Respect Saves Lives: How to Tackle Incivility in Healthcare

Incivility among hospital or clinic staff isn’t just about workplace culture. It’s a patient safety issue that must be addressed. Margaret Curtin with Curi Advisory Risk Consulting shares the steps all healthcare leaders can take now. 

Every day, we’re inundated with reports of violence and incivility in our communities. Unfortunately, these acts and the emotions that accompany them don’t stop at the hospital or clinic door. As healthcare leaders, we often find ourselves in environments where defiance, disrespect, anger, and hostility spill into our professional spaces.

While much attention is paid to “external” threats in healthcare, such as from patients, a quieter, more insidious danger often goes unaddressed: unprofessional behavior among staff. This “internal” incivility is more than just a matter of workplace culture—it’s a patient safety issue.

Keep reading for the steps you can take as a practice, clinic, or hospital leader to help halt incivility in healthcare.

Key Takeaways:

• Incivility in healthcare is unfortunately common, with more than half of nurses reporting experiencing incivility in the past year, and over 30% of physicians saying they regularly receive rude, dismissive, or aggressive communication.
• Workplace incivility can be disruptive, undermining team cohesion, morale, and overall organizational culture, as well as impacting patient safety.
• Healthcare leaders can reduce risk and enhance their organization’s culture by implementing a zero-tolerance behavior policy, providing team building and conflict resolution training, and investing in resources to improve staff well-being.

What Is Incivility?

Incivility has been described as low-intensity behavior with ambiguous intent to harm its target. It violates workplace norms for mutual respect and is typically characterized by rude, discourteous, or disrespectful actions, whether verbal or non-verbal.¹

These behaviors include belittling comments, dismissive gestures (such as eye-rolling or sighs), gossip, social exclusion, impatience with questions, and condescending language or tone.

Incivility among healthcare professionals is prevalent, with 53% of nurses reporting experiencing incivility in the past year, and 31% of physicians reporting receiving weekly or daily rude, dismissive, or aggressive communication.^2,3

The Hidden Threat of Incivility

While dismissive remarks, passive-aggressive responses, or simply ignoring a colleague’s request for help may seem minor or relatively harmless, research shows these actions can have serious consequences for performance, communication, and, ultimately, patient outcomes. Studies show that hospitals with a toxic work culture have a higher incidence of medical errors.⁴

In particular, I’ve seen that tensions between nurses and physicians can upend entire departments. At times, incivility may even border on bullying (which can be differentiated by more deliberate intent to harm and can fall under workplace harassment). Power dynamics are real.

Examples of the impact of incivility between physicians and nurses:

• Heard at an Anesthesia Patient Safety Foundation conference, a certified registered nurse anesthetist (CRNA) was verbally dismissed by a surgeon. Eye-tracking video later showed the CRNA became distracted for over 10 minutes afterward, unable to focus fully on the patient. The implication was clear: a moment of unprofessionalism can ripple into clinical risk.
  
  
• In an interview during a risk assessment, I was told that an OB/GYN pocketed a sponge post a C-section so that the circulating nurse’s sponge count would be inaccurate, as a form of retaliation for reporting the physician’s unprofessional behavior. The circulating nurse was concerned, which caused the patient to undergo unnecessary procedures to look for the sponge in the following days.
  
  
• During a malpractice case review it was identified that a labor and delivery nurse did not alert the obstetrician about a worrisome fetal heart tracing during the night because they had been yelled at and demeaned for calling the physician earlier in the evening. The patient underwent an emergency C-section the next morning, and the child was born with significant neurological impairment. The malpractice claim was settled in the high range on behalf of the hospital.

Why Civility Matters for Patient Safety

Incivility doesn’t have to be overt to be dangerous. Eye-rolling, sarcasm, or avoidance can create an environment where staff hesitate to speak up—even when patient safety is at stake. Communication breakdowns are the most common root causes of adverse medical events and malpractice claims.

Even being a bystander to rudeness affects performance. In one study, NICU teams that received a rude, disparaging introduction from a leader performed significantly worse in simulated medical scenarios than teams that received positive reinforcement.⁵

The message is clear: Small acts of disrespect can have big consequences.

4 Steps Leaders Can Take to Combat Workplace Incivility

1. Implement and enforce a zero-tolerance behavior policy that defines unprofessional behavior and includes reporting mechanisms with consequences for retaliation.
2. Model effective communication skills and provide/receive training in conflict resolution: Proven strategies include active listening (giving full attention to the speaker, not interrupting, reflecting back what you hear); viewing conversations as dialogue, not debate (avoiding jumping in to fix, argue, or contradict); and being accountable (monitoring your tone and body language, responding to inappropriate behavior with calm boundaries).
3. Provide training programs on team building: These can go beyond communication and conflict resolution; for example, they can highlight team dynamics, clarify roles and goals, create shared experiences, and help with decision making.
4. Invest in resources to improve well-being, including peer-support networks and mentorship programs.

Final Thoughts: Respect Is a Safety Tool

I recently listened to a podcast on conflict intelligence that underscored the need to write about this topic now. The expert being interviewed stated that, in general, incivility on the job is worsening, and it costs companies billions of dollars in lost productivity and staffing every day. In the healthcare setting specifically, the literal and metaphorical costs are just too high.

We talk a lot about clinical protocols, checklists, and technology to improve patient outcomes. But sometimes, the most powerful safety tool is something much simpler: respect.

When we treat each other with professionalism and civility, we create an environment where communication flows, focus is sharper, and mistakes are less likely to happen. We don’t just make the workplace better—we make it safer for everyone.

It’s time to start seeing civility not just as a workplace courtesy, but as a patient safety imperative.

Curi Resources

Curi Advisory Risk Consulting, powered by ERC, is here to help. We can support your training and education needs around communication, teamwork, and psychological safety.

Dealing with more than incivility? Discover strategies for workplace violence prevention. 

References:

1. Lippincott Nursing Center. (2025). Workplace Incivility, Nursing Pocket Card. https://www.nursingcenter.com/clinical-resources/nursing-pocket-cards/pocket-cards-post?identifier=workplace-incivility#/clinical-page/pocket-cards-post
2. (2024). Physician Incivility in the Healthcare Workplace. https://www.cmpa-acpm.ca/en/advice-publications/browse-articles/2024/physician-incivility-in-the-healthcare-workplace
3. (2025). Nursing Leadership Insight Study. https://www.aonl.org/system/files/media/file/2025/03/AONL-Nursing-Leadership-Insight-Study-2025.pdf
4. Freedman, Benjamin et al. (2024). The prevalence of incivility in hospitals and the effects of incivility on patient safety culture and outcomes. JAN. https://doi.org/10.1111/jan.16111
5. Riskin A, et al. (2015). The Impact of Rudeness on Medical Team Performance: A Randomized Trial. Pediatrics, 136(3), 487-95. https://doi.org/1542/peds.2015-1385

SHARE THIS POST