Civility (courtesy Dr. Andy McLean)
If you seek out the word “civility” in most any English language dictionary, you’ll get a description that defines civil discourse and/or behavior as “polite, respectful, and orderly conduct toward others—especially during disagreements or in public life.”
But how is civility tied to well-being? Civility provides a psychological safe space. Rudeness, disrespectfulness, and vitriol tend to close that space. And any organization or community that isn’t safe for open dialogue will result in people not feeling they belong, and leadership not receiving the information they need to be effective. In other words, civility is important not only for individuals, who don’t need to expend mental energy being vigilant against verbal or other attacks or ruminating, but also for organizational and community health.
Civility is modeled, and unfortunately we frequently see incivility modeled in the public square. Lack of civility can manifest covertly, subtly, and anywhere in between. However, in healthcare, we have excellent instruction in propriety going back well over a century. In a previous newsletter, I referenced Dr. William Osler’s “Aequanimitas,”—a speech to graduates at the University of Pennsylvania in 1889.
In short, Osler’s point is that where patient care is concerned, incivility in the clinic, boardroom, or operating room will lead to worse patient outcomes rather than better. Likewise, one metanalysis of healthcare workplace incivility noted such behavior in one fourth of interactions, indicating that incivility “was associated with a range of patient safety outcomes (PSOs) including near misses, adverse events, reduced procedural and diagnostic performance, medical error and mortality.”
Equanimity essentially means calmness under pressure. An additional term in Osler’s soliloquy was “imperturbability.” This is the ability to appear composed. Note the word “appear.” While being a healthcare provider requires emotional discipline, it does not mean being unfeeling, either inwardly or outwardly. There are many challenges in our day to day lives which will impact our ability to remain composed at any given moment. This is another reason for us to maintain our own health and well-being. And to be forgiving and try to do better next time when we don’t live up to our ideals.
There are times when it makes more sense to be effective rather than “right.” We need to be frugal in spending the currency of righteous indignation.
Strive to be the person others want to dialogue with, debate with, even disagree with, in the interest of patient care.
And though this appears to be somewhat of an oxymoron—an attempt at humility draped in narcissism, it was coined years ago as a reminder to myself: McLean’s Corollary, or, “There are few absolutes in life; your opinion is probably not one of them.”
If you would like to share inspirational quotes, stories, or ideas which might be helpful to others, please feel free to email Dr. Melissa Naslund at melissa.naslund@UND.edu.
