Top 5 Benefits of Civility Training

Does your organization suffer from a hidden culture of incivility—opening the door for dangerous medical errors, poor patient satisfaction and higher employee turnover? If so, you are not alone. In 2008, The Joint Commission recognized the widespread problem of “behaviors that undermine a culture of safety.”  In fact, uncivil behavior among healthcare employees now constitutes a sentinel event!

To combat this pervasive problem, The Joint Commission recommends that all accredited healthcare organizations be responsible for handling and preventing incivility in the workplace. In the Know’s REAL Healthcare Reform Civility Training Program makes fulfilling this recommendation easy.  Based on our popular book, “The REAL Healthcare Reform,” ITK’s program is a complete turnkey solution that contains everything you need to get a civility training program up and running immediately.

So, aside from meeting TJC’s recommendation, what’s in it for you? Healthcare organizations that implement civility training find that it:

  1. Reduces costly medical errors. Incivility ruins communication among your employees and poor communication is a direct threat to patient safety. Civility training decreases dangerous and potentially deadly medical errors by improving teamwork and communication.
  2. Increases employee retention. A staggering number of healthcare employees report having quit a job because of incivility. Civility training improves employee retention at every level, saving your organization the precious time and money involved in hiring and training new employees.
  3. Cuts down on “call-outs” and absenteeism. Working in a culture of incivility leads to more absenteeism.  As many as 47% of healthcare employees report spending less time at work because of incivility. Civility training creates an atmosphere that energizes and inspires those who are in it. Employees who are energized and inspired will look forward to coming to work, thus reducing the rate of absenteeism.
  4. Eliminates conflict and drama. Incivility leads to conflict and conflict equals DRAMA! Healthcare professionals who embrace civility are less likely to burn out, bully or “eat their young!” This means less conflict and drama among your employees!
  5. Improves client satisfaction and enhances the organizations reputation. Disgruntled, dissatisfied and disengaged employees don’t provide quality care to the clients they serve.  This leads to a decrease in client satisfaction. Clients who are dissatisfied with the care they receive share their negative experience with others in the community.  If your organizations embraces civility, you will enjoy improved client satisfaction and an enhanced reputation in the community.

Our Civility Training packages are available for as few as 12 learners and come complete with a copy of The REAL Healthcare Reform for each learner plus an Instructor’s Manual for the educator. You will find the Instructor’s Manual full of engaging classroom activities, thought-provoking discussion questions, convenient PowerPoint presentations, tips for improving participation and a CD with master copies of all the handouts and presentations.

The program materials are appropriate for every individual in your organization, clinical and non-clinical alike. Administrators, managers, nurses, aides, secretaries, and everyone in between, will find the program easy to use and understand. In addition, the program provides six hours of inservice credit for all your Certified Nursing Assistants.

To learn more about In the Know’s Civility Training Program, visit Embracing Civility then call 877-809-5515 to order your program today!

Nurses: Don’t Slam the Door Shut!

“When you’ve…walked through that doorway of opportunity, you do not slam it shut behind you. You reach back, and you give other folks the same chances that helped you succeed.”  ~ Michelle Obama

Regardless of your politics, it’s impossible to deny the truth of Mrs. Obama’s recent statement. It’s a truth that all of us who work in healthcare need to keep in mind. As you know, there is an epidemic of incivility racing through healthcare workplaces everywhere. Get a group of nurses together and, before long, the personal experiences with incivility come out:

“My first nursing job was in a toxic environment.  I was warned about the ‘strong personalities’ there and that I would need to learn to ‘stand my ground’ to succeed.  The worst offenders were two experienced, middle-aged male nurses who called themselves ‘silverbacks.’ They felt it was their responsibility to weed out the new, young nurses with disrespect and harassment. Those who could cut it were worthy of working there; those who could not had no choice but to leave.”

“Every morning, the charge nurse lined up us new grads and asked, ‘Ok, who’s gonna cry today?’ It was awful. Since I am not the type of gal to cry at work, I had an immediate target on me.  This nurse went nose-to-nose with me in front of all my co-workers and told me it was going to be her mission to make sure I failed at my job.”

“When I started my first job, there was an experienced nurse who terrified me—and that was 20 years ago.  I still remember her clearly and, when I think about her, I feel like a shaky new grad all over again.”

Some nurses might claim to have the answer to this issue, but their “solutions” only serve to promote more incivility:

“I think to avoid getting ‘eaten,’ new nurses have to act like clean slates and really listen to what their experienced colleagues say. We have been around the block and back and can dazzle them with the information stored in our brains.”

“I am harder on new employees who can’t admit when they don’t know what they are doing. They are very easy to spot and will harm patients if I don’t knock their pride down a notch or two.”

“There are levels in nursing (CNA, LPN, RN, head nurse, supervisor) and you have to play the levels — it’s a skill and it’s one of the most important skills not taught in nursing school. You have to prove that you respect the levels below you, and you have to be humble to the levels above. If you get it wrong, you’re sunk.”

All of the above statements came from experienced nurses. Some of them have worked as a nurse for 30 years or more. While they may not look at it this way, they were given the opportunity to make their mark on the healthcare field. They chose their career paths among the countless possibilities open to nurses. The same goes for you and me. We “walked through the doorway of opportunity” and have made our career choices, practicing nursing in our preferred settings. Now, we must be careful not to “slam the door shut behind us.”

It’s vital that we extend our hands to new grads, as they are the future of healthcare. Here are a few suggestions for how we can accomplish this:

  • Take personal responsibility for becoming a better preceptor, mentor or manager. If you never received training specific to your leadership role, seek out resources. Look for seminars, online training or books that might expand your leadership skills. If you know someone who excels as a leader, ask for words of wisdom on how to be a better mentor.
  • Forget about the past. Just because you may have been hazed as a new grad doesn’t mean you have to run roughshod over today’s young nurses. Consider this: the new grads you are training today may be the nurses who care for you or your loved ones in the future. So share your skills and knowledge with them in a manner that exudes workplace civility.
  • Stay excited about change. Young nurses may have learned different patient care techniques and strategies. Before you dismiss their ideas out of hand, think about all the changes that have taken place in healthcare since your first day as a nurse. Maybe some of your own patient care ideas have been implemented over the years. So rather than feeling “put out” or defensive when a new nurse questions your work, take a moment to consider that there may indeed be a better way of doing something.

You probably have other ideas for how we can “reach back” and give new nurses the best chance to succeed in their chosen field…and we’d love to hear them! So, please add your comments below. All of us experienced nurses have the power to eradicate that old “nurses eat their young” saying. Let’s turn it around so that the widespread perception becomes “nurses nurture their young.” Are you with me?

What Joint Commission Says about Incivility


Workplace incivility. Adult bullying. Lateral harassment. These terms make the news nearly every day, headlining another story about employees who are dealing with a toxic work environment.

Jana Raver is an organizational expert and professor at Queen’s University School of Business. She has done research proving that sixty percent of employees are exposed to workplace incivility—and that the “bullies” are often women. That’s bad news for an industry like ours which continues to be dominated by females.

And there is more bad news. While six of every ten employees are victims of workplace incivility, you can bet that the other four are affected by it indirectly. Harassing behaviors are distracting—especially for healthcare employees who must work as a team to meet the needs of their patients.

Ms. Raver says, “They start saying ‘this is not the place for me; I’m going to start looking for work elsewhere.’ And once you psychologically disengage from the organization then you’re not terribly motivated toward helping that organization to succeed, and you’ve always got one step out the door. Turnover is of course a logical consequence.”

This spells trouble, particularly for certified nursing assistants. As you know all too well, the annual turnover rate for CNAs can exceed 90%. If your organization has a “revolving door” when it comes to your nursing assistant staff, a culture of incivility only compounds the problem.

“Imagine how much more productive companies could be if they were to treat people with inclusion and respect and make sure that (workplace anti-harassment) policies are actually enforced,” Raver states.

This is exactly what the Joint Commission has in mind with their zero tolerance of disruptive or intimidating behaviors. Have you seen their statement on this issue?

Intimidating and disruptive behaviors can foster medical errors, contribute to poor patient satisfaction and to preventable adverse outcomes, increase the cost of care, and cause qualified clinicians, administrators and managers to seek new positions in more professional environments.  Safety and quality of patient care is dependent on teamwork, communication, and a collaborative work environment. To assure quality and to promote a culture of safety, health care organizations must address the problem of behaviors that threaten the performance of the health care team.

The Joint Commission standards require that each organization institute “a code of conduct that defines acceptable and disruptive and inappropriate behaviors.” They also require that the institution “create and implement a process for managing disruptive and inappropriate behaviors.”

Creating policies that meet these Joint Commission standards are an important step. However, if your workplace has been infected with incivility, it’s going to take more than rubber stamping new policies. Every employee, from administration to the “front lines,” needs to partake in civility training. They need to understand the importance of civility—especially in a high stress environment like healthcare. The training should cover ethical behavior, professional relationships, teamwork and conflict resolution. And, it should emphasize this indisputable key point: that the power—and the responsibility—to overcome a culture of incivility rests within each of us.


If you would like to learn more about how embracing civility can inspire your employees to do their best work, check out The Real Healthcare Reform. (The book is also available from Amazon.) If you need assistance developing a civility training program for your organization, please give us a call at 877-809-5515. We’d be happy to discuss your options.

Civility = Self-Awareness

“The test of a civilized person is first self-awareness…” ~ Clarence Day

As you probably know, the Joint Commission has mandated civility training for all healthcare organizations in order to combat the rise of intimidating and disruptive behaviors among healthcare employees.  Civility training is tricky…it’s not like teaching a nursing skill or the facts about a disease process.  To truly embrace civility, your employees have to become more self-aware.   Here is some information you can use to start the conversation about self-awareness with your staff:

Self-awareness is when you realize that, although you are not the center of the universe, everything you say and do can affect those around you.

True self-awareness comes when you recognize that your own thoughts and feelings can lead you to act in a way that is either helpful or harmful to others.

Here’s an example of how your thoughts and feelings can lead you to act in a way that is harmful to others: You just paid your monthly bills and realize you don’t have enough money to sign your daughter up for the softball team she wants to join. You are stressed, embarrassed and angry.  You arrive at work to find a group of co-workers laughing in the break room. Their happiness annoys you and you lash out.

Here’s an extreme example of a lack of self-awareness: Recently, radio talk show host, Rush Limbaugh learned that a female Georgetown law student spoke out in support of mandating insurance coverage for contraceptives.  Her stance on the matter angered the talk show host, so he went on the air and called her a “slut” and a “prostitute.”  Then he demanded she post online videos of herself having sex. His words had a negative effect on his listeners, his sponsors, the woman to whom he was referring, his career and society at large.  In his apology he said, “In this instance, I chose the wrong words in my analogy of the situation. I did not mean a personal attack on Ms. Fluke.” Although he was further attacked for a lack of sincerity in his apology, his sentiment was right. Whether you agree with him or not, he has the right to disagree with the woman’s stance.  However, the words he chose were harmful and did nothing to help matters in this situation.  He was upset about the woman’s views and he lashed out without thinking about the consequences.

The bottom line is this:  It’s okay to feel stressed, angry and embarrassed.  It’s okay to disagree and speak your views.  However, when you have self-awareness (aka civility), you know how to keep your thoughts and feelings from translating into harmful words or actions against others.


If you would like more ideas for promoting a civil workplace and fulfilling the Joint Commission-required civility training, please check out a new book published by In the Know: The Real Healthcare Reform: How Embracing Civility Can Beat Back Burnout and Revive Your Healthcare Career.  It provides targeted, action-oriented information and specific exercises to help healthcare workers understand the epidemic of incivility, why it is happening and what they can do right now to make it stop.  You and your employees will find the tactics and strategies needed to put civility to work and resolve the toxic atmosphere that may be polluting your workplace.

Written in a friendly, conversational tone, the book is appropriate for all healthcare employees, regardless of their discipline or how long they have been on the job. You can utilize it with your CNAs, nurses, therapists, social workers and more! If you have any questions about The Real Healthcare Reform or would like information about bulk discounts for your workplace, please call us at 877-809-5515.