Exemplars of Uncivil Encounters in Academic and Practice Environments Several examples of uncivil scenarios with corresponding responses using evidence-based approaches are presented in Tables 1 to 5. A scenario depicting an uncivil situation among nursing students assigned to collaborate on a group project is presented in Table 1, along with a response using an “I” message approach to address the issue. After gaining experience using an “I” messaging ap- proach, students are introduced to other evidence-based approaches. The next scenario and corresponding script uses the Caring Feedback Model 23 as an evidence-based approach to address an uncivil nurse-to- nurse encounter (Table 2). The Caring Feedback Model includes the fol- lowing steps: (1) state your positive intent/purpose; (2) de- scribe the specific behavior you noticed or heard about; (3) explain the consequence for you, your team, the patients, or the organization; (4) offer “a pinch” of empathy; and (5) make a suggestion or request. The next scenario is based on the approach suggested by Caspersen, 24 which includes the following elements: “When (the triggering event) happened, I felt/believed (feeling/ belief ) because my (need/interest) is important to me. Would you be willing to (request a doable) action?” Table 3 illus- trates Caspersen's approach when responding to an un- civil encounter occurring among coworkers.
The next evidence-based approach was developed by the Agency for Healthcare Research and Quality (AHRQ) 25 as part of the TeamSTEPPS approach designed to equip health care workers with the essential skills needed to address uncivil encounters when they happen, thus increasing the likelihood of success in stopping the behavior and protecting patient safety. The next scenario uses the DESC approach—an acronym for (D) describe the situation, (E) express your concerns, (S) suggest other alternatives, and (C) consequences stated (Table 4)—to illustrate an uncivil encounter between a staff nurse and the nurse manager. The next evidence-based approach was also developed by AHRQ 25 as part of the TeamSTEPPS approach. CUS is an acronym for Concerned, Uncomfortable, and Safety— an approach designed to script a response to use during an uncivil or conflicted situation, particularly when patient safety is in jeopardy. The scenarios depicted in Table 5 illus- trate 2 different uncivil experiences occurring in the patient care environment and corresponding responses using the CUS approach. These evidence-based approaches provide a helpful structure to script responses to address uncivil en- counters and to ultimately improve patient safety in health care organizations. Using Deliberate Practice to Repeat the Simulated Scenarios Deliberate repetitive practice (DRP) is a process for learning and mastering psychomotor skills by progressing through 3 primary phases: (1) understanding the skill and learning how to perform it accurately, (2) refining the skill until it be- comes more consistent, and (3)
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- Summer '16
- Elvira Phelps
- Nursing, Cynthia M. Clark