Embracing Civility

The REAL Healthcare Reform!

Tag: patient outcomes

Are You Fed Up?

If you are fed up with incivility in your healthcare workplace, watch this:


It’s Here! Civility Training for Your Organization!

It’s time to order your organization’s new Civility Training Program!  We are proud to offer the only healthcare-specific civility training program designed to meet the unique needs of the healthcare environment.

Based on our popular book, “The REAL Healthcare Reform,” this program is a complete turnkey solution that contains everything you need to get a civility training program up and running with minimal effort.

Training packages are available for as few as 12 learners and come complete with a copy of The REAL Healthcare Reform for each learner and an Instructor’s Manual for the educator.

The Instructor’s Manual is full of engaging classroom activities, thought-provoking discussion questions, convenient PowerPoint presentations, tips for improving participation and a CD with master copies of all the handouts and presentations. (Read a sample chapter!)

The best part is that the program materials are appropriate for every individual in your healthcare organization, clinical and non-clinical alike. Administrators, managers, nurses, aides, secretaries, and everyone in between, will find the program easy to use and understand. In addition, the program provides six hours of inservice credit for all Certified Nursing Assistants.

Healthcare organizations who provide civility training will find that it:

1. Meets Joint Commission’s recommendations.  This program meets the Joint Commission’s recommendation to provide training that reduces “behaviors that undermine a culture of safety,” particularly intimidating and disruptive behaviors among staff members.

2. Reduces costly medical errors. Incivility ruins communication among the healthcare team and poor communication is a direct threat to patient safety. Civility training decreases dangerous and potentially deadly medical errors by improving teamwork and communication.

3. Increases employee retention. A staggering number of healthcare employees report having quit a job because of incivility. Civility Training improves employee retention at every level, saving organizations the precious time and money involved in hiring and training new employees.

4. Cuts down on “call-outs” and absenteeism. Working in a culture of incivility leads to more absenteeism.  As many as 47% of healthcare employees report spending less time at work because of incivility. Civility training creates an atmosphere that energizes and inspires those who are in it. Employees who are energized and inspired will look forward to coming to work, thus reducing the rate of absenteeism.

5. Eliminates conflict and drama. Incivility leads to conflict and conflict = DRAMA! Healthcare professionals who embrace civility are less likely to burn out, bully or “eat their young!” This means less conflict and drama in the workplace!

6. Improves patient satisfaction and enhances the organizations reputation. Disgruntled, dissatisfied and disengaged employees don’t provide quality care to the patients they serve.  This leads to a decrease in patient satisfaction. Patients who are dissatisfied with the care they receive share their negative experience with others in the community.  Healthcare organizations that embrace civility enjoy improved patient satisfaction . . . and satisfied patients who speak well of the organization in the community enhance that organization’s reputation.

The benefits of using THIS Civility Training Program include:

1. The hard part is DONE!  Our Civility Training Program will save you time, effort and money.  You don’t have to create the program yourself.  We did that for you.  And you won’t have to hire an expensive “expert” trainer to come into your facility to deliver the training. The Instructor’s Guide will show you how to seamlessly deliver the content to healthcare professionals from a wide variety of backgrounds and settings with a wide range of learning styles.

2. Two simple products give you everything you need!  Our program consists of a workbook style booklet that goes hand-in-hand with the companion Instructor’s Manual. The Instructor’s Manual comes with a CD loaded with additional worksheets, quizzes and PowerPoint presentations. These two products contain everything you need to conduct your civility training.

3. It’s easy to customize the program to meet your specific needs! You can choose to arrange a full day “seminar” to cover all of the material in one day.  Or, you might like to break the content into chunks and deliver it over several shorter sessions.  This option is great for shift workers.  You can hold a morning session for one shift and an afternoon or evening session for other shifts.

4 There is a pricing option for every budget. When you are ready to order, call In the Know at (877) 809-5515 to choose the package that’s right for you. (See bulk discount pricing below.)

5. The program pays for itself. Incivility steals from your entire organization. Organizations like yours can end up paying dearly for incivility with their profit margins. In the Know’s Civility Training program will improve patient care, decrease costly medical errors and will inspire and energize your team. Best of all, it will decrease employee turnover at every level, saving you the time and money involved in hiring and training new employees.

To learn more about this new Civility Training Program, please call 877-809-5515. We are here to answer all of your questions!

Civility Training Program Package Options

Online ordering is currently not available for these packages,
so please call 877-809-5515 to place your order.

Number of Learners

Qty Discount Price Each Instructor’s Manual Your Cost
12 50% 9.97 69.99  $189.59
24 55% 8.97 69.95  $285.23
50 60% 7.98 34.98  $433.98
100 65% 6.98 34.98 $732.98
150 70% 5.98 Free $897.00
300 75% 4.98 Free $1,494.00



Answers to your personal questions about
combating workplace incivility right NOW!

We get lots of questions about workplace incivility, and we’d like to share them with you! While each problem is specific to the individual who sends it,
most people will be able to relate and make use of the information.

If you have something you’d like to ask our workplace incivility experts, click here and send us your anonymous question.  We will never publish real names or workplaces in this column.


Dear Civility STAT!

I work in a nursing home in Tennessee. Our employer does not provide a private break area away from resident’s and their families. We have to share the snack machines, fridge, and microwave. Our time clock and other personal items are in there. We are not paid for a 30 minute break, and we have no where to get away from resident care. Is this legal?

~ fed up in tn


Dear Fed-up in TN,

Thank you for submitting your question. It’s a good one!

First, regarding the unpaid lunch:Federal law does not mandate any specific meal or rest breaks. It does, however, give guidance as to whether or not an employee should be paid during these times. Short breaks (usually 20 minutes or less) should be counted as hours worked. True “meal periods” are usually 30 minutes or more, and do not need to be paid as work time.

But, here’s the catch: During an unpaid meal break, a worker must be completely free of his or her work duties. If the employee is still required to do any duties (even minor duties such as answering a phone), it can’t be considered a meal or lunch period and must be paid. So, if patients or families are coming in and engaging employees in patient-related discussions or making requests, it would seem that that could not be considered a break.

And, here is some OSHA stuff that addresses the problem with the public break room:

“OSHA’s bloodborne pathogens standard prohibits the consumption of food and drink in areas in which work involving exposure or potential exposure to blood or other potentially infectious material takes place, or where the potential for contamination of work surfaces exists [29 CFR 1910.1030(d)(2)(ix)]. Also, under 29 CFR 1910.141(g)(2), employees shall not be allowed to consume food or beverages in any area where occupational exposure through the contamination of food and beverages is likely.

From what I can tell, OSHA inspectors evaluate each facility on a case by case basis. If your break room has the public in and out frequently, and you are expected to share the same fridge and microwave with potentially infected residents, then OSHA might object.

Then, there’s the HIPAA issue. Mixing staff, residents and families in a space intended for staff to relax is a HIPAA violation just waiting to happen. Staff members talk. They have to. It’s part of the debriefing process. It’s how we process and deal with all the stuff that happens on a typical shift. Residents and family members will, sooner or later come upon a discussion in that public break room and a hipaa violation will be tremendously costly the facility.

And finally, it’s a morale issue. A private break room would create a space for your team to unwind. Nobody can stay “plugged-in” all day long. Your body and mind will become drained. Drained staff members are more likely to experience decreased morale, a drop in sharpness (leading to more medical errors) and loss of productivity. A private break room would give you and your co-workers a place to go to get away for a while and mentally recharge so you can return to your residents rested and re-energized.

You could present all these angles to your employer. But, if you also want to present a solution, ask yourself these questions:

  • Is there a space anywhere in the facility that is unused (or poorly used) that could possibly be converted into a private staff room?
  • Are there any staff members who would be willing to get involved in making the private staff room happen? Your employer might be more willing to agree to renovate a space if you meet halfway and offer some elbow grease.
  • If money is a problem and items like a fridge and furniture are not in the budget, maybe a fundraiser could help. Your employer may be willing to match funds if every staff member was willing to contribute $10-$20 dollars.

If you need more specific information about the laws in your state, call The TN Division of Labor Standards at 615-741-2858 (option 3) or toll-free at 1-866-588-6814.

Hope this helps. Please keep us posted. We love to hear your success stories!


If you have something you’d like to ask our workplace incivility experts,
click here and send us your anonymous question.

The Sinister Side of Incivility

We talk a lot about incivility in the healthcare workplace. It’s that insidious, irritating and distracting eye rolling, sarcasm, gossip and belittling we all have either witnessed or experienced. But there is a more serious side of incivility that goes beyond these minor annoyances. And that’s BULLYING.

Bullying is a much more sinister form of incivility that can have devastating emotional effects on workers, costly financial consequences for employers and dangerous or even deadly outcomes for patients.

Are you being bullied at work? If so, get help now!

Here is a helpful graphic that is full of terrific advice
from the folks at Career Journey in the UK.

Source: Career Journey

Nurse Managers: Ditch the Trinkets, Trophies and Doodads!

Looking for an innovative way to reward and inspire your team? It’s probably safe to assume they have enough pens, key chains, water bottles and canvas tote bags!

Before you order your next trinket or chachki, ask yourself if any of those giveaways ever really made a change. For example:

– Did your customized water bottles ever reduce costly medical errors?

– Did the pens and key chains increase employee retention?

– Did the canvas tote bags improve client satisfaction or enhance your organization’s reputation?

The Real Healthcare ReformChances are good that your answers are “No, no and no!” So, why keep doing it?

Instead of the typical gimmicks and giveaways, make your incentive dollars count!  Give a gift that shows just how much you value your employees, your clients and your organization.

Give the book, “The REAL Healthcare Reform: How Embracing Civility Can Beat Back Burnout and Revive Your Healthcare Career” as your next incentive gift!

By giving “The REAL Healthcare Reform” to your team, you will

    • Encourage civility,
    • Promote healthy teamwork,
    • Enhance your team’s communication,
    • Decrease your turnover rate,
    • Improve client care, and
    • Reduce costly medical errors.

That’s a valuable return you won’t get by giving t-shirts or tote bags!

With special bulk pricing in place, you can put of a copy of “The REAL Healthcare Reform” into the hands of every member of your organization for as little as $4.98 each. Here are your options:

of Books




























List Price:  Book / Instructor’s Manual
$19.95 ea. /  $125.00 ea.

Click here to learn more about
“The REAL Healthcare Reform” and read a sample chapter!


Civility STAT! A New Advice Column from Embracing Civility

  Answers to your personal questions about
combating workplace incivility right NOW!

We get lots of questions about workplace incivility, and we’d like to share them with you! While each problem is specific to the individual who sends it, most people will be able to relate and make use of the information.

If you have something you’d like to ask our workplace incivility experts, click here and send us your anonymous question.  We will never publish real names or workplaces in this column.



I work for small healthcare provider in a tiny suburb. Needless to say, everybody knows everybody! Shortly after taking the job, I became pretty close friends with one of my workmates. We would have lunch together, go out for drinks after work and even get our families together to barbecue on the weekends.
One day, this friend learned that her husband had been cheating on her. She came to me to cry, complain, drink wine and get advice. I let her cry, listened to her complain, served her wine and tried to give her advice. 
By the time Monday rolled around, news had gotten out that this husband was messing around with A LOT of other women. When my friend arrived at work on Monday, people began to ask her questions . . . questions that they already knew the answers to. When she realized that everyone knew her business, she blamed me for telling!
I swear, I never told a soul! Now, she won’t even talk to me anymore. She gives me dirty looks, she purposely creates situations to make me look bad. She rolls her eyes when I walk by and she excludes me from invitations to lunch or drinks after work. And even though I can’t prove it, I think she and another co-worker are responsible for the three flat tires I had on my car when I left work last night.
I’m at my wits end and don’t know what to do. Please help!
Sunk in the Suburbs

Dear Sunk, This is a tough situation. Becoming close friends with people you work with can be a real slippery slope. That’s why we say in “The REAL Healthcare Reform” that:

“It’s okay to be friendly—and you should be friendly—but you don’t have to be ‘best friends’ with your co-workers. Get your needs for friendship met outside of work.

The hard truth is that turning professional relationships into personal relationships can breed a familiarity that invites disrespect and incivility. That’s what you are experiencing right now. Your friend has been hurt and betrayed by her husband. And, now she feels hurt and betrayed by you (even if that feeling is misguided). In an attempt to protect herself from feeling the pain, she is lashing out with anger, incivility and bullying behaviors toward you. (Who knows what she is doing to her husband?)

Dealing with the dirty looks, the eye rolling and the exclusion is going to be the easy part. Simply do not allow yourself to fall into the trap of reacting. Your ex-friend would love to get you to engage in a conflict with her. Even though you are the victim here, she will be able manipulate the situation to make it look like she lost her husband and her best friend, all in one weekend. Everyone will rally around her!

Just do your best every day to show everyone how much you love your job and that you want to be a team player.

The other behaviors, such as trying to make you look bad and possibly flattening your tires are much more sinister problems that need to be dealt with by your supervisor or HR department.

Start by writing down everything that has happened so far. Be sure to include names and dates, if possible. Stick to the facts, not what you think, guess or assume. Take this information to your supervisor or HR department and ask for the policy on reporting bullying and disruptive behaviors. If no policy exists, you may want to mention that bullying and disruptive behaviors, particularly in a healthcare setting undermines the culture of safety and contributes to poor patient outcomes, more medical errors and costly employee turnover.

Find out if you have surveillance cameras in the parking lot where your car was parked when the tires were flattened. If so, you can find out exactly who did the damage. But, whether you know who did it or not, you need to file a police report. The police will ask you if you know of anyone who may want to hurt you, and they will ask those people the hard questions.

You may think that an advice column like this would encourage you to try to “talk it out” and “repair the friendship,” but, that’s not what you will get here. While it’s important to diffuse the situation and get the disruptive behaviors to stop, it’s equally important to RE-DEFINE your relationship with your co-worker as a professional relationship—not a personal one. In “The REAL Healthcare Reform” you’ll learn:

The purpose of a professional relationship is to work together toward the common goals of the workplace by servicing the customers, maximizing profit or productivity and maintaining or enhancing the reputation and success of the company.

This is different from personal relationships where the goal is to provide companionship, friendship or even intimacy to meet each person’s need for socialization and emotional connection.

The key to building and maintaining civil relationships with your co-workers is understanding that work relationships are professional…not personal!

Hope this helps. Please keep us updated, Sunk! If anyone else has advice for Sunk, please feel free to leave your thoughts in the comments!


Did You Miss the Show? Listen to the Archive Today!

RN.FM Radio

If you missed Linda and Stacey talking about “The REAL Healthcare Reform” with Keith Carlson and Kevin Ross on RN.FM Radio, you can catch it on the archives now!


Let us know what you think! We’d love to hear from you!


Improve Patient Outcomes with Civility Training

Workplace incivility is a hot topic these days. But “civility” and “civility training” are more than just the latest buzz words. Want proof? Consider the new study published in the Journal of Health Services Research. Conducted at the University of Rochester Medical Center, the study found that nursing home residents have less chance of developing pressure ulcers and/or incontinence if the employees in their facility feel united and work as a cohesive team.

Researchers looked at the incidence of incontinence and pressure ulcers for more than 45,000 nursing home residents living in 162 facilities throughout the state of New York.  In addition, they measured what they termed the “staff cohesion” of nearly 7500 nursing home employees. The staff answered questions on a survey about common goals, values, responsibility for care delivery and group identity.

When the two aspects of the study were compared, the authors found that even a small upturn in how employees got along led to a significant decrease in the incidence of pressure ulcers and incontinence. “We know from other fields of medicine that teamwork—the relationship between coworkers that facilitates decision making and care coordination—plays an important role in the quality of care,” said lead author of the study, Helena Temkin-Greener, Ph.D. “Our body of work in this area demonstrates that, while many nursing home managers may contend that they have teams in place to coordinate care, it is only when staff perceives that they are part of a cohesive unit that the quality of care is improved.”

Without staff cohesion, employees work in an environment hampered by poor communication (between employees and between shifts) and ineffective coordination of care. Preventable patient outcomes—like pressure ulcers—are more likely when the staff fails to communicate monitoring procedures, repositioning guidelines and other resident-specific information.

“This study empirically demonstrates that better work relationships between staff, as measured by staff cohesion, are associated with better outcomes for nursing home residents,” said Temkin-Greener. “Nursing home managers have the tools to encourage good patient care but they have to work at it and encourage practices that promote better cohesion, communication, and teamwork in their facilities. If they do this, the quality of care will improve.”

It’s undeniable that many healthcare workplaces are infected with incivility. And where incivility reigns, staff unity suffers. The good news is that even a slight improvement in the workplace environment can raise the level of patient care. When that happens, everybody wins. Employees are more satisfied, patients are healthier and healthcare organizations stop wasting time and money on preventable nosocomial conditions. That makes civility training a sound investment for every healthcare organization.

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