Part 2: Reviewing the Literature
Description of theory in article selected
The article captures the four tenets of DESC model which comprise; describe, consequence,
specify and express. From the contents of the article, there is restriction imposed by leadership
and management which curtails free flow of information, and hence low levels of employee
engagement. In essence, due to missing platforms of seamless cooperation between the health
organization leadership and low cadre employee, there is low levels of motivation for employees.
Only first line supervisors have direct contact with low cadre employees. Equally, the
communication channels have a lot of bureaucracies which limits satisfaction levels of junior
employees on ability of top management to meet their grievances (Clark & Fey, 2020) As a
consequence, there is need to change the old top down communication method to promote
inclusivity, participation and consensus building between leadership and employees.
Relationship of theory and Work Environment Assessment
According to findings of Nursalam et al. (2018), to consistently provide positive and
reenergized work place environment, there is need to foster individual self-reflection and
workplace team work model to enhance empowerment and productivity. Nurses should seek
empowerment which fuels them to seek equitable share of work, develop positive attitudes and
work based relationship and ensure that they have control in their tasks (Nursalam et al., 2018).
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Also, the article by Cynthia Clark titled, “Conversations to inspire and promote a more
civil workplace,” uses an evidenced based tool which aids in promoting awareness, which
individual and organizations teams can use to increase productivity. For instance, to promote
healthy communication, there ought to be open discussions, and spending time in conversation
for both employees and management proves useful in recognizing strategies of improving work
environment. Also, the framework proposed by Clark encourages adoption of reflection, probing
and committing to improve breakdown in communication (Clark & Fey, 2020). As a result, the
framework proposes that when nurse is faced with a challenging situation, they need to ask
themselves, the consequences of engaging in conversation or ignoring the conversation. Also, it
seeks to find out consequences to patient whenever they keep silent. More importantly, failure to
engage in conversation tend to result serious patient-care consequences.
Moreover, Clark’s framework supports adopting of safe practices such as education and
training, role playing and script development which are effective communication skills needed in
high stakes situation. Further, the framework proposes creation of safe environments between co-
workers embroiled in uncivil disputes. More importantly, Clark also proposes the description,
expression, statement and consequence statement (DESC) model to structure conversations
which border uncivility in the work place (Clark & Fey, 2020). For example, the DESC approach
is an example of evidence-based framework for improving communication and teamwork skills.
DESC models tends to foster safety and quality of care.
DESC model tend to promote four key elements for tackling incivility. Firstly, it Description of a
specific situation such as encouragement of the nurse to let the patient describe their condition of
diabetes. Secondly, it fosters expression of concerns that patients have for the nurse to tackle.
Thirdly, it encourages stating of alternatives to mitigate challenges. Lastly, Consequences stated
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should act as a warning for the nurse in contradicting the diagnosis made for the patient with
uncontrolled diabetes and possible renal failure. The same should, apply to the diagnosis done
for patient with cervical discectomy. Therefore, use of DESC model in conjunction with
cognitive rehearsal acts as effective methods of tackling incivility incidents between nurses and
other health providers (Pinckney, 2015). At the same, time use of effective communication,
conflict negotiation and problem solving are critical in meeting patient safety, and need to
provide effective patient care. Thus, to nurture collaboration, synthesis of unique strengths of
health workers of all disciplines should be assessed in their contribution to work place.