How stopping rudeness in its tracks can make work a safer place

Civility Saves Lives is already having a positive impact in healthcare settings

Uncivil and rude behaviour seems to be increasing in the workplace, making it difficult to confront difficult situations. But a campaign in the health service that arms employees with the skills to disarm conflict situations is having great results, according to Dr Chris Turner.

There is a lot of discussion at the moment about nastiness in social media, but rudeness in the workplace also appears to be on the rise.

We might be less willing to put up with any signs of bullying or discrimination, but that doesn’t mean we’re any better at dealing with the everyday tensions and awkwardness that go along with them.

I believe we’re increasingly self-righteous instead: meaning we’re unwilling to accept we’ve made mistakes or could be the cause of any issues or misunderstandings ourselves.

And that means conversations about issues either don’t happen or are closed down with a short response and a glare. Recent research from the US by management professor Christine Porath backs up the anecdotal evidence from what myself and fellow healthcare professionals have seen happening in our sector.

Asked about whether they had experienced uncivil or rude behaviour from work colleagues in the past week, employees pointed to a doubling in levels of incidents of rudeness since 2005.

Relationship breakdown

The Civility Saves Lives campaign was set up because unthinking rudeness in hospital wards, operating theatres and treatment rooms is a threat to life. A lack of communication and relationship breakdown leads to mistakes, poor performance, sickness absence and low levels of motivation.

While the context and implications are different for every sector, the problem for HR is the same. There’s a lack of awareness of how our behaviours affect other people; and a lack of skills to have the kinds of conversations needed to avoid deteriorating situations and to clear the air.

When we feel that someone has treated us with disrespect, we tend to believe they know they’ve done this; in other words that it has been deliberate.

We often feel anger and this results in the situation escalating. However, the evidence around this tells a different story – that we interpret our perception of the actions of others as hard evidence of their malign character, even though the intent is rarely to cause offence or harm. This is called “fundamental attribution error”.

When we commit similar acts though, we assume that people will see why we did it because, after all, we are good people forced to act in a certain way. This is called the “illusion of transparency”.

Psychological shortcuts

These psychological shortcuts can create a falsely reassuring and unhelpful narrative about the good guys and the bad guys and we feel justified in having destructive conflict.

There is still a tendency in HR, even when the issues are relatively low-level niggles, to look to formal processes.

Understandably so, as this is the response that most quickly gets HR to black and white clarity and a place people can feel most certainty. There’s a leaning towards getting ‘proof’ so this can happen.

HR wants to gather evidence so that there’s proof of a definite problem and blame can be attributed; changes in behaviour or new arrangements can be forced through. But when it comes to rudeness among staff there shouldn’t be a trial.

The challenge is getting that first conversation to happen, one that leads to more understanding. How do you do it when both sides of the situation are feeling awkward? The more petty and unnecessary the events involved, the harder it is for anyone to talk about it.

Civility Saves Lives has been working to raise awareness of the implications of incivility and what can be done in practice by HR and employers. The campaign has been creating a network of champions across healthcare, giving talks to managers and staff within NHS Trusts to spread the word.

If there’s further interest in encouraging changes in practices, then we can go back into department and workshop the issues in the context of the organisation and identify ‘second messengers’, the people internally who staff can turn to, and be trusted to initiate and manage that difficult first conversation.

By creating situations where we can better understand what is happening for both parties, we can get to faster, kinder understanding and resolution. This evidence based, creative commons, peer-on-peer system is known as “calling it out with compassion”.

There have to be spaces for earlier conversations, that are based on a principle of wanting to deal with problems informally – in a way that recognises we are all fallible, and that ultimately we all just want to be the best version of ourselves – rather than confrontation and the reliance on formal processes. It’s a long road to bringing about cultural change when it comes to recognising and dealing with incivility.

External workplace relationships experts such as CMP are having an impact with NHS employers, trying to raise levels of what they call ‘Conversational Intelligence’.

This has included setting up in-house mediation services, equipping different levels of staff with the ability to mediate, and make mediation a ‘normal’ response to minor conflict situations. CMP also gets involved with running group mediations among senior teams, hospital doctors and consultants where senior rank can lead to an assumption of “always being right”, where pressures can mean a lack of attention to the feelings of people around them.

Building trust

From our perspective in the public health sector, we’ve seen the importance of co-operation between the staff side and the organisations side. The impetus for dealing with those difficult conversations needs to come equally from employees.

As soon as it feels as if the ownership of processes is all coming from employer it changes the dynamic and trust weakens; it’s just as if the disciplinary route is kicking in.

Civility Saves Lives is based on helping people understand how their behaviour is affecting other people, not demanding or even asking for change, but leading to an awareness that means people want to change for themselves. And yes, sometimes that means HR taking a step back, supporting staff to deal with issues themselves.

All the evidence on the impact of rudeness in workplaces, the costs in terms of sickness absence and court cases are from the US. In the UK we are taking baby steps, and there’s a need for research into our situation and what bottom line differences civility can make.

But there is at least one case study of a pro-active effort to transform a culture.

When the leadership at Mersey Care NHS Foundation Trust publicly apologised to staff about the aggressive management culture they’d endured and implemented its Just and Learning Culture, there was an immediate £1.8 million saving in terms of reduced sickness absence, and a 59% reduction in disciplinary investigations between 2016 and 2017, even when the Trust’s workforce had doubled.

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Dr Chris Turner

About Dr Chris Turner

Dr Chris Turner is co-founder of Civility Saves Lives and a consultant in emergency medicine.
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