What is Incivility in Nursing? (With Examples, Causes, & How to Address)


Written By: Darby FaubionDarby Faubion RN, BSN, MBA

Darby Faubion is a nurse and allied health instructor with over 20 years of clinical experience. Darby lives in Louisiana and loves exploring the state’s rich culture and history. Darby has a passion for caring for veterans and a special interest in those affected by post-traumatic stress disorder. In her quest to make a difference for veterans, she founded a non-profit called “Operation Battle Buddy.” Read Full Bio »»
RN, BSN, MBA


If you have been a nurse for any length of time, chances are you have met or worked with someone who has acted offensively or rudely. This type of behavior by nurses is often referred to as incivility in nursing. Perhaps you have heard the term but wonder, “What is incivility in nursing?”

In this article, you will learn about incivility in nursing. I will share information with you about some of the main causes of incivility in nursing, give you examples of incivility, and tell you ways to address it when you encounter it. When you have finished reading, you will have a clearer understanding of incivility in nursing and ways to overcome it.



What Exactly Is Incivility In Nursing?


The American Nurses Association defines incivility in nursing as “one or more rude, discourteous, or disrespectful actions that may or may not have a negative intent behind them.” Incivility is considered a serious workplace issue in nursing, and it is every nurse’s responsibility to do their part to help stop this type of behavior.



How Prevalent Is Incivility In Nursing?


According to some research, approximately 85% of nurses experience incivility of some type. Unfortunately, the same research also indicates that experienced nurses are often the perpetrators! Despite the alarming prevalence of incivility in nursing, with education, strong leadership, and a willingness to promote better behavior, nurses can reduce the occurrence of incivility and promote better patient, nursing, and organizational outcomes.



7 Main Root Causes Of Incivility In Nursing


Incivility in nursing is a common occurrence, and, unfortunately, there are many causes. Understanding the root causes of incivility is essential for us to identify ways of addressing and overcoming the problem and creating better relationships among nurses and interdisciplinary healthcare team members. The following are the seven main root causes of incivility in nursing.

Cause #1: Heavy Workload

With a shortage of nurses nationwide, it is not uncommon for hospitals and other healthcare facilities to be understaffed. Unfortunately, these shortages leave nurses with unusually heavy workloads. Heavy workloads often lead to nurses becoming more irritable or frustrated, which could lead to poor behavior and acts of incivility toward other nurses.

Cause #2: Passive Leadership

Workplace dynamics are typically a reflection of the leadership within the organization. If an organization has strong, hands-on leaders who model positive behavior, chances are, their employees will demonstrate the same behavior. Conversely, in settings where leaders are less involved or use a passive leadership style, the rate of incivility is much higher. Passive leadership is a main contributor to incivility in nursing because staff in these settings know their bosses are not involved enough to address the issues at hand and prevent incivility from occurring.

Cause #3: Nurse Burnout

Another leading cause of incivility in nursing is nurse burnout. Nurse burnout leads to increased feelings of anxiety and stress, which is often associated with shorter tempers, behavioral outbursts, and overall bad attitudes. While it is unfortunate that nurses experience burnout, it is equally unfortunate that feeling burnout leads to poor behavior that impacts others, such as incivility.

Cause #4: Personality Conflicts

Some research indicates that personality differences and the conflicts that arise because of them are contributing factors leading to incivility in nursing. To be effective as nurses, we must find ways to embrace the differences between ourselves and our peers and work together to create an atmosphere that is conducive to building strong interprofessional relationships free of incivility in nursing. Building good relationships, despite differences in personalities, helps promote better organizational, professional, and patient outcomes.

Cause #5: Poor Communication Skills

As a nurse and healthcare educator, I cannot stress enough the importance of developing strong communication skills. Nurses must communicate with patients, their families, nursing peers, and other members of the interdisciplinary team. Unfortunately, when there is a lack of effective communication skills, there is an increased risk of incivility in nursing. Many professionals believe the incivility that occurs due to lack of communication is a chain reaction that stems from the insecurity some nurses feel when they are unable to articulate their thoughts and feelings effectively. However, it is crucial that we learn to find ways of communicating with one another in ways that promote team-building and supportive relationships rather than incivility.

Cause #6: Co-workers Not Pulling Their Weight

One of the most frustrating things for nurses is having a busy schedule and heavy patient load and working with co-workers who do not pull their weight. When peers become lax on the job, it is common for incivility in nursing to occur. Nurses may lash out by talking about co-workers, refusing to assist when needed as payback, or even socially isolating the nurse they feel is not helping.

Cause #7: Lack of Respect

Another main cause of incivility in nursing is the lack of respect some nurses have for one another. Unfortunately, lack of respect affects all ranks of nurses. Some nurses lack respect for leadership, while other nurses show little respect for any nurses at all, regardless of their position or rank. When there is a lack of respect, the poor behaviors associated with incivility become more prevalent, which can negatively impact employee, patient, and organizational outcomes.



What Are The Most Common Examples Of Incivility In Nursing?

(The following are 15 examples of the most common types of incivility in nursing.)


Example #1: Criticizing Another Nurse

One of the most common examples of incivility in nursing is when one nurse criticizes another. For instance, one nurse may criticize the way another applies a bandage or their method of doing an assessment. While there is a general way of doing things, such as a head-to-toe assessment or a wet-to-dry dressing, each nurse has their own way of doing things. If proper protocol is followed, there is no need to critique another nurse, and it is especially not okay to do so in a malicious manner.


Example #2: Using Intimidation Tactics

Intimidating another nurse is not just an act of incivility in nursing. It is harassment, and it is something employers take very seriously. Although any nurse can use intimidation as an act of incivility, it is more common for nurses in positions of authority or leadership to intimidate nurses who work in lower-ranking positions.


Example #3: Gossiping About a Co-Worker

While opinions vary about whether gossip is the spreading of only untrue statements or if both true and untrue statements are considered gossip, one thing is certain: gossip is harmful. Gossip occurs when one person takes pieces of information about someone and passes that information along to someone else. Depending on the nature of the information shared, gossip could negatively impact one's reputation and relationships and is a blatant act of incivility in nursing.


Example #4: Blaming Someone Else for Your Wrong Actions or Mistakes

One of the most frustrating things I have ever dealt with as a nurse, team leader, or administrator is working with people who lack self-accountability. I much prefer working with nurses who are willing to admit when they make a mistake and willing to learn from those mistakes than someone who is quick to lay the blame on others. Blaming someone else for your wrong actions or misdoing is another example of incivility in nursing. Unfortunately, it occurs more often than I care to admit, but by holding ourselves accountable, we can reduce the risk of incivility due to the lack of accountability occurring.


Example #5: Lack of Respect for Authority or Leadership

Another form of incivility in nursing is when someone shows a lack of respect for a person in a position of leadership or authority. Nursing is a profession that very much teaches the importance of following the chain of command, both for the protection of patients, staff, and the healthcare organization where care is provided. When there is a lack of respect for the people responsible for leading teams of nurses and healthcare providers, it can negatively impact the quality of car patients receive and, subsequently, patient and organizational outcomes.


Example #6: Refusing to Give Credit to Someone for Their Work

Another frustrating example of incivility in nursing is ignoring someone else's contributions in collaborative work or failing to give them credit for work they completed independently. As nurses, we should celebrate one another's work and contributions and encourage our co-workers and peers to grow and develop personally and professionally. When we demonstrate incivility by refusing to acknowledge other's work or contributions, it reflects our own poor character.


Example #7: Racial Incivility

According to a survey from the National Commission to Address Racism in Nursing, 63% of nurses say they have been the victim of some type of racism, now often referred to as racial incivility, in the workplace. While nearly 60% of the nurses polled said they challenged racism in their workplace, more than half said they saw no changes despite those challenges.


Example #8: Lack of Cultural Competence

As nurses, we work with peers from diverse backgrounds. It is crucial that we develop and implement behaviors that support cultural diversity. Cultural competence is our ability to understand and respect the values, beliefs, and attitudes of people who have different cultural backgrounds. Cultural competence is not only important in building strong nurse/patient relationships, but it is also an essential step in helping combat incivility in nursing.


Example #9: Sexual Harassment

Sexual harassment occurs when there is any verbal or physical harassment of a sexual nature. For instance, examples include making sexual jokes, referring to a person's sexual body parts, requesting sexual favors, unwelcome sexual advances, unwanted touching or physical contact, exposing oneself, or sending sexually explicit photos, text messages, or emails. Sexual harassment of any kind should be reported to your supervisor immediately.


Example #10: Refusing to Assist a Co-worker with Patient Care

While most nurses like to think we can handle our jobs independently, there are times when we all need a little help. It is typically in a nurse's nature to be a giver and helper. When nurses purposely refuse to assist a co-worker in need, it can be considered an act of incivility in nursing. This is especially troubling when assistance is needed in providing patient care.


Example #11: Social Isolation

One of the cruelest forms of incivility in nursing, in my opinion, is social isolation. Social isolation occurs when someone is ignored, or interaction with others is restricted or limited. Whether social isolation occurs as a form of punishment or to make a person feel unwelcome, it is cruel and uncalled for. This type of incivility can leave victims feeling emotionally traumatized. Many nurses who fall victim to this type of incivility choose to terminate their employment and seek jobs elsewhere.


Example #12: Purposely Interrupting Others

Even the smallest of children learn that interrupting others is considered rude behavior. However, the courtesy of showing respect is often lost among adults. In fact, a common example of incivility in nursing is when nurses purposely interrupt others when they are talking or conducting a demonstration. Interrupting others shows disregard for what the other person is saying or for their position and is something we should all be careful to avoid in our behavior.


Example #13: Using an Arrogant Tone When Communicating with Others

Another example of incivility in nursing occurs when we communicate with someone with an offensive or arrogant tone. The tone of voice we use when speaking to others or presenting written communication to them can set the stage for the conversation or an entire relationship, which means it is crucial that we develop good communication skills and implement them in daily practice.


Example #14: Asking for Advice, Then Purposely Ignoring It

One type of incivility in nursing occurs when someone asks for advice to make others feel their opinions or experiences are valued, only to purposely ignore the advice. This type of incivility often occurs when one nurse is jealous of another's position or if they intend to create animosity between team members by promoting doubt about one's knowledge, skills, or experience.


Example #15: Invading Someone’s Personal Space

Everyone has a right to their personal space, and, as nurses, we should respect that right. When we lack regard for someone's personal space by invading their privacy or intruding on the space where they feel safest, this is another example of incivility in nursing.



7 Things Nurses Can Do To Address Incivility When They Encounter It


When faced with incivility in nursing, it is natural to have a flood of emotions and want to react. To keep things from escalating and getting out of hand, the problem should be addressed professionally. The following are seven things you can do to address incivility in nursing when you encounter it.

Thing #1: Identify Your Own Feelings

It is difficult to de-escalate any situation if you are offended, hurt, exhausted, or on the defense. So, the first thing you should do to address incivility in nursing when it occurs is to check your feelings. Think about why you feel the way you do and decide if your feelings are justified. If they are, consider ways to address the problem in a calm, rational way.

Thing #2: Walk Away

You have the right to remove yourself from any situation that subjects you to incivility in nursing. If someone is acting uncivil toward you, tell the person you need a moment and simply walk away. Leave the room or take a walk. Whatever you need to do to separate yourself from the aggressor is what you should do. When you walk away, it gives you time to calm down and gather your thoughts, and it also gives the other person time to calm down and think about their behavior and, hopefully, act in a more civilized manner.

Thing #3: Know When and How to Respond

When I was younger, I remember my grandfather used to say sometimes the best response was no response at all. The older I get, the more I realize how absolutely true that statement is. When you are faced with incivility in nursing, it is crucial to know when and how to respond or if you should respond at all. If a response is necessary, keep it brief and move on. Avoid engaging in argumentative statements, which could cause the situation to escalate instead of resolving it.

Thing #4: Try Not to Take Things Too Personally

One of the most difficult steps in addressing incivility in nursing is to try not to take things too personally. Keep in mind that, even if it feels personal, the other person's behavior toward you may not be. Sometimes, the person's behavior may be related to their own feelings of fear, anxiety, trauma, or fatigue. Although their poor behavior may be directed toward you, it may have nothing to do with you at all. So, try to stay calm and be the voice of reason.

Thing #5: Set Boundaries to Protect Yourself

I am the type of person who tries to find the good in everyone. Although that is an excellent quality to have, always seeking the best in others has led to me being in situations where others felt it was okay to overstep what should have been natural personal boundaries. Over time, I learned the importance of setting personal boundaries.

When you set personal boundaries, you make it clear what behaviors you will tolerate and the behaviors you feel are unacceptable, which will help protect you from incivility in nursing. Remember, protecting your mental and emotional health is essential, and setting personal boundaries can help ensure you do that.

Thing #6: Know When You Need to Involve a Manager or Supervisor

Incivility in nursing can be as simple as someone making a snide remark or as serious as someone making physical threats against you. When you feel the situation has grown out of control or it is uncomfortable, you should talk to your manager or supervisor. If you ever feel unsafe or threatened, whether physically or verbally, talk to your supervisor. Avoid trying to handle situations that have escalated alone. Instead, lean on those in leadership to ensure the safety and security of everyone involved.

Thing #7: Get Involved with Promoting Company Awareness

Your hospital or healthcare organization should have procedures and policies in place designed to protect you from incivility in nursing. It is your responsibility to know your company’s policies and to follow them. Additionally, you can become active in creating a culture of civility within your facility by demonstrating professionalism and reporting instances of incivility.



My Final Thoughts


As nurses, we work with patients, nurses, and interdisciplinary team members with different personalities. It is our responsibility to treat others fairly, nonjudgmentally, and with professionalism. Unfortunately, not every nurse takes this responsibility seriously. Disregarding the thoughts and feelings of others may be considered an act of incivility in nursing.

In this article, we discussed factors to answer the question, “What is incivility in nursing?” By identifying the meaning, causes, and examples of incivility in nursing, we can more easily recognize when incivility occurs, help reduce negative consequences, and improve education to prevent future poor behavior.



Frequently Asked Questions Answered By Our Expert


1. Is Incivility Same As Bullying In Nursing?

While the behaviors are similar, bullying and incivility in nursing are not the same. Incivility is usually not as extreme as bullying. However, they both can have dire consequences on the workplace environment and professional relationships.


2. How Does Incivility Affect Patient Outcomes?

Incivility in nursing causes strained relationships within the interprofessional team. This strain often leads to a breakdown in communication and a lack of cooperation within the nursing team, which negatively impacts patient outcomes.


3. Are There Any Legal Implications Of Incivility In Nursing?

While there is currently no state or federal statutory law that gives rise to legal action for incivility in nursing, it is possible that a nurse who commits an act of incivility will be sued in civil court.


4.Can Incivility Impact A Nurse’s Career?

Depending on the type of incivility, it can have a significant impact on a nurse’s career. The nurse who commits incivility could be reprimanded on the job or risk termination. Anyone who is a victim of incivility could feel emotionally traumatized and may even feel they no longer wish to continue working at their place of employment.


5.How Do I Stop Myself From Being Uncivil In The Nursing Workplace?

The best way to stop incivility in nursing is to model good behavior. You do not have to be a manager or administrator to demonstrate good behavior. You can model good behavior by being courteous, offering help to team members, being accountable for your behavior, and encouraging the same behavior from others.



List Of Sources Used For This Article


1. https://www.ncsbn.org/news/ncsbn-research-projects-significant-nursing-workforce-shortages-and-crisis
2. https://www.nursingworld.org/practice-policy/work-environment/end-nurse-abuse
3. https://onlinedegrees.bradley.edu/blog/fostering-civility-among-nursing-staff
4. https://www.nursingprocess.org/cultural-competence-in-nursing.html
5. https://www.rainn.org/articles/sexual-harassment
6. https://www.nursingworld.org
7. https://www.nursingprocess.org/communication-in-nursing.html


Darby Faubion, RN, BSN, MBA
Darby Faubion is a nurse and Allied Health educator with over twenty years of experience. She has assisted in developing curriculum for nursing programs and has instructed students at both community college and university levels. Because of her love of nursing education, Darby became a test-taking strategist and NCLEX prep coach and assists nursing graduates across the United States who are preparing to take the National Council Licensure Examination (NCLEX).