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Incivility in remote health workplaces
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”.
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.
- 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.
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, (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.