1. LATERAL VIOLENCE
CARRIE AND WINNIE

2. 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

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

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

5. 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

6. WHY ADDRESS THIS AN ISSUE
Lateral violence violates The Code of Ethics for Nurses with Interpretive Statements (ANA, 2001)
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

7. It’s all about
the Patient

8. 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).

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 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).

12. 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

13. 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: /OJIN.Vol19No01PPT01
Coursey, 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), 9-14
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), .

14. 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),
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