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The influence of external factors

External factors can come from many places.

They include tiredness, hunger, time constraints, feeling under pressure or being in an unfamiliar or new environment to name a few.

External stressors can impact how you interpret the situation around you and influence your reaction to it.

Video case study 1 (7mins) from the RCOG e-learning module on improving workplace behaviour explores this concept.

Practical tips

1. When external factors are influencing you it can help to make your team aware of this so they can support you.

You do not need to share all the details, but an honest “I am experiencing some difficulties, so please forgive me if I am less patient than usual and please do tell me” is hugely helpful and demonstrates good leadership/professionalism.

If factors are significantly affecting your behaviour talk to your supervisor or clinical lead and consider whether you need support or time off

2. If you find you behave in a way that could have been better, apologise and explain

3. Strengthening your ability to manage external influences, your so called ‘resilience’, can help. This should not be a substitute for addressing the external stressor directly but can be of additional help:

4. Ask for support if and when you need it

5. Look after yourself and prioritise your wellbeing

Infographic: Evolution of incivility

Infographic by Civility Saves Lives: "Evolution of incivility", showing how incivility can go on to have unintended negative consequences

See this and more infographics by Civility Saves Lives at