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"WORKPLACE INCIVILITY MAY BE subtle, but its effects are not" (Cortina & Magley, 2009, p. 272). Uncivil behaviors in the workplace can negatively influence employee health, job satisfaction, productivity, commit- ment, and turnover (Andersson & Pearson, 1999; Lim & Cortina, 2005; Porath & Erez, 2007). In nur- sing workplaces, incivility has been linked to a variety of nega- tive organizational outcomes, in- cluding increased burnout and turnover intentions and decreased job satisfaction and commitment (Laschinger, Leiter, Day, & Gilin, 2009; Smith, Andrusyszyn, & Laschinger, 2010). Furthermore, workplace incivility creates a heavy financial burden for health care organizations, estimated at $23.8 billion annually in the United States to cover direct and indirect costs associated with un- civil and violent workplace beha- viors, such as absenteeism, turn- over, lost productivity, and legal action (Sheehan, McCarthy, Barker, & Henderson, 2001). Lewis and Malecha (2011) estimated the yearly cost of lost productivity due to workplace incivility to be $11,581 per nurse. Clearly, the high personal and organizational cost of workplace incivility must be addressed to promote nurse retention and to sustain effective health care organizations.
Nursing leaders are indispen- sable in creating positive nursing work environments that retain an empowered and satisfied nursing workforce (Duffield, Roche, O'Brien- Pallas,Catling-Paull, & King, 2009; VanOyen Force, 2005; Weberg, 2010). The style of leadership that nursing managers develop influ- ences important staff, patient, and organizational outcomes (Cummings, Hayduk, & Estabrooks, 2005; Leka, Jain, Zwetsloot, & Cox, 2010). Posi- tive and supportive leadership styles can lower patient mortality (Cummings, Midodzi, Wong, & Estabrooks, 2010), improve nurses' health (Boumans & Landeweerd, 1993, 1994), job satisfaction (Larrabee et al., 2003; Laschinger & Leiter, 2006), organizational commitment (Avolio, Zhu, Koh, & Bhatia, 2004; Laschinger & Leiter, 2006), emotional exhaustion (Cummings et al., 2005), and intent to stay in their position (Cowden, Cummings, & Profetto- McGrath, 2011; Duffield et al., 2009).
Hutton (2006) suggests the need for a preventative rather than reactionary approach to work- place incivility, stressing the im- portance of early diagnosis and intervention in mitigating organi- zational costs associated with toxic work environments. Nurse leaders play a critical role in estab- lishing the quality of the work environment by setting acceptable standards of behavior and ensur- ing employees have access to what they need to...