LATERAL VIOLENCE

Christina Rowland RN, BSN, AGAC-NP Candidate, 2017

NURSES EAT THEIR YOUNG

BACKGROUND

Lateral violence, is described as repeated, offensive, abusive,

intimidating, or insulting behaviors; abuse of power; or unfair sanctions
that make recipients feel humiliated, vulnerable, or threatened, thus
creating stress and undermining their self-confidence.

Lateral Violence is prevalent in all aspects of healthcare, particularly

among nurses in Acute Care

SIGNIFICANCE

The inherent stresses of dealing with high stakes situations, particularly

in acute care settings, increase the nurses vulnerability for outbursts
and disruptive behaviorsboth as the victim and as the perpetrator
(Joint Commission, 2008).

Overt vs covert

ECONOMIC IMPACT OF LATERAL

VIOLENCE

Fosters medical errors

Contributes to poor patient satisfaction and to preventable adverse

outcomes

Increases the cost of care

Causes qualified clinicians, administrators and managers to seek new

positions in more professional environments.

EXAMPLES

ROOT OF THE PROBLEM

Oppression Theory

Wounded Healer Theory

EVIDENCE BASED PRACTICE

A limitation in the literature exists because there are few studies that have
evaluated and measured the effectiveness of interventions against lateral
violence.

Although the research consists mostly of qualitative design, all experts

suggest that quantitate research is needed to measure interventions.

Some preventive measures include leadership awareness, educational

training, formulating policies, monitoring the work environment, and improved
communication

In a recent study,Howerton-Child and Mentes (2010)has proposed the

education and training of all staff, to prevent workplace violence.
Development of interventions to facilitate a positive work environment will
require application of new and exciting paradigms, as well as thoughtful
exploration and recreation of the conventional work environment

The American Association of Colleges of Nursing (AACN) stipulates interprofessional communication and collaboration for improving patient
outcomes as essential for baccalaureate nursing education with
emphasis on inter-professional and intra-professional communication,
collaboration and socialization, with consideration of principles related
to communication with diverse cultures

Teamwork and concepts of teambuilding and cooperative learning

Relationship building and group dynamics

Conflict management, conflict resolution strategies and negotiation

JOINT COMMISSIONS POSITION

The Joint Commission (2008) offers the following suggestions on how to

deal with lateral violence and incivility

Educate all team members on appropriate professional behavior as

defined by the organizations code of conduct, with an emphasis on
respect

Include training in basic business etiquette, particularly phone skills and

people skills

Hold all team members accountable for modeling desirable behaviors, and
enforce the code consistently and equitably among all staff regardless of
seniority or clinical discipline in a positive fashion through reinforcement
as well as punishment

Develop and implement WPB policies and procedures appropriate for the
organization

ANA POSITION STATEMENT

Provision 11.5 of theAmerican Nurses Association (2010)Code of

Ethics for Nurses, the Code specifically addresses the need for respect
anyone with whom the nurse interacts, as well as Caring and
companionate relationships with colleagues and others.

PLAN

Early intervention and getting prompt information about unacceptable

behavior are important. Salins 2008study showed five aspects of
prevention and monitoring of workplace bullying:

Surveys, written policies, training, information, and the statistical

reporting of the number of cases found.

Interventions for incivility and bullying behaviors are needed at both

individual and administrative levels

Formal practices, including educational programs, human resource

involvement, policies, and codes of conduct, decrease the prevalence of
bullying.