2 DEFINATIONLateral 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 anotherReduces one’s confidence and self esteem
3 LATERAL VIOLENCE * AKA* Horizontal ViolenceWorkplace IncivilityBullyingWorkplace AggressionNurses Eating Their Young
4 MANIFESTATION Talking behind one’s back Discouragement; humiliation Blocking chance for promotionBelittling or criticizing a colleague in front of others
5 MANIFESTATIONIsolating or freezing a colleague out of group activities; exclusionSabotage; withholding pertinent informationIn-fightingFailure to respect confidences and privacyEyebrow raising, snide remarks, turning away, making faces
6 WHY ADDRESS THIS AN ISSUE Lateral violence violates The Code of Ethics for Nurses with Interpretive Statements (ANA, 2001)Barriers impede knowledge & skill acquisitionTo improve professional practice lifeTo stress for new to practice nursesTo improve conflict resolution skillsTo attritionTo stop new generations of nurses from being socialized into negative practicesThe Joint Commission mandates change for patient safety in Sentinel Alert 40
8 WHO DOES IT IMPACTLateral 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).
9 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
11 Joint commission recommendation Familiarize students with The Joint Commission expectation: Sentinel Event Alert 40: Behaviors that Undermine a Culture of SafetySentinel Event | Joint CommissionIn 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).
12 TIPS ON PREVENTING LATERAL VIOLENCE (rowell, 2010) Zero tolerance toward violent of abusive behaviorProtection from retribution if reportedUtilize employee assistance programsInterrupt the violence: assess the nursing unit and raise awarenessEncourage open dialogueCreate unit specific guidelines
13 REFERENCESAmerican Nurses Association. (2001). Health and Safety SurveyChristie, 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: /OJIN.Vol19No01PPT01Coursey, J., Rodriguez, R., Dieckmann, L., & Austin, P. (2013). Successful implementation of policies addressing lateral violence. AORN Journal, 97(1),DITMER, D. (2010). A SAFE ENVIROMENT FOR NURSES AND PATIENTS: HALTING HORIZONTAL VIOLENCE, 1(3), 9-14Griffin, 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),.
14 REFERENCESJoint 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),Woelfle, C. & McCaffrey, R. (2007). Nurse on nurse. Nursing Forum, 42(3),Young, S. (2011). Does nursing school facilitate lateral and horizontal violence?. Tennessee Nurse, 74(3), 1