To the Editor, Dr Gould:

The educational program mentioned in the September/October 2014 issue article by T. Nikstaitis and L. C. Simko (2014)1 might patch up the ancient problem of incivility in nursing, but I feel that the root cause is not being addressed. I rarely hear the question asked, "Why is there incivility in nursing?" Obviously, incivility is detrimental to any environment; however, I believe that the major cause of incivility in nursing is the antiquated organization of nursing units today. The current model of nursing is often unbalanced, leaving one nurse drowning in a heavy assignment, while another nurse has a leisurely day. To be a floor nurse in this situation makes maintaining a cheery disposition impossible, and resentment inevitably bubbles up. This is a problem in most areas of nursing, but I believe it is a rare phenomenon in team nursing.

I am a critical care RN working in a hospital prep/recovery area where nursing care is team based, meaning all RNs on the team provide care for all patients in their assigned group, sharing equal responsibility for patient outcome. Incivility is rare in team nursing because it hinders progress for everyone, including the patients. As a result, RNs in this setting adapt by using objective communication and avoiding negative undertones in conversation, which creates a happier environment for nurses and patients alike. A study by Fernandez and colleagues2 in 2012 also shows that team nursing decreases medication errors, adverse intravenous outcomes, and uncontrolled pain. It is my hope that all units eventually transition to team nursing, which encourages autonomy among staff, enables the doctors to round with nurses during every visit, and keeps patients from having to wait for assistance.

Sincerely,

Heather Wehmeyer, BSN

Lake Worth, Florida

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