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In long-term care it is increasingly apparent that who is on shift is just as important as how many staff are on shift. Quality care is difficult to achieve when we do not routinely engage with one another in a positive, or civil, manner.
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Practice-Based Scenarios

The following 11 scenarios illustrate some of the more common examples of workplace incivility in long-term care settings. You can work through them by yourself or gather some colleagues and work through them together as part of a facilitated discussion. You may want to tackle one or two scenarios at a time, rather than working through all of them at once.

Read through each scenario example and select which response you feel best fits the situation. We encourage you to think of other approaches that might be helpful in addressing the uncivil behaviour in each scenario.
Get STarted

Scenario 1

Noreen is prickly with the people she works with. You observe her making a sarcastic remark at the nursing station before stomping off down the hall. You are not the only one who has noticed this behaviour, but you are afraid to say or do anything that might further upset Noreen. What do you do?
Have a one-on-one conversation with Noreen
Have a conversation with your supervisor and ask her to remind everyone of what respectful behaviour and communication looks like

For example,
• “Noreen, can I speak with you privately?”
• Describe the impact the behaviour had on you
“I’m not sure that you noticed the impact your comment had on those of us at the nursing station. I felt disrespected by your remark, and you left the nursing station before any of us could respond”.
“I know how hard you work – all of us are working full out right now. When I hear a comment that is disrespectful to us, it makes our work more difficult because we feel less like a team”.
• Give Noreen space and time “I just wanted to leave that with you”.

While Option B is a possible alternative, there is no guarantee that Noreen will be on shift when the supervisor addresses the team or if she is on shift, she may not recognize the comment is directed at her.

Scenario 2

Whenever Steven calls Laura to assist him with a transfer she never answers her phone. This has become a pattern and many other staff on the floor are becoming frustrated with Laura and how she does not help her partner with transfers. What should Steven do?
Speak with Laura privately at the start of the shift.
Document the times that he attempts to call Laura for help, then talk to his supervisor.

Scenario 3

Joti has just been hired and makes it a point to be friendly with all her co-workers. However, she notices that her colleague Priya never greets her and gives her the cold shoulder. Joti can’t think of anything she has said or done that would prompt this behaviour. What should she do?
Stop greeting Priya but continue to greet everyone else
When she's in the break room, tell her colleagues how frustrated she is with this behaviour
Find a time to speak with Priya in private.
Mention it to her supervisor.

Scenario 4

A new staff member, Carly, has just been hired into a desirable day shift position. She hears a rumour from one of her colleagues indicating that she only got the position, because she is related to the manager. There is no truth to this rumour. How should she respond?
Carly goes to the manager to express what she’s heard. The manager issues a blanket announcement to staff telling them not to gossip or spread rumours.
Carly goes to the manager to express what she’s heard. The manager speaks to staff on the unit, “I understand there’s a rumour about Carly. These are the facts. I encourage you to check out the story first before making an assumption as this can be hurtful to your colleagues.”

Option B is the preferred choice.

Scenario 5

Marten, a recently graduated LPN, is leading report on his first solo shift. He reads out the bowel movement list and suggests that Mrs. Rose has an enema. Two of the care aides look at each other and roll their eyes. One says sarcastically, “Well, good luck with that. We only ever use a suppository for her”. Marten feels rebuffed by their comment but simply continues reading the list. Small things like this continue to happen over the following few weeks – it’s always the same HCA who makes the sarcastic comment or rolls their eyes at his suggestions. Marten knows he needs to speak with the HCA about their behaviour but feels very apprehensive about doing so. What should he do?
Ask the HCA during the next report why she continues to be sarcastic and roll her eyes
Respond with his own snarky comment, or make eye contact with one of the other HCAs on shift and roll his eyes at them
Immediately make an appointment with the manager to report the HCA’s behavour and recommend discipline
Recognize the HCA has lots of knowledge and experience with the residents. Approach the HCA during a quiet moment, acknowledge that experience and invite them to share that knowledge with him over the next few shifts.

Option D is the preferred choice.

Scenario 6

Kwame is reading the evening shift report and notes that one of the scheduled baths did not get done this morning. The evening HCAs begin to grumble about the day shift, “They always just leave the heavy work for us.” How should Kwame respond?
Click here to see one possible response

One possible approach could be for Kwame to...

Pause report. “Let’s talk about this. I’m not entirely sure what kind of a shift days had today, but I did chat with the day nurse as they were going off shift and she noted that they worked short for half the shift. Can we extend some grace and compassion towards the day team and think about what we could do to support them? We’ve all experienced working short, and during those times there’s just not enough time to get everything done. No one feels good leaving at the end of that kind of shift, knowing that some tasks remain incomplete.”

Scenario 7

Raj asks a co-worker, Liz, to assist one of the residents with their meal. Liz yells that she’s busy and why don’t they do something for a change. Raj feels attacked and embarrassed by these public remarks, how should they respond? Pick all that apply.
In a loud voice, tell Liz that is disrespectful and leave the dining room to tell their manager.
Walk over to Liz and tell her they do not wish to be spoken to in that manner.
Do not address it publicly. Find a quiet time later in the shift to explain to Liz that they would have been willing to help had she communicated her request in a respectful manner.
The response seems out of character for Liz. Find some time later in the shift to check in with her to see what might be going on for her that caused her to yell out like that (“I just want to check in with you. Your behaviour at dinnertime seemed quite out of character”).

Scenario 8

Martha overhears Sharon telling their supervisor that Martha never makes her residents’ beds. Martha knows that this statement is untrue and is upset Sharon is making her look bad, what should she do? Pick all that apply.
Confront Sharon in fron of their supervisor
Say nothing but post a snarky comment on social media about Sharon
If she feels comfortable speaking directly to Sharon, approach Sharon privately and tell her what she overheard. Ask her why she believes that.
If she doesn’t feel comfortable speaking directly to Sharon, approach her supervisor privately and explain what she overheard.

Option C and D are the preferred choices.

Scenario 9

There is a tendency for weekend staff to call in sick. It’s not always a specific person, but it is impacting everyone’s workload. It is Sunday morning and Dalisay has called in sick. The nurse-in-charge, Lindsay, overhears staff gossiping about her ‘frequent fake sick calls’. How should Lindsay address this?
Click here to view one possible approach

One possible approach could be for Lindsay to...

Call a huddle – “let’s talk about this. We don’t know what’s going on in someone else’s life outside of work. It is not our job to police our colleagues’ attendance. We will have to trust that management will address this. Our job is NOT to talk about Dalisay”

Remind staff to be soft on people and hard on problems.

As the nurse in charge, speak to management about setting up a team meeting to address concerns surrounding short staffing and outlining strategies for working with limited resources.

Scenario 10

Lisa, an LPN, worked her first, post-orientation shift yesterday morning and has come in today to find a long list on her desk, written in red pen. Lisa finds that the list is from the evening LPN yesterday and it has outlined every task that Lisa did not complete yesterday. How should Lisa react? Choose all that apply.
Speak to the evening nurse and explain that it was your first shift. State that you want to learn but ask if there is a more mutually agreeable way for constructive feedback to be offered.
Take the list to the manager and identify who wrote the list.
Confront the evening nurse, “how are you thinking this is helpful? Is this how you mentor new staff?’
I know you’ve worked here for a long time. I’d love to hear any advice you have about where/how I should prioritize my efforts.

Options A and D are the preferred choices.

Scenario 11

Harpreet was frustrated with one of her colleagues, Sukhi, after their shift this morning and wrote a scathing Facebook post. While she did not name Sukhi directly, it was obvious who she was talking about. Harpreet realised that this was inappropriate and deleted the comment later that afternoon. A different colleague had already seen the post, taken a screenshot prior to it being deleted and showed it to Sukhi.

A - What should Harpreet have done once she realized her mistake in writing the post?
B - What could Harpreet have done instead of writing the Facebook post?
Click here to view several possible approaches
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