Date of Award

Spring 2020

Project Type

Clinical Doctorate

College or School




Program or Major


Degree Name


First Advisor

Donna Pelletier

Second Advisor

Rosemary Taylor

Third Advisor

Elizabeth B. McGrath


INTRODUCTION: Nurse incivility is a well-documented phenomenon discussed in the literature and woven into the nursing lexicon. Nurse incivility results in negative consequences for nurses, patients and organizations. Adding to its complexity is the fact that nurses may be unable to identify and address covert uncivil behaviors and lack an effective tactic to mitigate situations.

AVAILABLE KNOWLEDGE: The nursing literature describes the existence of nurse-to-nurse incivility and its correlation with negative outcomes. Regulatory bodies such as The Joint Commission (TJC) also recognize the adverse outcomes resulting from civility and issued two alerts addressing workplace behavior. Additionally, the American Nurses Association (ANA) (2015) added their weight to the issue and clearly described expectations of professional behavior.

METHODS: Ambulatory oncology nurses were invited to participate in the study. The Qualtrics software platform supported the pre-test, Short Negative Acts Survey (S-NAQ), educational module and post-test. T-tests compared pre-test and post-test results and responses from Magnet/Pathway to Excellence versus non-Magnet/Pathway to Excellence employed nurses. INTERVENTION: Participants accessed Qualtrics via an electronic device. Following completion of the initial elements, participants read two clinical vignettes illustrating the evidence-based cognitive rehearsal technique known as “I” message and completed a post-test.

RESULTS: Twenty-one ambulatory oncology nurses completed the Qualtrics module and the data demonstrate that nurses gained an understanding of incivility. The module length was modeled after Qualtrics metrics that facilitate maximum participation and completion.

CONCLUSIONS: For approximately half of the participants, cognitive rehearsal was new information. Pre-test and post-test results indicate that participants acquired new understanding of this evidence-based practice. According the S-NAQ results, participants reported a lower frequency of negative acts as compared to the literature.