Lateral violence in NursingElly Heim, Sarai Levy, Kelli MacDonald & cindy Acker
Objectives By the end of our presentation the audience will be able to: 1. Define lateral violence. 2. Differentiate three forms of lateral violence. 3. Articulate three negative effects of lateral violence. 4. Formulate two strategies on how to deal with lateral violence.
Terms Lateral violence Harassment Enculturalisation Zero tolerance
Terms of Identification Lateral violence can be addressed by pseudonyms such as: Bullying Horizontal Violence Work Place Harassment Targeting Hazing Nurses eat their young
Forms of Lateral Violence Gossip Shunning, Ignoring and Isolation Sabotage work and credibility Curt unprofessional responses Intolerance & Blaming Lewis (2006)
Common Profile of a Bully Position of power Articulate Aware of effects of actions Opportunistic Manipulative May be protected friends in power (management) Organizationally astute Knowledge base of regulations Aware of loopholes Gained experience fromprevious incidents Lewis (2006)
Why it continues VICTIM: Under reported Weak management and leadership Fear of repercussions Avoidance / denial (hopes it will fix itself) powerlessness BULLY: Individual personalities Empowerment Satisfaction Control Entitlement
Historical Influences Oppressed Group Model Power Imbalance Nurses report mainly to physicians Lacked autonomy and control Submissive-aggressive syndrome Low self esteem Lack of self respect Sheridan-Leos, 2008
Current Influences Hospital Policy CRNNS Leaders Educators Individuals Sincox & Fitzpatrick, 2008 CRNNS, 2007
GASHA Violent Behaviour Abusive or Threatening Behaviour Abusive or Inappropriate Language Any Form of Harassment including Sexual Racism Bullying GASHA, 2008
Emotional abuse by co-worker reported by 12% Low co-worker support reported by 45% of females and 51% of males Likelihood of reporting fair or poor general health twice as high in nurses who report low respect Prevalence and Effects (Statistics Canada, 2005)
The lived experience of being bullied Stress Guilt Fear Enculturalisation Power/control Reflection/rationalization (Corney, 2008)
Effects on Work High burnout Drains nurses of enthusiasm for nursing Lack of initiative to do the job well Inability to perform optimally resulting in poor patient care (Sheridan-Leos, 2008)
Effects on the Organization Nurses leaving workplace or even profession Impact on retention of qualified staff Economic cost to organization Negative effect on recruitment of new staff due to development of a reputation for tolerating LV (Sheridan-Leos, 2008)
Combating Lateral Violence Lead by example • Compliment your coworkers • Respect each other’s idea • Support colleagues struggling with personal issues. • Think before you talk (Lubejko,2009)
Combating Lateral Violence • Don’t ignore LV behaviour • Tell someone you can trust • Document LV episodes • Assess your own behaviour • Personally addresses LV • Report incident to Nurse Manager (Sofield & Salmon;Massacsetts Nurses Associate; RCN 2005; OSACH, 2009).
Formal Resolution - Lengthy procedure - Investigation and disciplinary action are taken - Difficulty in reestablishment of working relationship (OSACH, 2009) Informal vs. Formal Resolution Informal Resolution - LV is quickly resolved - No investigation or disciplinary action taken - “No-blame” outlook - Eased reestablishment of working relationship
Ways to Stop the Cycle Redirect harmful conversations Educate self & others Self governance Proactive leadership Encourage others to not participate Continual Self governance The Promotion of positive work spaces Cleary, M., Hunt, G., Walter, G., & Robertson , M., (2009)
What can Nurse Manager’s Do? • Monitor nursing staff’s behaviour • Encourage staff (new) to report LV • Take complaints of LV seriously • Assist victims of LV in getting counseling (OSACH, 2009) • Self/Staff Education on LV -cognitive rehearsal techniques • Expect and Enforce behaviour standards • Evaluate personal leadership (Patterson, 2007)
Questions Give another term for lateral violence? What is the #1 form of lateral violence? Name one way to stop the cycle of lateral violence? What are some signs of lateral violence? Has anyone experienced or witnessed lateral violence in the workplace/at clinical? What would you do if you were a victim of lateral violence?