The Cosmic Connection—Susan Luparell, Kathleen Heinrich and Cynthia Clark—snowshoeing in the mountains of Idaho.

Susan Luparell: We know, anecdotally, that the problem exists in a number of settings. As we know from the literature, there is horizontal violence between staff nurses in practice settings. And it’s also in the academic world—not only with students acting uncivilly toward faculty, but also faculty to students and faculty to other faculty. What really piqued my interest and made me realize, “Wow, this may be a big problem!” was literature that came out in 2001. A national survey asked faculty to indicate how often they were seeing certain behaviors (Lashley & de Meneses, 2001).

These behaviors ranged from tardiness, talking in class and being inattentive to more egregious behaviors, such as students yelling at faculty in the classroom and yelling at faculty in clinical sites. They also mentioned physical contact by students, and the numbers for that were pretty astonishing. Everyone reported that students were inattentive and talked in class, but close to 40 percent of respondents said faculty had been yelled at by students in the classroom. Nearly 50 percent said faculty had been yelled at by students in clinical studies, a setting where students are assumed to be on their better behavior. Almost 25 percent of respondents, one in four, had some kind of uninvited physical contact—students throwing chairs, for example.

Cynthia “Cindy” Clark: My clinical background is in psychiatric nursing. Prior to coming to academe, I worked mostly with violent youth as a family and adolescent specialist. My clinical practice, to a large extent, involved adjudicated, violent youth, and my specialty area was violence prevention. Now, fast-forward to the mid-1990s, when I began teaching in higher education. I didn’t see much of the troublesome behavior that Susan cited, but about the time the Lashley study came out, I began to see my students changing their behaviors and started thinking, “Gosh, I’m seeing some behaviors that, if we don’t make interventions early, could result in what I used to see as violence.”

I started doing kind of “person-on-the-street” interviews with other faculty and discovered they were having similar experiences. Getting into the literature and reading Susan’s dissertation were like, “Yeah, this is real!” Since then, I’ve been studying it with a vengeance in both education and practice, and developing instruments. I’m now free to empirically look at myriad levels of incivility—not only students to faculty but also between faculty and students and student-to-student incivility. I am currently conducting a study to examine how nursing education can help prepare nursing students to deal with, prevent and address incivility in the practice setting.

Kathleen “Kathy” Heinrich: Incivility was not my dissertation topic. I came to it through a number of synchronicities. I’ve been teaching since 1978 and, throughout those years, have experienced wonderful, collegial relationships. I’ve also seen and experienced a lot of incivility. I had never considered making a study of incivility until 2005, when I was asked by the National League for Nursing [NLN] to participate in a plenary session. As a panelist, I had seven minutes to address faculty-faculty incivility. I accepted, assuming I could find something written on the topic. When I didn’t find anything in the literature, I gave the 1,400 nurse educators in our audience a minute to write about a time when they were left “feeling disrespected, disregarded or dismissed by a faculty colleague or administrator.”

After they shared their stories with one another, I said, “If you give me your stories—without names—I will analyze them, as if they were qualitative data, and share them with other nurse educators.” Two hundred and sixty-one of them did that. One of those storytellers, recalling an incident with her administrator, observed, “I knew she was joy stealing.” And I thought, stealing joy, that’s exactly what being on the receiving end of incivility feels like.

So, from those stories emerged 10 “joy-stealing games,” as I came to call them. I fulfilled my promise, wrote several RNL articles on the topic and thought, now I’ll go back to doing what I do for a living, preparing faculty groups to present and publish. What I hadn’t counted on—and this was serendipitous—was meeting Cindy on that panel and then connecting with Susan. Here we are, five years later, still involved with each other and the topic of incivility.

Morin: You’re all on the cutting edge of this topic. How did you connect?

Luparell: Oh, Cindy’s responsible for that. We tease her about being an extrovert. Dr. Cindy Clark brought us together.

Clark: I met Kathy on a conference phone call set up to prepare us for the plenary session at the 2005 NLN Summit. I was like, this woman is cool! So I reached out to Kathy. I had read Susan’s work before and thought she was great, too, so I said, “I think the three of us have something here.” We had our first “Cosmic Connection” phone call on October 17, 2005. It was magic. I remember feeling a sense of tremendous joy and relief. I also remember, in our second call, being very tearful, because of what I had been dealing with—the stories I had been hearing—and finding Kathy and Susan such a safe place, with such a dear, collegial kind of warmth. I thought, this is working for me.

Heinrich: I felt exactly the same way. It was such a relief, after having read these very disturbing and upsetting stories, to speak with two colleagues who knew what that felt like and were so committed to initiating change. It was amazing. While I was ambivalent about whether I wanted to continue studying incivility, I loved talking with Susan and Cindy.

Our monthly, hourlong phone calls became such a valued part of my life that I decided to make cultivating civility a research area of mine. After about six months, remembering back to past collaborations that started out with a honeymoon phase and ended up hellish, I screwed up my courage to say: “I so value you two that I want to make sure we keep our connection as productive and pleasurable as it is right now. Would you be willing to formalize our relationship into a mutually beneficial partnership?”

Like all good pioneers, they said, “Well, OK, but what is that?” I explained that this meant each of us would come to our next phone call with a list of wishes, along with a list of fears and concerns, about entering into this relationship. From these sharings, we would craft a partnership agreement that included a contract and a covenant. The contract is a nuts-and-bolts, task-oriented agreement about who does what when; the covenant is an agreement about how we’re going to treat each other. To my delight, Susan and Cindy agreed.

So in our next monthly phone call, in a lively conversation, we shared our wishes. The phone call a month later was so different. This time, you could have heard a pin drop. It was the first time any of us had shared our fears and concerns about entering into a relationship with prospective partners, and it turned out to be a pretty frightening thing to do. To give an example, here’s a fear I shared. Ours is a threesome, I said. I grew up with two sisters. So there were always two innies and one outie. I was afraid that Susan and Cindy would go to conferences, or whatever, and talk about me, and I would be left out. I felt very vulnerable sharing this tidbit of family history with professional colleagues, but Cindy and Susan’s warm understanding quickly dispelled my concern.

Having expressed our wishes, fears and concerns, during the next phone call we discussed our partnership agreement. From our wishes, we crafted our contract about the nuts and bolts. For instance, we agreed that we would converse once a month about the joys and challenges of conducting our respective research and disseminating the findings in presentations and publications.

For our covenant—how we treat each other—our first rule was to assume best intentions always. To address my specific concern, we agreed that, if two of us speak with each other about anything that involves the third partner who isn’t present, the two would share that discussion with the third in our next phone conversation. That made me feel so safe; I have never been concerned about being an outie again. The power of these partnership practices? Our conscious compact has kept our threesome pleasurable and productive over these last five years.

We decided to call ourselves the Cosmic Connection, because we always felt so energized after our phone calls. With our partnership agreement crafted, we created a vision that reads: “Our relationship is a soft place to land that fuels each partner’s passion for her own scholarly endeavors in ways that catalyze her scholarly productivity and enhance her individual and our collective scholarly development.” Actually, the phrase “a soft place to land” is Cindy’s, and that’s what we have become for each other.

Our vision balances our desire to be recognized for our individual work with our desire to help each other. Beyond giving us direction, it challenges us to grow individually and as a group.

Clark: That’s why we wanted to do the webinar together. Our goal is to take what we’ve learned about fostering civility and positive relationships to the greater nursing community, to make it safe to talk about. The goal for all three of us, as we travel to workshops, etc., is to provide a safe place for stories to be told, a place for healing to occur. In every single workshop I conduct, at some point I ask the nurse educators in attendance this question: How many of you, in your master’s or doctoral programs, have been taught how to effectively manage classroom behavior? I can have an audience of 200, and just a few participants will raise their hands! To be able to normalize for them, that’s why we’re here. Managing a classroom or a clinical experience isn’t something most of us learn in our graduate programs. I enjoy providing a safe space to talk about that and bring it to the fore.

Luparell: By the way, we don’t just sit around, hold hands and sing “Kumbayah”! We discuss really practical and functional matters. It can be very draining to immerse your scholarly life in researching and thinking about, virtually nonstop, the topic of incivility. You wake up in the middle of the night thinking about some aspect of it—variables, what should be studied, etc. Early on, we realized we were among, if not the only three, just a handful of folks who were really passionately interested in understanding the topic. In my institution (Montana State University, Bozeman, Montana), most of the scholarly work is more traditionally focused on health, wellness, illness and other kinds of nursing scholarship.

So for me, and also for Cindy in her academic setting—Boise State University, Boise, Idaho—to take this less traditional scholarly route and seek validation for it, that it was indeed a worthwhile way to spend our time, was very important. At the same time, knowing about the competition that can be involved in scholarship, in academics, regardless of your discipline, those were some of our concerns. We talk about so much. How would we sift out whose idea was whose? And how would we handle it if something I said came up in an article Cindy wrote? And that’s where the rule—always assume the best intentions—came into play. That was very important for me.\

One of the other terms we used was that we’re “bone honest” and so, when we call in to our group, we’re going to say what we think, not only in terms of critiquing one another’s ideas and getting feedback, but also how we’re feeling about something. We also have a kind of shared understanding—and it’s a very difficult road to walk when you’re leading a workshop on this—that many faculty members come to workshops to see what can be done about troublesome students. But it’s not a one-sided problem. Everyone plays a part and, as faculty members, we need to turn the mirror on ourselves to see whether it’s because of a lack of initial training or other individual practices.

The issue is so complex. It’s a difficult road, to help people look at this topic more broadly than maybe they intended when they picked up one of our articles or came to one of our workshops. To talk about civility is hard. So, for me, besides the friendships we’ve developed, I find real practical use for our group. Although we’ve been talking monthly since 2005, we’ve laid eyes on each other fewer than a handful of times. I’ve seen Kathy in person maybe five or six times, and Cindy and I, even though we’re geographically closer to each other than we are to Kathy, we’ve seen each other even fewer times than that. But it feels like we’ve known each other for a long time. If I saw them walking on my street right now and ran out to greet them, it would feel like we just had coffee together yesterday. The three of us have been together only once, and that was during a conference in Boise (see photo). RNL

To be continued

Karen H. Morin, DSN, RN, ANEF, FAAN, president of the Honor Society of Nursing, Sigma Theta Tau International, is graduate programs director and professor at the University of Wisconsin-Milwaukee College of Nursing. Cynthia Clark, PhD, RN, ANEF, FAAN, is a professor of nursing at Boise State University in Boise, Idaho, USA. Clark’s principal body of research is in the area of fostering civility in nursing education and practice, including the role of nursing education in preparing future nurses to address incivility in the practice setting, faculty-to-faculty incivility, and intervention studies. Susan Luparell, PhD, ACNS-BC, CNE, assistant professor of nursing at the College of Nursing, Montana State University, Bozeman, is an experienced critical care clinical nurse specialist and teaches a graduate course on effective clinical teaching. Kathleen Heinrich, PhD, RN, educator, author and speaker, is principal of K T H Consulting in Guilford, Connecticut, and author of the book A Nurses’ Guide to Presenting and Publishing: Dare to Share.

Reference:
Lashley, F. R., & de Meneses, M. (2001). Student civility in nursing programs: A national survey. Journal of Professional Nursing, 17(2), 81.

Previously published RNL articles on the topic of civility:

By Cynthia Clark
“The sweet spot of civility: My story”
"Why civility matters” 
“What educators can do to promote civility”
“What students can do to promote civility”
“From incivility to civility: Transforming the culture"

By Kathleen Heinrich
“Joy-stealing games”
“Joy stealing: How some nurse educators resist these faculty games” 
“Full-circle moment: Recognizing the joy stealer within”