factors and measures that may impact organizational health
How healthy is your workplace?You may think your current organization operates seamlessly, or you may feel it has many issues. You may experience or even observe things that give you pause. Yet, much as you wouldn’t try to determine the health of a patient through mere observation, you should not attempt to gauge the health of your work environment based on observation and opinion. Often, there are issues you perceive as problems that others do not; similarly, issues may run much deeper than leadership recognizes.There are many factors and measures that may impact organizational health. Among these is civility. While an organization can institute policies designed to promote such things as civility, how can it be sure these are managed effectively? In this Discussion, you will examine the use of tools in measuring workplace civility.To Prepare:Review the Resources and examine the Clark Healthy Workplace Inventory, found on page 20 of Clark (2015).Review and complete the Work Environment Assessment Template in the Resources.BELOW IS THE QUESTION—————Post a brief description of the results of your Work Environment Assessment. Based on the results, how civil is your workplace? Explain why your workplace is or is not civil. Then, describe a situation where you have experienced incivility in the workplace. How was this addressed? Be specific and provide examples.BELOW IS THE REQUIRED READINGLearning ResourcesRequired ReadingsBroome, M., & Marshall, E. S. (2021). Transformational leadership in nursing: From expert clinician to influential leader (3rd ed.). New York, NY: Springer.Chapter 5, “Collaborative Leadership Contexts: It Is All About Working Together (pp. 155-178)Chapter 8, “Creating and Shaping the Organizational Environment and Culture to Support Practice Excellence” (pp. 237-272)Chapter 7, “Building Cohesive and Effective Teams” (pp. 212-231)Select at least ONE of the following:Clark, C. M., Olender, L., Cardoni, C., Kenski, D. (2011). Fostering civility in nursing education and practice. The Journal of Nursing Administration, 41(7/8), 324-330.Clark, C. M. (2018). Combining cognitive rehearsal, simulation, and evidence-based scripting to address incivility. Nurse Educator.Clark, C. M. (2015). Conversations to inspire and promote a more civil workplace. American Nurse Today, 10(11), 18-23. Retrieved from https://www.americannursetoday.com/wp-content/uploads/2015/11/ant11-CE-Civility-1023.pdfGriffin, M., & Clark, C. M. (2014). Revisiting cognitive rehearsal as an intervention against incivility and lateral violence in nursing: 10 years later. Journal of Continuing Education in Nursing, 45(12), 535-542.PLEASE DONT FORGET TO ADD 4 REFENCES NOT MORE THAN 5YEARS OLD WITH 7TH EDITION AND APA FORMAT:PLEASE GO THROUGH THE RUBIC CORE SKILL: diagnosing an ORGANIZATION the way you would diagnose a patient — with a validated instrument, objective data, and a differential — rather than with impressions.
THE INSTRUMENT: the Clark Healthy Workplace Inventory (or similar) yields a score you can interpret against defined bands (very healthy / moderately healthy / mildly healthy / barely healthy / unhealthy). The graded move is not the score; it is the INTERPRETATION — which specific items drove the score down, and what they imply.
THE CENTRAL CONCEPTS:
— CIVILITY vs. INCIVILITY: Clark’s work defines incivility as low-intensity deviant behavior with ambiguous intent to harm — eye-rolling, sarcasm, exclusion, withholding information, dismissive responses to questions. Its ambiguity is precisely what makes it corrosive: it is deniable.
— The CONTINUUM: incivility → bullying (repeated, targeted, with a power differential) → workplace violence. Naming this escalation continuum is a strong analytic move, because it shows that “minor” rudeness is not categorically different from the serious end; it is the same phenomenon at lower intensity, and tolerating the low end normalizes the escalation.
— “NURSES EAT THEIR YOUNG” / LATERAL OR HORIZONTAL VIOLENCE: peer-to-peer aggression. The most compelling explanatory frame is OPPRESSED GROUP BEHAVIOR THEORY (Freire, applied to nursing by Roberts) — members of a group with limited power over their own conditions direct frustration horizontally, at each other, rather than upward at the actual source of the constraint. That theory explains something the “bad apples” account cannot, and using it well is what distinguishes a strong paper.
— The CONSEQUENCES, and they are measurable, not merely unpleasant: incivility degrades communication, and communication failure is a leading root cause of sentinel events (Joint Commission data). It increases errors, absenteeism, turnover, and burnout. THE PATIENT SAFETY LINK IS THE ARGUMENT THAT MATTERS — a hostile unit is an unsafe unit. Cite it, because it converts a “soft” issue into a quality-and-safety issue that administrators must act on.
EVIDENCE-BASED INTERVENTIONS: AACN’s SIX STANDARDS FOR A HEALTHY WORK ENVIRONMENT (skilled communication, true collaboration, effective decision-making, appropriate staffing, meaningful recognition, authentic leadership) — this is the natural framework to organize your recommendations around. Also: COGNITIVE REHEARSAL (Griffin’s evidence-based technique — rehearsing scripted responses to specific uncivil behaviors in advance, so that the response is available in the moment rather than composed under stress), TeamSTEPPS, code-of-conduct policies with real enforcement, zero-tolerance policies that are actually enforced (an unenforced policy is worse than none, because it teaches staff that reporting is futile), leadership modeling, and shared governance.
STRUCTURE: complete the inventory → report and interpret the score → describe a specific incivility incident and analyze it → theory → evidence-based strategies to address it AND to bolster existing strengths → cite scholarly sources.
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