. Griffin is Director of Nursing Research, Education, and Simulation, Boston Medical Center, Boston, Massachusetts; and Dr. Clark is Professor, Boise State University, School of Nursing, Boise, Idaho, and Nurse Consultant, Ascend Learning/ATI Nursing Education, Leawood, Kansas.
The authors have disclosed no potential conflicts of interest, financial or otherwise.
According to a recent survey conducted by the Work-place Bullying Institute (2014), 27% of Americans have suffered abusive conduct or incivility at work. Another 21% have witnessed such behaviors, and 72% are aware that workplace incivility happens. The impact of these behaviors can be devastating and lasting. For example, workplace incivility can negatively impact employee physical and mental health, job satisfaction, productivity, and commitment to the work environment (Clark, 2013a; Spence-Laschinger, Wong, Cummings, & Grau, 2014). Workplace incivility also creates a heavy financial burden for health care organizations. Some estimates suggest that the annual cost of lost employee productivity due to workplace incivility may be as high as $12,000 per nurse (Lewis & Malecha, 2011). In addition, the costs of incivility escalate when the expenses associated with supervising the employee, managing the situation, consulting with attorneys, and interviewing witnesses (i.e., doctors, nurses, patients, and others impacted by the offender or who witnessed the incivility) are included (Clark, 2013a; Pearson & Porath, 2009). Clearly, incivility in the workplace is a serious problem and must be addressed--especially since incivility by health care professionals can result in serious mistakes, preventable complications, and even death (Tarkan, 2008).
One evidence-based strategy to address incivility and lateral violence is through the use of cognitive rehearsal, a behavioral technique generally consisting of three parts:
Participating in didactic instruction about incivility and lateral violence.
Identifying and rehearsing specific phrases to address incivility and lateral violence.
Practicing the phrases to become adept at using them.
Defining Incivility, Bullying, and Workplace Mobbing
There are several terms in the nursing literature used to describe undesirable and intimidating behaviors and interactions that occur between and among nurses and other health care workers. This section provides working definitions for three of the more common examples--incivility, bullying, and workplace mobbing. Historically, many nurse scholars have housed these terms all under the rubric of horizontal (also known as lateral) violence (Roberts, Demarco, & Griffin, 2009); however, although these terms are sometimes...