UMMS Affiliation

Graduate School of Nursing

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Document Type



Infectious Disease | Nursing | Occupational Health and Industrial Hygiene | Virus Diseases


BACKGROUND: Incivility among workers in the health sector is recognized as an occupational hazard. The COVID-19 outbreak brought sudden and profound changes to many health care settings, many of which have been identified as antecedents to workplace incivility. The purpose of this retrospective study was to explore the experiences of registered nurses with workplace incivility, cyber-incivility, and incivility outside of work during the early phase of the COVID-19 pandemic.

METHODS: This mixed-methods study used convenience sampling. Data were collected from June to September 2020 via an online survey, which consisted of both closed- and open-ended questions. Participants were recruited from national nursing organizations and unions. Data were analyzed using descriptive statistics and thematic analysis for open-ended responses.

FINDINGS: A total of 526 nurses' responses were included in the analysis. More than one third experienced greater incivility at work during the COVID-19 outbreak than before the pandemic (37.4%), and almost half (45.7%) said they witnessed more incivility than before the pandemic. Cyber-incivility and incivility outside of work were also issues. Qualitative results indicated that respondents felt they were on edge during this period. Other themes included leadership failure, fractured co-worker relationships, heightened incivility from patients and families, and hostility and ostracism from the general public.

CONCLUSION/APPLICATION TO PRACTICE: Occupational health nurses, nursing leaders, and staff nurses need to work to restore relations that were fractured by incivility during the pandemic. In the future, improved preparedness, including establishing clear channels of communication, may lessen incivility by decreasing role stress and organizational chaos.


COVID-19, cyber-incivility, incivility, occupational stressors, registered nurses

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Copyright © 2021 The Author(s). This article is distributed under the terms of the Creative Commons Attribution 4.0 License ( which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (

DOI of Published Version



El Ghaziri M, Johnson S, Purpora C, Simons S, Taylor R. Registered Nurses' Experiences With Incivility During the Early Phase of COVID-19 Pandemic: Results of a Multi-State Survey. Workplace Health Saf. 2022 Mar;70(3):148-160. doi: 10.1177/21650799211024867. Epub 2021 Jul 28. PMID: 34318719; PMCID: PMC8322958. Link to article on publisher's site

Journal/Book/Conference Title

Workplace health and safety

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Creative Commons License

Creative Commons Attribution 4.0 License
This work is licensed under a Creative Commons Attribution 4.0 License.