leadership, assignment

Work Environment Assessment

GIFTY S. MANU

Masters in Psychiatric-Mental Health Nurse Practitioner (PMHNP), Walden University

NURS - 6053N: Interprofessional Organizational and Systems Leadership

Dr. Betty  Joubert

July 28, 2021

Work Environment Assessment

Introduction

Incivility at the workplace is on the rise and frequently ignored in nursing education and clinical practice. Workplace incivility is when the workforce demonstrates discouraging behaviors such as supervisors misuse their power, staff disrespecting each other, or leaders giving out punishments that make the employees feel distressed and shamed, creating stress; and self-confidence (Warner, Sommers, Zappa, & Thornlow, 2016). Uncivil behaviors can come in so many forms, shapes and such behaviors may effects recipients.

According to Clark, healthcare is one of the most challenging places to work and can be stressful. Also, due to its stressful nature, healthcare professionals sometimes experience frustration, which gets in their way of communication. Their frustration and stress come out as not respectful and inconsiderate manner. Health care professional believes in providing ultimate care to their patients; and effective stress management, respectful communication and proper handling of emotions is a factor (Clark, 2015). Nurses must cultivate the adequate skills needed to address incivility, whilst organizational leaders promote an environment conducive for nurses to feel empowered to speak up (Clark, Olender, Cardoni & Kenski, 2011).

The recent Joint Commission (TJC) survey reported 50% or greater nurses are victims of incivility in the workplace (Clark, et al., 2011). The sad part of this is that these negative behaviors are a learned process, transferred through staff nurses to new nurses and student nurses through interaction within the hierarchical nature of the profession. Lack of civility in healthcare may increase medical costs, unsafe working conditions, and poor patient care. However, effective strategies like essential skills in nursing education, in-services, competencies, and practice can work together to foster civility in an organization (Clark, et al., 2011).

Work Environment Assessment

After completing Clark's Healthy Workplace inventory, the result clearly states the nature of my work environment and indicates how civil and healthy it is. A total score of 82 means the servant leadership skills demonstrated by management in establishing a conducive working environment (Clark, 2015). I love working at my organization because nurses voices are heard and valued. Our organization has a new director who took over approximately four years ago, and there has been a drastic change in the work environment. The work environment reflects his outstanding leadership skills, and the workforce has witnessed these positive changes. He upholds the mission of the organization and leads by example. Due to his dedication and servant leadership, the workforce supports the mission, core values of the organization with a positive attitude (Clark, 2015). The evidence of teamwork, trust, honesty, and collaboration is seen every day at work (Clark, 2015). The organization has many excellent programs for novice and experienced nurses, bonuses, and a competitive salary (Clark, 2015). However, with all these fantastic benefits, there is also the need for advancement, growth, and maturity incivility in the organization (Clark, 2015).

There is a communication and transparency disconnection between management and staff (Clark, 2015). The only concern is communication which will eventually change. An ineffective communication happens in so many forms; for example, huddles are done only in the morning, leaving the evening and night shift to rely on information from other staff members instead of the head. According to Clark's Healthy Workplace inventory, my organization's work environment range of civility was moderately healthy. The outcome of the inventory did not surprise me because of the kind of grit attitude of the workforce (Clark, 2015). I thought civility is not talking down on people. After Clark's healthy workplace inventory, I realized many factors that contribute to the civility of an organization. Before conducting the assessment, I believed ineffective communication was essential for a healthy work environment, and I was proven right (Clark, 2015).

Reviewing Literature

The theory presented in this article is that healthcare professionals can identify healthy workplace components, prepare for challenging conversations, and models for conduction a challenging discussion. Healthcare professionals should communicate in respectful, considerate ways because lack of effective communication among employees tend to affect their jobs, loyalty to the organization, and delivery of safe, high-quality patient care (Clark, 2015). A healthy workplace may lack conflict. Conflicts hurt productivity, morale, and patient care. A healthy workplace may result in low employee turnover and certainly, increase staff contributions and promote efficiency. There is a shared organizational mission, vision, values, and sustenance of a high level of individual care and civility at all levels (Griffin & Clark 2014). The theory relates to my work environment assessment result because an organization with respectful communication has a culture of civility and kindness and treats colleagues, coworkers, employees, students, and others with dignity and respect.

My organizational leaders should have an open-door policy, encourage open discussion, ongoing dialogue, and effective conversation about the elements of a healthy workplace (Griffin & Clark 2014). These processes mentioned above may enhance the value of challenging communication or conversation in the workplace. There should be a discussion on addressing employees' similarities and differences, such as culture and language. The ability to embrace individual similarities, differences and spending time in conversation to identify strategies to enhance the workplace environment has proven valuable (Clark, 2015). For example, to prepare ourselves for a challenging conversation, I ask ourselves several vital questions, like what will happen if I engage in this conversation. What will happen if I don't? What will happen to the safety of our patients if I stay silent (Clark, 2015)? The following process, such as creating a safe zone, using cognitive rehearsal based on an evidence-based framework, can improve communication, greater nurse satisfaction, and increasing patient satisfaction rate. In-services, symposiums, forums, script development, role-play in practicing effective and efficient communication skills will enhance the acquisition of safe practice skills (Clark, 2015).

Evidence-Based Strategies to Create High-Performance Interprofessional Teams

The shortcoming revealed (effective professional communication) in Clark's healthy workplace inventory can be addressed by enhancing written communication which remains the most prevalent form of communication between specialized and primary care (Vermeir et al., 2015). The strategies recommended are delineation of ownership of the communication process should be clear, peer review, process indicators, and follow-up tools are required to measure the impact of quality improvement initiatives (Vermeir et al., 2015).

In colleges, graduate and postgraduate training, there should be training on how healthcare providers should become engraved as an essential skill and quality characteristic of each workforce (Vermeir et al., 2015). The two strategies implemented to bolster successful practice of creating respectful communication and reduces leadership disconnection in the organization are performing huddles beginning every shift, communication boards, and the use of internet communications like Teams to disseminate information on effective professional communication (Schipper, Bakker, De Wit, Ket & Abma 2016). The workforce should be encouraged to establish effective, efficient, respectful, and professional communication in a healthcare organization to improve effective patient care outcomes and more civil employees (Griffin & Clark, 2014).

For example, I had an incident where my supervisor questioned my precepting skills after two nurses reported me. In application of DESC theory, the experienced nurses would have described the problem they had with me. Next, they would express their concern that the patient would not be adequately triaged. Following, they could then state alternatives as to how the questions may be asked. Lastly, they could have presented the consequences that the patient would eventually suffer, for the medical team might miss an essential aspect of care after not adequately being triaged. All in all, we as nurses have a "professional and ethical obligation to foster civility and healthy work environments to protect patient safety" (Clark, 2019, p.64).

Conclusion

In conclusion failure to plan and manage creates a chaotic environment for the workforce, leaders and the organization. Mitchell states “change usually fails because management doesn’t follow a framework for change (Mitchell, 2013).” By using a change framework could help improve teamwork, effective and respectful communication, action plan and leadership. To prevent organizational failure depends on effective and efficient planning (Marquis & Huston, 2017). Effective and efficient communication is crucial in healthcare (Vermeir et al., 2015).

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