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Incivility in remote health workplaces

14 Aug 2023

Uncivil workplace behaviours that border on bullying can have a destructive impact on staff wellbeing and health care delivery. As Therese and Kristy from CRANAplus’ Mental Health and Wellbeing team write, the best way to combat incivility is to “Be the behaviour you want to see in your workplace”.

Therese Forbes, Senior Psychologist

Kristy Hill, Act­ing Exec­u­tive Direc­tor, Men­tal Health and Wellbeing

The Bush Sup­port Line reg­u­lar­ly receives phone calls from remote health work­ers who are expe­ri­enc­ing sig­nif­i­cant dis­tress due to work­place issues, includ­ing unac­cept­able work­place behaviour.

We all know that when peo­ple are rude and dis­mis­sive to each oth­er, staff well­be­ing suf­fers, but what’s often over­looked is the impact this could be hav­ing on our clients/​patients. Unciv­il behav­iour sig­nif­i­cant­ly impacts on patient care and has a direct and neg­a­tive impact on patient out­comes, as well as sig­nif­i­cant and harm­ful effects on the per­for­mance of med­ical teams.¹

This is in part because expo­sure to rude­ness weak­ens the col­lab­o­ra­tive mech­a­nisms essen­tial for patient care and safe­ty. Clients enter the health­care sys­tem, rely­ing on health­care work­ers to look after them and make them well, and yet they some­times receive sub­stan­dard care at the expense of this unciv­il behaviour.

What is civility?

Civil­i­ty is best described as the rules of engage­ment’” for how peo­ple relate to each oth­er. Demon­strat­ing civil­i­ty means show­ing regard for those around us and being thought­ful, respect­ful, cour­te­ous, and polite.

Civil­i­ty sounds sim­ple. How­ev­er, there is more to it than avoid­ing unciv­il behav­iours. It relies on pos­i­tive ges­tures that encour­age, inspire, lift up and pro­mote engage­ment, con­nect­ed­ness and collaboration. 

Why is civil­i­ty important?

Civil­i­ty mat­ters in rur­al and remote health work­places because col­lab­o­ra­tion and open com­mu­ni­ca­tion con­tribute to high-qual­i­ty patient care, work­force reten­tion and greater sat­is­fac­tion and well­be­ing for staff. This is height­ened in rur­al and remote health set­tings, where you are often required to work close­ly with­in a small team. 

Civil­i­ty is also impor­tant because work­ers may be liv­ing and work­ing away from their usu­al social sup­port or have lim­it­ed exter­nal social contacts. 

Treat­ing not only your co-work­ers and col­leagues but your clients and patients with civil­i­ty requires authen­tic­i­ty, trust, com­mu­ni­ca­tion and more than any­thing else, respect. 

What does inci­vil­i­ty look like?

Research sug­gests that inci­vil­i­ty is of increas­ing inci­dence and con­cern in Aus­tralian health work­places and across all pub­lic and pri­vate sectors.²,³

Inci­vil­i­ty is a key antecedent to bul­ly­ing and may include ostracism, sab­o­tage, infight­ing, scape­goat­ing and crit­i­cism. Unciv­il behav­iours are char­ac­ter­is­ti­cal­ly rude and dis­cour­te­ous and dis­play a lack of regard for others.

Exam­ples include:

  • Fail­ing to acknowl­edge anoth­er person’s presence
  • Tak­ing cred­it for oth­ers’ efforts
  • Sab­o­tag­ing an individual’s efforts
  • With­hold­ing knowl­edge or infor­ma­tion from others
  • Talk­ing down to others
  • With­draw­ing from open com­mu­ni­ca­tion or effort
  • Spread­ing rumours about col­leagues (gos­sip­ing)
  • Being dis­cour­te­ous in every­day exchanges, for exam­ple, not say­ing please’ or thank you’.

Bull­run — stock​.adobe​.com.

What can you do? 

Behav­ing civil­ly in the work­place is everyone’s respon­si­bil­i­ty. Here are a few things you can do to increase civil­i­ty in your workplace:

  • Be a role mod­el. Check out our Mind­ful Mon­day on Mod­el­ling the behav­iour you want to see’.
  • Call out unciv­il behav­iour. The behav­iours you walk past are the behav­iours you accept.
  • Take a bird’s eye view of your work­place cul­ture and con­tribute to address­ing the things that you can.
  • Alert man­agers to the issues out­side your sphere of influ­ence that require atten­tion. Lead­ers and man­agers play an essen­tial role in mod­el­ling civ­il behav­iours and inter­ven­ing ear­ly when inci­vil­i­ty occurs.
  • Seek help when you need it. Talk to one of the expe­ri­enced psy­chol­o­gists on the Bush Sup­port Line, who can help to clar­i­fy the issues and iden­ti­fy prob­lem-solv­ing behaviours.

If you would like to learn more about civil­i­ty, tune into the lat­est episode of CRANAcast: Sup­port­ing your Well­be­ing The Pow­er of Civil­i­ty’ with Therese Forbes. 

1. Riskin, A et al. Rude­ness and Med­ical Team Per­for­mance; Pae­di­atrics (2017) 139 (2).

2. Hutchin­son, M. (2009) Restora­tive approach­es to work­place bul­ly­ing: Edu­cat­ing nurs­es towards shared respon­si­bil­i­ty. Con­tem­po­rary Nurse, 32, (12): 147 – 155

3. Atashzadeh Shoorideh F, Moosavi S, Balouchi A. (2021) Inci­vil­i­ty toward nurs­es: a sys­tem­at­ic review and meta-analy­sis. J Med Ethics Hist Med. 3;14:15.