Essay Example: Nursing Incivility in Clinical Practice: Ethical Dilemmas and Professional Values

Nursing Incivility in Clinical Practice: Ethical Dilemmas and Professional Values

1. Introduction

1.1 Topic presentation and thesis statement

Nursing incivility encompasses low-intensity deviant behaviors with ambiguous intent to harm, including rudeness, condescension, and dismissive remarks among nursing staff. These behaviors erode professional respect and undermine cohesive collaboration, creating an ethical dilemma when experienced nurses engage in uncivil conduct toward colleagues. Such conduct can jeopardize patient safety and violates core nursing values. This paper examines the multifaceted ethical challenges posed by incivility in the clinical setting, analyzes relevant ethical principles and the ANA Code of Ethics, and explores viable strategies to promote a respectful professional environment.

1.2 Significance of addressing nursing incivility in ethical practice

Addressing incivility is imperative for maintaining ethical practice because it directly impacts patient outcomes, team cohesion, and the moral climate of healthcare organizations. Incivility contributes to increased stress, burnout, and turnover among nurses, leading to staffing shortages and higher risk of medical errors. By confronting these behaviors, nurses affirm the principles of beneficence, non-maleficence, and justice, fostering environments that prioritize patient well-being and professional integrity.

Note: This section includes information based on general knowledge, as specific supporting data was not available.

2. Identification of Ethical Dilemma and Ethical Concepts

2.1 Description of the incivility scenario in clinical setting

In a midsize hospital medical-surgical unit, Novice Nurse B experienced repeated episodes of incivility from Senior Nurse A. During shift handoffs, Senior Nurse A frequently interrupted Nurse B’s report, dismissing questions with curt remarks and belittling suggestions. This pattern extended to indirect comments about Nurse B’s competence in front of patients and other staff, creating a hostile work environment. The persistent discourteous interactions undermined team communication and heightened anxiety for Nurse B, raising concerns about potential compromises in patient care quality.

2.2 Relevant ethical principles (beneficence, justice, non-maleficence, veracity, fidelity)

The incivility scenario implicates several ethical principles. Beneficence demands actions that promote patient welfare, yet hostile interactions can distract nurses from patient-focused care. Non-maleficence requires avoidance of harm, and incivility may indirectly harm patients through communication breakdowns. Justice involves fair and equitable treatment of colleagues and patients; incivility breaches respect and fairness. Veracity, the obligation to tell truth, is compromised when individuals withhold honest feedback due to fear of reprisal. Fidelity, the commitment to professional responsibilities and trustworthiness, is undermined when team members engage in disrespectful behaviors.

2.3 Reference to ANA Code of Ethics provisions

The American Nurses Association (ANA) Code of Ethics provides clear guidance on such conduct. Provision 1 emphasizes respect for human dignity and the moral worth of each individual, mandating nurses to treat colleagues with courtesy. Provision 5 outlines the duty to self and others, requiring nurses to maintain collaborative relationships. Provision 6 addresses the nurse’s duty to environments of care, including the obligation to preserve a culture of safety and civility. These provisions collectively establish the ethical mandate to prevent and address workplace incivility among nursing professionals.

Note: This section includes information based on general knowledge, as specific supporting data was not available.

3. Exploration of Courses of Action and Outcomes

3.1 Option 1: Direct confrontation and mediation (ethical support)

Option 1 involves direct confrontation and mediation, wherein Nurse B engages Nurse A in a private, respectful dialogue to discuss the observed behaviors and their impact on teamwork and patient safety. Utilizing conflict-resolution techniques, a neutral facilitator or clinical nurse educator may mediate the discussion, ensuring that both parties express concerns and expectations. This approach aligns with the ethical principle of fidelity by honoring professional commitments to collegiality and honesty, and with beneficence by seeking to restore a supportive environment. The likely outcome is improved understanding and mutual respect; however, it requires willingness from both nurses to participate in open communication and risks exacerbating tensions if handled poorly.

3.2 Option 2: Reporting to management (ethical support)

Option 2 envisions formally reporting the incidents to unit management or the human resources department through established channels for workplace concerns. Filing an incident report adheres to non-maleficence by proactively addressing behaviors that threaten team function and patient safety. This route ensures accountability and may trigger organizational interventions such as increased supervision or disciplinary measures. While reporting can deter future incivility and uphold justice by ensuring fair treatment, it may also foster resentment or fear of reprisal among staff, potentially affecting team cohesion if follow-up actions are perceived as punitive.

3.3 Option 3: Implementation of conflict resolution training (ethical support)

Option 3 recommends the implementation of comprehensive conflict resolution and civility training across the unit or organization, focusing on communication skills, emotional intelligence, and cultural competence. This systemic intervention supports beneficence by promoting a caring, respectful workplace and justice by providing all staff members with equal access to professional development. Over time, such training can cultivate a culture of mutual respect, reduce incidence of uncivil behaviors, and enhance patient care outcomes. Nevertheless, this option demands institutional commitment, allocation of resources, and ongoing reinforcement to sustain meaningful change.

Note: This section includes information based on general knowledge, as specific supporting data was not available.

4. Impact on Care and Future Practice

4.1 Effect on current patient care and team dynamics

Incivility exerts a tangible effect on patient care and team dynamics. Distracted or demoralized nurses may overlook critical patient cues, leading to delayed treatments or errors. In the described scenario, Nurse B’s anxiety diminished confidence in clinical decisions and inhibited willingness to ask for assistance. The resulting disruption to team communication compromised the unit’s operational efficiency and patient satisfaction. High-stress interactions also contribute to moral distress among nurses, as they struggle to reconcile professional values with an unsupportive work environment.

4.2 Implications for professional development and future ethical decisions

Reflecting on this ethical issue informs future professional development and decision-making. Awareness of the underlying ethical principles equips nurses to identify incivility proactively and employ strategies that align with professional standards. Cultivating skills in assertive communication and conflict resolution becomes integral to ethical practice, enabling nurses to advocate for respectful environments. Additionally, engaging in organizational initiatives to promote civility strengthens leadership competencies and fosters resilience, preparing nurses to navigate complex interpersonal challenges responsibly.

Note: This section includes information based on general knowledge, as specific supporting data was not available.

5. Conclusion

5.1 Restatement of thesis and summary of key points

This paper has examined nursing incivility as an ethical dilemma, detailing its manifestations in a clinical setting and analyzing its implications through the lens of beneficence, non-maleficence, justice, veracity, and fidelity. By referencing relevant provisions of the ANA Code of Ethics, three potential courses of action—direct mediation, formal reporting, and conflict resolution training—were evaluated. The analysis underscores the need for deliberate strategies to prevent harm and uphold nursing values.

5.2 Final reflections and commitment to ethical nursing practice

Confronting incivility is not optional but a fundamental aspect of ethical nursing practice. Commitment to respectful communication, accountability, and ongoing professional development ensures that nurses cultivate environments that prioritize patient welfare and professional dignity. By embracing these principles, the nursing profession can mitigate workplace incivility and strengthen its moral foundation.

Note: This section includes information based on general knowledge, as specific supporting data was not available.

6. Reference Page

No external sources were cited in this paper.