Ms. DalPezzo is Assistant Professor of Nursing, Cedar Crest College, Allentown, Pennsylvania; and Ms. Jett is Course Leader and Faculty, Baptist Health Schools Little Rock, School of Nursing, Little Rock, Arkansas.
The authors thank Dr. Sandra Pennington and Dr. Gail Roux of Rocky Mountain University of Health Professions in Provo, Utah, for their support and guidance during the authors’ doctoral studies and the preparation of this manuscript.
Address correspondence to Katherine Talley Jett, MNSc, RN, NEA-BC, Course Leader/Faculty, Baptist Health Schools Little Rock, School of Nursing, 11900 Colonel Glenn Road, Suite 1317, Little Rock, AR 72210-2820; e-mail: email@example.com.
Vulnerability is characteristic of the human condition (Purdy, 2004; Sellman, 2005). The word vulnerable is derived from the Latin verb vulnerare, meaning to wound (Dictionary.com, n.d.). Thus, to be vulnerable is to be susceptible to being wounded or hurt, or open to moral attack or criticism (Dictionary.com, n.d.). As humans, we are susceptible to physical, emotional, and psychological wounding and are open to attack and criticism from others; hence, we are vulnerable.
In the nursing literature, vulnerable is used to describe populations who are marginalized, disenfranchised, poor, or subject to discrimination (Aday, 2001). The term is rarely used in connection with nursing faculty, yet those who teach nursing are susceptible to physical, psychological, and emotional harm from students, peers, and administrators. Such harm can arise from uncivil or dangerous encounters with students, horizontal violence from colleagues, and lack of support by administrators. This article explores these sources of nursing faculty vulnerability and presents possible solutions that promote faculty safety and welfare.
Disruption of the Learning Environment
One of the most common sources of harm to nursing faculty is uncivil encounters with students. Acts of student incivility can range from rudeness and disruptiveness to severe injury or loss of life to faculty members. Fortunately, the majority of uncivil acts encountered are of the less severe type. In a recent study, both faculty and students agreed that the top five uncivil behaviors include cheating, using cell phones or pagers in class, holding distracting side conversations, making sarcastic remarks or gestures, and sleeping in class (Clark & Springer, 2007). Other widespread behaviors include inappropriate use of a computer during class, demanding exceptions and favors, groaning, refusing to answer questions, inattentiveness, lateness, acting bored, leaving class early or cutting class, and being unprepared for class (Clark & Springer, 2007). Although such behaviors may seem benign, they disrupt the learning environment and may invoke anxiety, anger, and self-doubt in nursing faculty (Luparell, 2007a; Thomas, 2003a).
Aggression and Bullying
Disruption of the classroom is not the only source of harm to nursing faculty. At times, student incivility escalates to include acts of aggression and bullying. This type of incivility can include harassment over grades, accusations of unfairness or discrimination, disparaging remarks, insubordination, intimidation, and verbal abuse. Unfortunately, these behaviors are not uncommon. In a survey of 409 nursing faculty, 24.8% reported objectionable physical contact with students, 42.8% reported verbal abuse from students in the clinical setting, and 52.8% reported being yelled at in the classroom (Lashley & De Meneses, 2001). Luparell (2007a) reported similar findings, with 21 faculty members reporting 36 incidents of incivility ranging from classroom rudeness to aggression and threats to personal safety.
Such hostile behavior by students is often rooted in anger at perceived injustices, discrimination, rigidity, or unreasonable expectations by nursing faculty (Clark, 2008; Thomas, 2003a). In some studies, students report being angered by unexpected or arbitrary changes to the syllabus, class assignments, clinical schedules, and tuition (Clark, 2008; Thomas, 2003a). Similarly, belittling and demeaning remarks, unreasonable demands, and unfair or subjective grading practices also provoke students and can result in feelings of powerlessness and animosity (Clark, 2008). If not diffused, student anger and aggression can become pervasive and disrupt the learning environment, which can exact a psychological and emotional toll on both students and nursing faculty over time.
Acts of Violence
Aggression, bullying, and anger are significant problems, but violent student behavior presents the most serious threat to faculty welfare. Horrific incidents of workplace violence can arise from disputes over grades and course failures, prompting unstable students to seek revenge against faculty (Kolanko et al., 2006). Although incidents remain relatively rare, the problem of violence on college campuses is growing. During the past 30 years, at least 19 major shootings have occurred at American colleges, ten of which were within the last nine years, killing at least 14 faculty members (Lipka, 2008; Smith & Supiano, 2008; CNN.com/crime, 2009). In several of these attacks, faculty members were specifically targeted, including nursing professors at the University of Arizona (Smith, 2007). Thus, the potential for bodily injury or death due to student violence is a real threat to faculty well-being that cannot be ignored on college campuses.
Effects of Student Incivility on Nursing Faculty
All types of student incivility, from classroom disruption to acts of violence, may have deep and lasting harmful effects on vulnerable nursing faculty. Interviews conducted with faculty members reveal that loss of sleep, injury to self-esteem and confidence, emotional exhaustion, and reliving the experience are common reactions to uncivil encounters with students (Luparell, 2007a). In addition to physical and emotional reactions, faculty members also report spending considerable time and money documenting and defending themselves when involved in such situations (Luparell, 2007a).
Although the physical, temporal, and financial tolls of incivility are sobering, perhaps the most serious consequence is the loss of passion for teaching. Nurse educators who are confronted with incivility report a loss of enthusiasm and motivation for their work, as well as a decreased quality of life (Luparell, 2007a). Such low morale affects the quality of nursing education and leads to changes in pedagogy that minimize conflict with students (Luparell, 2007a).
Already faced with considerable stress from heavy workloads and other campus obligations, some faculty are driven by incivility to leave academia (Luparell, 2005, 2007a). During a time of unprecedented staff and faculty shortages, this is a serious concern. The American Association of Colleges of Nursing (2007) reported that more than 30,000 applicants to baccalaureate programs were turned away in 2007 primarily due to lack of nursing faculty. Thus, it is imperative that the profession not lose more faculty members because of student incivility.
Incivility from Colleagues and Administrators
Coping with student incivility and violence is challenging enough for any educator; yet, in addition to this challenge, nurse educators must also cope with uncivil treatment by colleagues and administrators. Although this mistreatment is rarely discussed, its existence has been confirmed by many faculty members (Heinrich, 2006a, ¶ 1). The most common forms of mistreatment include horizontal violence from peers and abuse of power by administrators
Horizontal violence includes hostile and aggressive actions, attitudes, words, or other behaviors that are manifested by an oppressed, powerless individual or group toward another member of the same group (Thobaben, 2007). This behavior “controls, humiliates, denigrates, and injures the dignity of another” and “indicates a lack of mutual respect and value for the worth of the individual” (Blanton, Lybecker, & Spring, 1999, ¶ 2). Horizontal violence can occur in any workplace where there is an unequal power hierarchy or where a group’s self-expression and autonomy is controlled by another group with greater prestige, power, and status.
Among nursing faculty, horizontal violence occurs in many forms. Competitiveness, ostracism, bullying, blaming, silencing, lack of recognition, devaluation of accomplishments, and lack of support are some of the disturbing interpersonal behaviors described by nurse educators at nine universities in four countries (Glass, 2001, 2003, 2007). Also, in some institutions, junior faculty who lack terminal degrees report feelings of inferiority due to the bullying or dismissive attitudes of those with doctoral degrees (Glass, 2001). In addition, issues related to job security, tenure, and promotion create tension, stress, and competitiveness among peers (Glass, 2001, 2003).
Heinrich (2006b, 2007) describes horizontal violence in nursing academia as joy-stealing games. From the spontaneous writings of 261 nurse educators during the 2005 National League for Nursing Summit, Heinrich identified 10 games that educators use to undermine peers. These games include destructive behaviors such as distorting, setting up, lying, shaming, betraying, breaking boundaries, splitting, mandating, blaming, and silencing colleagues (Heinrich, 2006b, 2007). Besides being hurtful and demoralizing, Heinrich (2006b) maintained that such behaviors also have a detrimental effect on knowledge development and scholarship within the profession.
Abuse of Power by Administrators
In addition to the problem of horizontal violence, nurse educators also are subjected to lack of support and abuse of power by administrators. This abuse can be either subtle or blatant. Subtle forms of abuse can include inequitable treatment; failure to give faculty credit for ideas or accomplishments; ignoring or excluding people from groups, activities, or projects; and lack of support during difficult times (Glass, 2001, 2003). More blatant forms of abuse include intimidation, verbal attacks and cutting remarks, and intentionally limiting academic progression (Glass, 2001, 2003). Xu and Kwak (2005) warned that faculty can also be subjected to discrimination via unequal teaching loads and poor annual evaluations.
Effects of Peer and Administrator Incivility on Nursing Faculty
Incivility from colleagues and administrators takes a huge toll on nursing faculty. If left unchecked, horizontal violence results in a toxic work environment, job dissatisfaction, and psychological and physical stress (Baltimore, 2006; Longo & Sherman, 2007). Victims of horizontal violence report symptoms such as trouble sleeping, anxiety, low self-esteem, poor morale, and depression (Longo & Sherman, 2007; Thobaben, 2007). When employees are affected to this degree, the organization also will suffer from low productivity, reduced loyalty, lack of initiative, and increased faculty turnover (Hutchinson, Vickers, Jackson, & Wilkes, 2006; Woelfle & McCaffrey, 2007). When conflict and unpleasantness among peers become unbearable, educators may simply choose to leave academia (Thomas, 2003b). Mistreatment of faculty by administrators has similar effects, resulting in feelings of disempowerment and vulnerability and an increased likelihood of leaving academia (Glass, 2001).
Faculty vulnerability is a real and serious issue that must be addressed to improve recruitment and retention and to ensure the quality of nursing education. Although nurse educators clearly are harmed by student, peer, and administrator incivility, there are measures that can be taken to minimize vulnerability.
Strategies to Minimize Student Incivility
The first step in managing student incivility is to establish clear policies regarding conduct on college campuses, as well as in the classroom (Ehrmann, 2005; Luparell, 2005) College policies must be written in unambiguous language and should clearly delineate the behavioral expectations of all students. Preferably, there should be a zero tolerance policy for displays of aggression or threats of violence. Also, policies must contain clear procedures for handling disruptive students and for removing them from the classroom (Luparell, 2005). Likewise, faculty members must reinforce the college’s standards in their own classrooms by setting clear and realistic rules for in-class behavior. Rules must be described in detail in the student handbook or course syllabus and should include the specific behaviors that are prohibited (Ehrmann, 2005; Luparell, 2005).
Once behavioral expectations are clearly defined, faculty must intervene to stop undesirable behavior as soon as it occurs. However, faculty often are hesitant to address behavior problems, preferring to avoid the conflict that inevitably results from these confrontations (Luparell, 2007b; Thomas, 2003a). Such avoidance may result from educators’ lack of skills necessary to address angry and aggressive students (Ehrmann, 2005). Therefore, colleges should offer workshops that teach faculty how to cope with uncivil students and how to protect themselves during such encounters (Ehrmann, 2005; Luparell, 2005). Conflict management, negotiation skills, crisis management, and campus safety procedures are topics that should be included in workshops and in the orientation of all new faculty. In addition, nursing departments should seek the involvement of campus security when planning, developing, and implementing safety workshops and departmental safety procedures.
Faculty education must also include early identification of potentially violent students. This is critically important if colleges are to avoid tragedies such as the 2007 Virginia Tech massacre. Warning signs such as an adverse reaction to criticism, use of intimidation or threats, bizarre thoughts and behavior, low tolerance of stress, and apprehensiveness on the part of faculty and other students are indicative of potential problems and should be reported immediately (Thomas, 2003a). Severely stressed students, or those whose behavior is beyond control, must be referred to counseling without delay (Ehrmann, 2005; Thomas, 2003a).
To minimize the possibility of campus violence, schools must also examine their admission policies (Luparell, 2005; Thomas, 2003a). Most nursing programs require a criminal background check prior to admission, and schools must carefully review those students who do not have clear records. Students with histories of assault, abuse, or other violent acts are high risk and should not be admitted to schools of nursing. Also, as clinical sites tighten their rules regarding background checks, schools may need to adopt zero tolerance policies regarding any type of miscreant behavior from students.
Finally, to minimize uncivil behavior, educators must recognize that civility in the classroom is a responsibility shared by both the student and the teacher. Therefore, educators must ensure their behavior does not inadvertently provoke episodes of anger and aggression in students. This can be accomplished by engaging in reflective practice. Reflective practice begins by examining one’s own behavior and interaction style and by determining how one is perceived (Luparell, 2005). To be treated civilly by students, educators must model respectful behavior and demonstrate care and regard for those they teach. Failure to do so can contribute to the breakdown of civility in the academic milieu.
Strategies to Minimize Peer Incivility
In addition to strategies for managing student incivility, there also are measures that can be taken to minimize incivility from peers and administrators. The most important step in reducing harmful behavior among peers is to modify the departmental culture. This responsibility must begin with the dean or chairperson of the department. Because effective leaders create a vision and then develop commitment to that vision, deans and chairpersons are in a position to develop an organizational culture of caring, support, and respect among nursing faculty. Leaders must make it clear that behaviors such as sarcasm, gossiping, intimidation, verbal disparagement, undermining, blaming, or ostracism of colleagues will not be tolerated. Of course, leaders must also role model the behaviors that they want emulated by faculty. Department leaders must take care to avoid favoritism, inequitable treatment, and other abuses of power when dealing with faculty. One way that these behaviors can be avoided is by actively seeking feedback from staff through formal and informal means on an annual basis. In addition, leaders should be encouraged to engage in self-reflective practice to ensure that they have not developed a leadership style that supports horizontal violence or abuse of power (Longo & Sherman, 2007).
Heinrich (2007) stated that the antidote for a toxic workplace is to transform it into a community of scholarly caring. In such a community, faculty cooperate with each other and collaborate on scholarly projects and involve students in the process (Heinrich, 2007). Heinrich suggested that when these things occur, horizontal violence will lessen, passion for education will be renewed, and new members will be attracted to a career in nursing education.
Finally, several studies proposed that incivility can be overcome if nurses refuse to allow themselves to become victims (Baltimore, 2006; Heinrich, 2006a; Longo & Sherman, 2007; Thobaben, 2007). The first step in avoiding victimization is to admit that workplace violence exists; the second is to bring it out in the open by talking about it (Baltimore, 2006; Heinrich, 2006a; Longo & Sherman, 2007; Thobaben, 2007). For such dialogue to occur, it is important that schools have policies in place that enable nurses to report incivility without fear of retaliation or retribution.
Nursing faculty rarely are viewed as a vulnerable population; however, those who teach nursing are susceptible to physical, psychological, and emotional harm from many sources. Disruption of the classroom, aggression and violence by students, and incivility from peers and administrators are serious problems that are widely reported by nursing faculty. As the profession faces a significant shortage of educators, it is imperative that faculty vulnerability be minimized to retain current educators and attract new ones to the field. This can occur only if faculty and administrators work together to address the issues of vulnerability that currently affect so many schools of nursing.
- Aday, L.A. (2001). At risk in America: The health and health care needs of vulnerable populations in the United States (2nd ed.). San Francisco: Jossey-Bass.
- American Association of Colleges of Nursing. (2007, December3). Enrollment growth slows at U.S. nursing colleges and universities in 2007 despite calls for more registered nurses. Retrieved December 22, 2007, from http://www.aacn.nche.edu/Media/NewsReleases/2007/enrl.htm
- Baltimore, J.J. (2006). Nurse collegiality: Fact or fiction?Nursing Management, 37(5), 28–36.
- Blanton, B.M., Lybecker, C. & Spring, N.M. (1999).A horizontal violence position statement. Retrieved July 7, 2009, from http://proactive-nurse.com/index.php?option=com_content&Itemid=22&id=83
- Clark, C.M. (2008). Student voices on faculty incivility in nursing education: A conceptual model. Nursing Education Perspectives, 29, 284–289.
- Clark, C.M. & Springer, P.J. (2007). Thoughts on incivility: Student and faculty perceptions of uncivil behavior in nursing education. Nursing Education Perspectives, 28, 93–97.
- CNN.com/crime. (2009). Two killed in Michigan college shooting. Retrieved August 6, 2009 from http://www.cnn.com/2009/CRIME/04/10/mich.college.shooting/index.html
- Dictionary.com. (n.d.). Retrieved December 12, 2007, from http://dictionary.reference.com/browse/vulnerable
- Ehrmann, G. (2005). Managing the aggressive nursing student. Nurse Educator, 30, 98–100. doi:10.1097/00006223-200505000-00006 [CrossRef]
- Glass, N. (2001). The disease of nursing academia: Putting the vulnerability ‘out there’ (part 2). Contemporary Nurse, 10, 178–186.
- Glass, N. (2003). Studying women nurse academics: Exposing workplace violence in Australia: Part 2. Contemporary Nurse, 14, 187–195.
- Glass, N. (2007). Investigating women nurse academics’ experiences in universities: The importance of hope, optimism, and career resilience for workplace satisfaction. In Oermann, M.H. & Heinrich, K.T. (Eds.), Annual review of nursing education: Vol. 5 (pp. 111–136). New York: Springer.
- Heinrich, K.T. (2006a). Joy stealing: How some nurse educators resist these faculty games. Part 2 of a two-part article. Reflections on Nursing Leadership, 32(3). Retrieved January 8, 2008, from http://www.reflectionsonnursingleadership.com/Pages/Vol32_3_Heinrich.aspx
- Heinrich, K.T. (2006b). Joy-stealing games. Reflections on Nursing Leadership, 32(2). Retrieved January 8, 2008, from http://www.reflectionsonnursingleadership.com/Pages/Vol32_2_Heinrich.aspx
- Heinrich, K.T. (2007). Joy stealing: 10 mean games faculty play and how to stop the gaming. Nurse Educator, 32(1), 34–38. doi:10.1097/00006223-200701000-00010 [CrossRef]
- Hutchinson, M., Vickers, M., Jackson, D. & Wilkes, L. (2006). Workplace bullying in nursing: Towards a more critical organisational perspective. Nursing Inquiry, 13, 118–126. doi:10.1111/j.1440-1800.2006.00314.x [CrossRef]
- Kolanko, K.M., Clark, C., Heinrich, K.T., Olive, D., Serembus, J.F. & Sifford, K.S. (2006). Academic dishonesty, bullying, incivility, and violence: Difficult challenges facing nurse educators. Nursing Education Perspectives, 27, 34–43.
- Lashley, F.R. & De Meneses, M. (2001). Student civility in nursing programs: A national survey. Journal of Professional Nursing, 17, 81–86. doi:10.1053/jpnu.2001.22271 [CrossRef]
- Lipka, S. (2008, October27). Two students die in shooting at U. of Central Arkansas [Electronic version]. The Chronicle of Higher Education. Retrieved August 6, 2009 from http://chronicle.com/article/2-Students-Die-in-Shooting-/41853
- Longo, J. & Sherman, R.O. (2007). Leveling horizontal violence. Nursing Management, 38(3), 34–37, 50–51.
- Luparell, S. (2005). Why and how we should address student incivility in nursing programs. In Oermann, M.H. & Heinrich, K.T. (Eds.), Annual review of nursing education: Vol. 3 (pp. 23–36). New York: Springer.
- Luparell, S. (2007a). The effects of student incivility on nursing faculty. Journal of Nursing Education, 46, 15–19.
- Luparell, S. (2007b). Managing difficult student situations: Lessons learned. In Oermann, M.H. & Heinrich, K.T. (Eds.), Annual review of nursing education: Vol. 5 (pp. 99–110). New York: Springer.
- Purdy, I.B. (2004). Vulnerable: A concept analysis. Nursing Forum, 39(4), 25–33. doi:10.1111/j.1744-6198.2004.tb00011.x [CrossRef]
- Sellman, D. (2005). Towards an understanding of nursing as a response to human vulnerability. Nursing Philosophy, 6, 2–10. doi:10.1111/j.1466-769X.2004.00202.x [CrossRef]
- Smith, L. (2007, April16). Major shootings on American college campuses [Electronic version]. The Chronicle of Higher Education. Retrieved November 20, 2007, from http://chronicle.com/free/2007/04/2007041610n.htm
- Smith, L. & Supiano, B. (2008, February15). Major shootings on American college campuses [Electronic version]. The Chronicle of Higher Education. Retrieved August 6, 2009 from http://chronicle.come/article/Major-Shootings-on-American/22373
- Thobaben, M. (2007). Horizontal workplace violence. Home Health Care Management & Practice, 20, 82–83. doi:10.1177/1084822307305723 [CrossRef]
- Thomas, S.P. (2003a). Handling anger in the teacher-student relationship. Nursing Education Perspectives, 24, 17–24.
- Thomas, S.P. (2003b). ‘Horizontal hostility.’American Journal of Nursing, 103(10), 87.
- Woelfle, C.Y. & McCaffrey, R. (2007). Nurse on nurse. Nursing Forum, 42, 123–131. doi:10.1111/j.1744-6198.2007.00076.x [CrossRef]
- Xu, Y. & Kwak, C. (2005). Teaching nursing in America: An Asian faculty experience and reflection. Home Health Care Management & Practice, 17, 250–253. doi:10.1177/1084822304272405 [CrossRef]