The National League for Nursing (NLN) is calling for a cultural transformation in schools of nursing to cocreate and implement civility and inclusiveness strategies and interventions among nurse educators and, by extension, nursing students. The NLN’s mission and core values led us to believe that one of the most important roles we play, as nurses and nurse educators, is creating and sustaining a culture of civility and respect in nursing education, so that both faculty and students may thrive and students may develop the skills necessary to transform clinical practice environments. It is imperative that faculty cocreate and maintain academic and practice environments that foster civility.
“Civility is characterized by an authentic respect for others when expressing disagreement, disparity, or controversy” (Clark & Carnosso, 2008, p. 13). Attributes include being fully present, respecting one another, honoring differences, and engaging in genuine discourse with a sincere intention to seek common ground (Clark & Carnosso, 2008). Respect is foundational to a civil environment; it has been defined as courteous communication, authentic listening, and an active interest in the relationship that a person directs toward an individual, which acknowledges, appreciates, honors, and values one’s person for being (Carroll, 2018).
The NLN believes that, by understanding the concept of civility and purposefully working together to develop and sustain respectful environments within schools of nursing, faculty will restore civility to nursing education and 1) build healthy academic environments, 2) create future leaders who can lead and maintain those environments, and 3) model discourse that positively impacts both patient and clinician outcomes to improve the health of the nation (Laschinger, 2014; Maxfield & Grenny, 2017; Rosenstein & Naylor, 2012).
The NLN is committed to generating a national dialogue directed toward schools of nursing to embed a culture of civility into the vision, mission, and shared values of nursing programs and to thread civil encounters throughout everyday interactions with colleagues and students (Clark, 2017a). Academic incivility negatively impacts faculty, staff, and student well-being; weakens professional relationships; and impedes effective teaching and learning. The cocreation of a healthy workplace is imperative to transform nursing education and build a foundation of quality patient care (Clark, 2017b). Faculty, staff, and students must assume the power of taking responsibility for cocreating a civil environment, sharing a collective commitment, and cherishing the joy of establishing a healthful work environment, grounded in a vibrant and respectful community of colleagues.
- Discuss with students the relationship between civility and safe patient care.
- Raise students’ consciousness about what civility looks like, how to respect differences, and how celebrating differences in the context of respect and openness changes perspectives.
- Model civil conflict resolution with students. Include opportunities for students to learn and practice cognitive rehearsal and active learning.
- Identify and address individual and programmatic sources of implicit bias and mixed messaging.
- Consider ways by which to assess civility as part of student evaluation.
- Foster self-awareness among faculty to recognize behaviors that may contribute to an uncivil environment.
For Leadership in Nursing Programs
- Engage faculty and staff in courageous conversations directed toward the cocreation and sustainability of team or civility charters (e.g., credos, pledges, commitment to coworkers), core values, diversity, caring, and organizational change (Clark & Ritter, 2018).
- Engage in leadership development programs/courses to be the catalyst for the creation of healthy workplaces.
- Model self-care and professional well-being (e.g., stress management, building resiliency) for faculty, recognizing the importance of looking at self before leading others.
- Require the total faculty, including staff, to engage in faculty development about how to practice civility within the faculty team.
- Consider strategies to assess faculty/staff civility as part of faculty/staff’s annual review.
- Find ways to evaluate the gaps in civility within a school of nursing and implement evidence-based strategies and interventions to foster civility and healthy academic work environments.
For the NLN
- Promote a healthy faculty and student campaign.
- Continue to scan and address the national and global nursing education environment to create strategies for schools of nursing that build and support academic civility.
- Provide faculty development about how to implement best practices and evidence-based strategies to foster and sustain civility in academic environments.
- Support research for intervention, replication, and multisite studies to identify best practices and evidence-based strategies to foster and sustain civility in academic environments and to determine how civility is practiced in schools and nursing.
- Publish revision of the 2006 Healthful Work Environment Toolkit. The 2018 revised toolkit, How to Improve the Health of Our Learning Environment: Fostering Civility among Students and Faculty (NLN, 2018), has a greater emphasis on fostering safe, civil, and collegial learning environments.
Carroll L. (2018). Student and faculty perceptions of respect and respectful learning environments
(Doctoral dissertation). Available from ProQuest Dissertations and Theses Database (UMI No. 10845813).
Clark C. M. (2017a). Creating and sustaining civility in nursing education
(2nd ed.). Indianapolis, IN: Sigma Theta Tau International Publishing.
Clark C. M. (2017b). An evidence-based approach to integrate civility, professionalism, and ethical practice into nursing curricula. Nurse Educator
, 42, 120-126. doi:10.1097/NNE.0000000000000331
Clark C. M., & Carnosso J. (2008). Civility: A concept analysis. Journal of Theory Construction and Testing
, 12(1), 11-15.
Clark C. M., & Ritter K. (2018). Policy to foster civility and support a healthy academic work environment. Journal of Nursing Education
, 57, 325-331. doi:10.3928/01484834-20180522-02
Laschinger H. K. (2014). Impact of workplace mistreatment on patient safety risk and nurse-assessed patient outcomes. The Journal of Nursing Administration
, 44(5), 284-290. doi:10.1097/NNA.000000000000006
Maxfield D., & Grenny J. (2017). Crucial moments in healthcare: Patient safety and quality of care impacted by silence around five common workplace issues
. Retrieved from https://www.vitalsmarts.com/press/2017/05/crucial-moments-in-healthcare-new-studyshows-staff-drama-puts-patients-at-risk/
Rosenstein A. H., & Naylor B. (2012). Incidence and impact of physician and nurse disruptive behaviors in the emergency department. Journal of Emergency Medicine
, 43(1), 139-148. doi:10.1016/j.jemermed.2011.01.019