The nursing profession has had the long-standing stigma of eating their young (Anderson & Morgan, 2017). While this does not come as a surprise to anyone in the profession; it does need to stop. Working in nursing is truly like working in a pressure cooker. It is not to question if it will get hot, but more how hot and how much pressure will there be each day. This pressure is bound to get to anyone because, let’s face it, we are working with life and death scenarios daily. Nursing continues to treat each other with disrespect, incivility, and hostility and student nurses are often targets for this type of bullying too. How can nursing schools impact this phenomenon by arming their nursing students with the tools needed to deflect and correct this onslaught of maltreatment?

Incivility in nursing is complex and connected across a culture of well-established toxicity. This incivility has substantial implications for nurses, healthcare institutions and patients. Today, nursing students are many times targeted in this form of bullying and is at a point that must be addressed or else the profession of nursing is at great risk in not having enough nurses to serve the population. The United States Bureau of Labor Statistics projects a need for nursing to increase by at least 15%, by 2026 [1]. This national average noted shows a growth curve, that is faster, than any other profession. There is a projected need of almost 204,000 newly graduated nurses by 2026, to fill the gap in those nurses retiring, new demand, and newly created nursing positions [1]. At this moment in time, new nursing graduates find themselves entering a profession that is facing a pandemic along with the increase seen in incivility due to multiple factors.

Nursing incivility also has a direct link to poor patient satisfaction as well as an increase in medical errors. According to The Joint Commission of Hospital (TJC) accreditation [2], “safety and quality of patient care is dependent on teamwork, communication, and a collaborative work environment”. As a mechanism for accreditation, healthcare organizations must work towards addressing this problem and promote a culture of safety to be successful in passing this metric. Nursing is the largest team in healthcare accreditation, so it is imperative that they lead by example on this.

Anderson and Morgan’s (2017) dive into the research of perceptual phenomenon of nurses that “eat their young” which basically lead to the newly graduated nurses walking into a lion’s den awaiting to be eaten. Thus, reinforcing the perceptive belief that incivility can happen in the clinical area, within academia by nursing faculty, and may be at the heart of cannibalizing of nurses today. This perception can create emotional, physical, psychological issues and barriers which ultimately impact a nursing student’s academic and future professional success. Nursing students are the way in to changing this stigma of nursing. The answer may just lie in the inclusion of social emotional character development (SECD) within nursing curriculum.

Schools of nursing are generally focused on the first-time pass rate (F-TPR) of their students which equates the focused curriculum pathways to those that support passing initial licensure exams with the first attempt. This focused curriculum is typically on didactic learning involving pharmacology, pathophysiology, clinical procedures, and specific care problems that may be seen in the clinical areas being studied. The Board of Nursing has mandated objectives that must be met to have an accredited school of nursing and unfortunately, SECD is not a required component but could be aligned into the inclusion of many support areas that are required. The American Association of Colleges of Nursing (AACN) submits suggested essentials of baccalaureate education [3]. Essential VIII states that “professionalism and the inherent values of altruism, autonomy, human dignity, integrity, and social justice are fundamental to nursing” (AACN, 2021). If we can truly commit to engaging in the promotion of healthy professional relationships, work environments, and positive conflict resolution, then the emphasis on needs to come from within nursing curricula. Believing that individuals have an intrinsic ability to communicate and behave professionally is just an assumption [4]. SECD curriculum aligns with that essential tenant and could be utilized to foster that connection for students to support how they handle a direct affront to an uncivil environment.

SECD education integrates the direct facilitation of social-emotional skills that support an individual’s ability to maintain an intact moral and ethical code of conduct. SECD can assist students in helping to make and foster positive relationships, develop moral, civic, and ethical codes of conduct, and increase self-awareness when conflicted with social-emotional and behavioral triggers [5,6]. Nursing, at its core, is one of caring for others. Intentionally embedding SECD in nursing programs could foster the support needed to help students combat the incivility that awaits them while supporting the principles of caring practice. With a bolstered education in SECD principles, nursing students can lead the way in changing the negative behaviors exhibited in their profession and model how to positively foster professional relationships even in a pressure filled environment.

Intentional embedding of SECD principles, within nursing programs, may be the primer for supporting the mandates given by TJC and AACN that foster a healthy work environment. When nurses work collaboratively, in an emotionally and physically safe environment, they can better support patient centered care, decrease unintentional errors, and decrease the stress that is naturally found during a workday. It also allows for a nurse to have a healthier and fulfilling professional sense of self by knowing that they are walking into a safe place to work. Starting the process of adult learning SECD in nursing programs may be the answer to ending the issue of incivility within the profession.

REFERENCES

1. Commons, W. (2019). Top 3 reasons nursing schools are rejecting applicants in 2019. Nurse.Org.

2. TJC. (2020). Sentinel event alert 40 behaviors that undermine a culture of safety. Jointcommission.org.

3. American Association of Colleges of Nursing. (2021). The new AACN essentials. Www.aacnnursing.org.

4. Luparell, S. (2011). Incivility in nursing: The connection between academia and clinical settings. Critical Care Nurse, 31(2), 92–95.

5. Wangaard, D., Elias, M. J., & Fink, K. (2014).Educating the head, heart, and hand for the 21st century. SEEN: Southeast Education Network, 16(2), 16-19.

1. Commons, W. (2019). Top 3 reasons nursing schools are rejecting applicants in 2019. Nurse.Org.

2. TJC. (2020). Sentinel event alert 40 behaviors that undermine a culture of safety. Jointcommission.org.

3. American Association of Colleges of Nursing. (2021). The new AACN essentials. Www.aacnnursing.org.

4. Luparell, S. (2011). Incivility in nursing: The connection between academia and clinical settings. Critical Care Nurse, 31(2), 92–95.

5. Wangaard, D., Elias, M. J., & Fink, K. (2014).Educating the head, heart, and hand for the 21st century. SEEN: Southeast Education Network, 16(2), 16-19.