Background: Incivility in health care settings was first identified in 1976. Ten years later, a nurse published an article asking colleagues, “Do we eat our young?”. In 2000, the Institute of Medicine (IOM) sent a challenge for a safer health care environment and in 2008 the Joint Commission emphasized that disruptive behavior continued to compromise patient safety. Incivility in nursing is quickly becoming a topic of interest, yet it had not been studied from a qualitative approach by exploring it as a social process.

Purpose: The purpose of this grounded theory study was to adopt an abductive process to acquire an in-depth understanding of the critical factors that trigger the existence and fuel the persistence incivility in nursing and to develop a substantive theory to address the concept of incivility.

Philosophical Underpinnings: The philosophical underpinnings that guided this study were symbolic interactionism and pragmatism. Method: A constructionist grounded theory approach by Charmaz guided the qualitative research method. Individual and focus group face-to-face interviews were conducted to collect data from 29 Registered Nurses. Data analysis involved initial, focused, axial, and theoretical coding alongside memo-writing and reflexive journaling.

Results: The theory that developed from the data grounded in the voices of Registered Nurses was self-positioning. The four main categories that emerged from the gathered data supporting the theory are neglecting, alienating, relinquishing, and finding oneself. These categories represent the critical factors triggering the existence and fueling the persistence of incivility in nursing.

Conclusion: An in-depth understanding of the critical factors triggering the existence and fueling the persistence of incivility in nursing has been acquired by adopting an abductive process through a constructionist grounded theory approach by Charmaz. The theory of self-positioning serve as a guideline to nursing education, nursing practice, nursing research, and health/public policy in implementing specific plans of action to diminish the incidence of incivility, address the health and well-being of Registered Nurses, provide quality care, and ensure patient safety.