LATERAL VIOLENCE CARRIE AND WINNIE

DEFINATION Lateral violence is any verbal or physical abuse behavior in the workplace by one employee to another who is in either an equal or lesser position (Woelfle & McCaffery, 2007) Results in injuring the dignity of another Reduces one’s confidence and self esteem

LATERAL VIOLENCE * AKA* Horizontal Violence Workplace Incivility Bullying Workplace Aggression Nurses Eating Their Young

MANIFESTATION Talking behind one’s back Discouragement; humiliation Blocking chance for promotion Belittling or criticizing a colleague in front of others

MANIFESTATION Isolating or freezing a colleague out of group activities; exclusion Sabotage; withholding pertinent information In-fighting Failure to respect confidences and privacy Eyebrow raising, snide remarks, turning away, making faces

WHY ADDRESS THIS AN ISSUE Lateral violence violates The Code of Ethics for Nurses with Interpretive Statements (ANA, 2001) http://www.nursingworld.org/codeofethics Barriers impede knowledge & skill acquisition To improve professional practice life To stress for new to practice nurses To improve conflict resolution skills To attrition To stop new generations of nurses from being socialized into negative practices The Joint Commission mandates change for patient safety in Sentinel Alert 40

It’s all about the Patient

WHO DOES IT IMPACT Lateral Violence negatively impact both the work environment and the nurse’s ability to deliver optimal patient care. 40% of clinicians “kept quiet” or “ignored” an improper medication due to an intimidating colleague (Institute for Safe Medication Practices, 2004). Low staff morale, increased absenteeism, attrition of staff, deterioration in the quality of patient care. Nurses leave the profession due to lateral violence and bullying contributing to the nursing shortage. A study of student nurses reported that 53% had been put down by a staff nurse (Longo, 2007). 56.9% reported having been threatened or experienced verbal abuse at work (ANA, 2001).

Lateral violence and theory of nurse as a wounded healer After experiencing a traumatic event, an individual’s coping strategies are either effective or ineffective. When an individual’s coping is ineffective, the impact of the trauma is unrecognized and the pain remains unresolved. These individuals then function as a ‘walking wounded,’ and experience problems in their social, intimate, and work relationships. In denying their own conflicts and vulnerabilities, these individuals project their anger on  both patients and colleagues while considering themselves unharmed, yet being less able to empathize with others

Joint commission recommendation Familiarize students with The Joint Commission expectation: Sentinel Event Alert 40: Behaviors that Undermine a Culture of Safety Sentinel Event | Joint Commission In 2006, the Joint Commission established standards for healthcare providers that include a standard of leadership for all. Under this leadership standard, agencies are mandated to recognize and correct behaviors that are inappropriate and disruptive within the workplace. This standard calls to action all in leadership positions (Joint Commission Resources, 2006).

TIPS ON PREVENTING LATERAL VIOLENCE (rowell, 2010) Zero tolerance toward violent of abusive behavior Protection from retribution if reported Utilize employee assistance programs Interrupt the violence: assess the nursing unit and raise awareness Encourage open dialogue Create unit specific guidelines

REFERENCES American Nurses Association. (2001). Health and Safety Survey Christie, W., Jones, S., (December 9, 2013) "Lateral Violence in Nursing and the Theory of the Nurse as Wounded Healer" OJIN: The Online Journal of Issues in Nursing Vol. 19 No. DOI:10.3912/OJIN.Vol19No01PPT01 Coursey, J., Rodriguez, R., Dieckmann, L., & Austin, P. (2013). Successful implementation of policies addressing lateral violence. AORN Journal, 97(1), 101-109 DITMER, D. (2010). A SAFE ENVIROMENT FOR NURSES AND PATIENTS: HALTING HORIZONTAL VIOLENCE, 1(3), 9-14 Griffin, M. (2004). Teaching cognitive rehearsal as a shield for lateral violence: An intervention for newly licensed nurses. The Journal of Continuing Education in Nursing, 35(6), 257-263. .

REFERENCES Joint Commission Resources. (2006). Civility in the health care workplace: Strategies for eliminating disruptive behavior. Joint Commission Perspecitve of Patient Safety, 6(1), 1-8. Longo, J. (2007). Horizontal violence among nursing students. Archives Of Psychiatric Nursing, 21(3), 177-178 Woelfle, C. & McCaffrey, R. (2007). Nurse on nurse. Nursing Forum, 42(3), 123-31. Young, S. (2011). Does nursing school facilitate lateral and horizontal violence?. Tennessee Nurse, 74(3), 1