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’.

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.

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, (1−2): 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.