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Lateral Violence in Nursing

This presentation goes through what lateral violence in nursing is, why it is a problem, and proper interventions on how to manage and possibly eliminate it.

Allison Whitener

on 1 May 2011

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Transcript of Lateral Violence in Nursing

LateralVIolence Is 'Nurses Eating their Young' REALLY a current issue in nursing? First off: What is it? Lateral Violence: "nurse on nurse aggression and inter-group conflict ( Stanley, 2007)."

Horizontal Violence
Horizontal Hostility
Verbal Abuse
More commonly known as “ Nurses eating their young” Griffin study pointed out the top 10 most frequent forms of lateral violence in nursing by frequency. HOW IS nursing impacted by this? High stress level Recognize when bullying exists An effective leader can use interpersonal skills to influence other nurses to work towards the goal of eliminating lateral violence. WHAT CAN we TAKE FROM THIS?? How could effective management improve Lateral Violence? More research is being done to determine the best ways to reach the nursing population regarding education and prevention of lateral violence SOURCES sources in nursing Most at Risk:
Main reason: Facing obstacles in a new environment
Evidenced Based: “Approximately 60 of newly registered nurses leave their first position within six months of employment because of some form of lateral violence” (Sheridan-Leos, 2008).
OR Nurses: Griffin states “ No other area in the hospital has a higher probability of lateral violence than the operating room” (Patterson,2007) Least at Risk
Main reason: Men are more dominant and more likely to express their views. RISKS/POPULATIONS #1: Nonverbal innuendo raising of eyebrows, making faces #2: Verbal affront lack of openness, abrupt responses #3: Undermining #4: Withholding information #5: Sabotage #6: Infighting #7: Scapegoating #8: Backbiting #9: Failure to respect privacy #10: Broken confidences turning away, intentionally not available deliberately setting up a negative situation bickering with peers attributing all that goes wrong to one individual complaints to others about a nurse and not speaking directly to her “ Powerlessness triggers a cycle of oppressed group behaviors among nurses leading to frustration, non assertive behavior, non support of coworkers, and conflict in the work environment” ( Stanley, 2004). Origin of Lateral Violence/ Theory “nurses are an oppressed and powerless group dominated by others” (Sheridan-Leos, 2008).
Oppressed because nursing is mostly women reporting to mostly male physicians and administrators Oppressed-Group Model Submissive-Aggressive Syndrome ‘describes when nurses feel they have lost their power and react by overpowering others through aggressiveness’(Sheridan-Leos, 2008)”. LITERATURE SUPPORTS THIS.. Freire’s Oppression Theory “members of an oppressed group display common behavioral characteristics (low self esteem and self-hatred) “ (Sheridan-Leos, 2008). Nurses feel powerless and oppressed in healthcare, feeling alienated and having little control
Instead of using confrontation nurses express their frustration on other nurses through lateral violence
Often nurses say that lateral violence is a ‘safer’ form of stress relief than confrontation Lateral violence affects quality of pt care and contributes to the breakdown of communication between staff. financial problems due to absence reduced self esteem sleep disturbances increased depression or self blame emotional withdrawal from patients painful feelings perpetuation of power imbalances anger guilt depression such as what should you do If you experience lateral violence? Utilize behavioral health services as needed Be aware of the effect of bullying and look for signs that bullying if affecting you Know your rights. Be knowledgeable about policies and procedures in your workplace. Document the specifics for all incidents of bullying Prepare for the possibility that the organization will prioritize their interests If other measures fail then seek legal counsel (Murray, 2009) How can effective leadership improve lateral violence? #1 An effective leader recognizes when lateral violence exists, and recognize that it is an important problem that needs to be handled. #2 An effective leader will recognize any role he/she plays in lateral violence, and he/she will take responsibility to change any negative behavior. Effective nursing leaders are role models for other nurses on how to trust and respect their fellow staff nurse. A supportive, caring work environment based on trust and respect diminishes lateral violence. #3 When there is a conflict, an effective nurse leader will use a technique called “carefronting” instead of confronting. #4 In this technique, the nurse leader will use concepts such as respect, forgiveness, and courage to bring about a resolution. An effective leader will integrate both his/her personal needs and the needs and wants of others. By considering others wants and needs, an effective leader handles the situation and person/people involved in a responsible manner. An effective nurse leader practices healthy ways to release anger such as diffusing anger. #5 Effective leadership includes enhancing work relationships by encouraging socialization outside of the workplace. #6 #1:
Managers need make sure that their staff is knowledgeable about Lateral Violence so that they can understand it and recognize it in the workplace. “The use of cognitive rehearsal will help provide nurses with the skills to combat Lateral Violence, and could be an effective method in preventing the negative consequences of Lateral Violence. .”(Embree & White, 2010) “Cognitive Rehearsal asks individuals to hold in their mind information that they have just received. The act of consciously not responding, or not reacting, allows individuals time to process the information based on what they have previously been taught about the information coming in.” (Griffin, 2004) #2: #3:
Behavioral Intervention can also be used, which is immediate confrontation of the nurse who practices Lateral Violence. (Griffin, 2004) #4:
Managers could also use mediation techniques to identify conflicts early and by resolving them through listening, reframing the concern, identifying a common ground, and by clearly defining decisions. (Center for American Nurses, 2008) #5:
Managers need to let their staff know that there will be no tolerance of Lateral Violence on the Unit. #6:
Emphasize that as of 2007 the Joint Commission had incorporated Lateral Violence into its standards. (Center for American Nurses, 2008) #7:
Organizational Strategies that could be implemented are the development of multidisciplinary groups to survey staff and their behaviors, develop educational opportunities, establish standards in the workplace regarding behaviors, emphasizing zero tolerance of Lateral violence, and rewarding positive behaviors. (Center for American Nurses, 2008) Lateral violence occurs across all disciplines and specialties of nursing. It is up to US to bring an end to lateral violence as it can only be stopped if: Work environments are created that do not support the behaviors and attitudes that are involved in or lead to lateral violence. Nurses must speak up if they are a victim of lateral violence or have witnessed lateral violence occurring. Lateral violence needs to be eliminated from nursing schools as well; to reach this goal education on lateral violence needs to be implemented into the curriculum. Units need to create a way to investigate if lateral violence is occurring among coworkers ( Ex: exit interviews). Suggestions for creating a disciplinary system that is solely responsible for addressing lateral violence on nursing units. In the end, the quality of patient care is negatively impacted, as well as the nurse’s professional experience.
"Horizontal violence seems ironic in a discipline that has caring for others as its main focus." (Woelfle & McCaffrey, 2007) Presented by: Sowsina Gola, Aimee Gray, Rebecca Jackson, Kristen Morgan, Serena Ridenhour, Allison Whitener
Brothers, D., Condon, E., Cross, B. A., Ganske, K. M., & Lewis, E. (2010, November). Taming the beast of lateral violence among nurses. Virginia Nurses Today, 18(4), 7-11. Retrieved from EBSCOhost. Center for American Nurses. (2008). Lateral Violence and Bullying in the Workplace. 1-12. Dulaney, P., & Zanger, L. (2010, July). Practice and Academic Leaders: What Are You Doing to Stop Lateral Violence. Lateral Violence Update: We Are Still Listening & We Thank You, 11. Retrieved April 29, 2011. Embree, J.L. & White, A.H. (2010). Concept Analysis: Nurse-to-Nurse Lateral Violence. Nursing Forum, 45(3). 166-173. 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. continued Kelly, B. (2011). Lateral violence. ISNA Bulletin, 37(2), 1. Retrieved from EBSCOhost. Leos-Sheridan, N. (2008). Professional issues. Understanding lateral violence in nursing. Clinical Journal of Oncology Nursing, 12(3), 399-403. Retrieved from EBSCOhost. Patterson, P. (2007). Opening managers' eyes to lateral violence. OR Manager, 23(12), 10-11. Retrieved from EBSCOhost. Stanley, K., Martin, M., Michel, Y., Welton, J., & Nemeth, L. (2007). Examining lateral violence in the nursing workforce [corrected] [published erratum appears in ISSUES MENT HEALTH NURS 2008 Jan;29(1):97]. Issues in Mental Health Nursing, 28(11), 1247-1265. Retrieved from EBSCOhost. Woelfle, C.Y., & McCaffrey, R. (2007). Nurse on nurse. Nursing Forum, 42(3), 123–132.
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