Nurses need more support to deal with rude and disrespectful treatment by fellow team members, suggests new research.
The study, led by the University of East Anglia, found a lack of civility from doctors and fellow nurses had a significant impact on levels of burnout.
“If managers are dismissive of concerns from frontline co-workers, patient care is threatened”
However, the researchers said nurses with strong self-belief – or “self-efficacy” – were less likely to be troubled by rudeness and discourtesy from co-workers and managers.
Their findings, published in the journal Heath Care Management Review, are based on a survey of nearly 600 Canadian nurses.
At the start of the study, participants were assessed on their levels of self-efficacy and their perceptions and experiences of workplace “incivility” – defined as rudeness by colleagues, managers and patients.
They were also asked about burnout, their overall mental health, and whether or not they intended to leave their job. The nurses were surveyed on all these factors again a year later.
Those with higher levels of self-efficacy, who were more confident about their ability to deal with stressful interactions at work, were less likely to report or notice colleagues being rude to them.
They also experienced less emotional exhaustion and cynicism a year after they were first surveyed, and reported fewer mental health issues.
Lead author Roberta Fida, a lecturer in organisational behaviour, said the findings were encouraging, because self-efficacy was something that could be supported and promoted by “proactive hospital management”.
“Every effort must be made to ensure incivility is not tolerated and to create working conditions that prevent subsequent burnout to ensure both employee and organisational health,” she said.
“Developing strategies to strengthen nurses’ ability to deal with negative behaviour from different sources is also critical to ensuring high-quality patient care,” said Dr Fida.
Nurses’ confidence in being able to handle rudeness from colleagues was a crucial factor in maintaining the teamwork necessary for good care, she said.
“Confidence in their ability to deal with incivility from supervisors is also important in this respect,” she noted. “If managers are dismissive of concerns or ideas from frontline co-workers, patient care is threatened.”
Nurse burnout exacerbated by disrespectful colleagues
The research team said nurses should be given opportunities to strengthen their coping skills. Seeing colleagues and line managers successfully dealing with stressful situations was one way of learning how best to manage such difficulties, they suggested.
Words of praise and encouragement from managers and co-workers could also help build self-esteem, they said.
While self-efficacy was linked to nurses’ ability to deal with mistreatment, the study found it was not related to whether or not nurses intended to leave their job.
The study was conducted with Heather Laschinger, from the University of Western Ontario in Canada, and is part of a wider research project on nursing work environments.