Argument Against Lateral Violence

Alexandra Robbins was writing a book about the secrets of the nursing subculture in hospitals around the United States. One surprising thing that kept coming up was the practice of hazing. Hazing is when a person is put through tests or challenges normally to humiliate her. The practice has even turned deadly in some cases. Some examples of hazing in the hospital are colleagues keeping vital information to themselves, playing favorites, name-calling, spreading rumors, and even discrediting other nurses until they quit. Nursing is the number one profession to experience some type of hazing from older or better nurses. It is getting so bad that the rate of nurses quitting due to hazing has drastically gone up in the last 30 years. In one case,

Internationally, various studies and reports have raised concern regarding hostile behaviors in the nursing workplace. Incivility in nursing is defined as rude or disruptive behaviors which often result in physiological or psychological distress for people involved and if left unaddressed, may progress into a threatening situation (Broome 2011). Although aggression and violence from patients and visitors are cause for concerns, nurses reported hostility among colleagues, managers and other professionals have been the most concern and an impact to nurses’ society. Incivility defines as “a rude or unsociable speech or behavior (Merriam 2010). The types of behaviors that constitute between nurses can be due to stress, heavy workload, bullying, harassment and aggressions. Incivility and bullying in nursing are complex problems that have garnered much attention in recent years (Felbinger 2008). Emerging evidence suggests that incivility in the workplace has significant implications from nurses, patients, and health care organizations causing a high turnover rate.

Imagine being a newly graduated nurse and landing a job on your dream unit. There is this one nurse who likes to taunts the new nurses. You began to realize that she does things to make you uneasy and you began to feel like the target of workplace bullying. Horizontal Violence has become a newly coined termed to further define the concept of bullying in the workplace. According to Becher and Visovsky (2012), Horizontal Violence is described as “an act of hostility that creates an undesirable work environment that weakens teamwork in the clinical setting”. Managing bullying is the regular assessment of exposures of violence in healthcare facilities. As a junior nursing student I gravitated toward this topic because I will be graduating soon

Healthcare workers suffer the most when it comes to workplace violence. Violence in the workplace can have major effects on the victim such as depression and post-traumatic stress disorders. It can also lead to many emotional behaviors such as feeling sad, angry, disgust or fear felt by the victim. These emotions can have an influence on work functioning. Violence in the healthcare work is a major issue and is constantly growing than any other work field. “Healthcare workers are 16 times more at risk of experiencing violence from patients or clients than other service workers” (Lanctôt, N., & Guay, S. 2014). The most common abuse seen in the healthcare work is verbal abuse ranging from 22 to 90%, and the least being physical assault ranging

Conflicts within the nursing profession may be seen among the different age generations, with senior nurses holding different values than new graduates. For example, there are many cases where horizontal violence and bullying occurs between senior nurses and new nurses. However, in most cases, nurse bullying results from ineffective communication (Sauer, 2012). Interprofessional conflict may occur due to the medical hierarchy and existing profession stereotypes. According to Whitehead (2007), a barrier to physician collaboration is the vision of a ‘flattened hierarchy’ where a physician’s traditional power, decision-making responsibility, and status is reduced. Although these traditional beliefs may still be held among not only physicians but also the public, IPE and IPC allow for the potential of “better communication and development of relationships between health care professions that can be valuable even within a hierarchical system” (Whitehead, 2007, p.

Workplace incivility affects our everyday interactions, professional nursing relationships and our organizations. It is important to be aware of incivility to address it. Incivility in the workplace doesn’t have to be a major event, but it may be little things daily that can make a huge impact. This affects the employee which impacts productivity and patient care. Employee turnover rates, job dissatisfaction, and poor workplace environments can be attributed to incivility. Employees may feel as though they are unable to report incivility due to retribution or loss of employment. It is time for people that need help to be courageous and speak up. Incivility in the work environment needs to stop.

A literature review was conducted to answer the following evidence-based research question "What are the effects of horizontal violence in the workplace on nurses and patient care?" The review includes a systematic review, two qualitative reviews, one quantitative review and a mixed method review that will aid in answering the research question while focusing on the effects of horizontal violence on nurses and what interventions could possibly be used to prevent this type of violence in the workplace. These studies were retrieved through various electronic databases in which will be discussed in the remainder of the literature review. The literature that was used were all published within the last five years with four of them being published in the United States and one from the United Kingdom. Information regarding the reports such as research limitations, level of evidence, research method and design are included in the discussion and implications of nursing. The literature review found that nurse on nurse bullying does indeed effect nurses in a physical and emotional way as well as effecting the adequacy of patient care.

Since starting the LPN program, I have seen some unprofessional actions presented by some of the facilities. For example, we were visiting Life Care Center South Hill a few weeks ago and arrived at 5 AM and was expected to be on the floor by 6 AM for the shift exchange and report. However, more than a handful of the nurses, including the aids were at least 15 minutes late for their shift almost every single day that we were there. Patient’s call lights were going off and been left unanswered due to the night shift had already “signed off” from their shift. On top of it, two aids argued with each other very loudly I might add, in front of everyone. I saw this as very unprofessional because regardless of the issues that we have with other coworkers, they should be taken with each other in a private manner and if it does not get resolved, then it should be taken to the next higher up position such as the nursing supervisor. Punctuality is just one of the key components in professionalism.

Violence against healthcare providers is a significant problem that has been receiving growing attention. Incidents of workplace violence are experienced by nurses and physicians on a day-to-day basis, especially in emergency departments. The corollary of this phenomenon has become a significant matter due to the psychological stress it is placing on healthcare providers, hence affecting their efficiency and productivity. We may often undermine the consequences of workplace violence, but studies show that it may cause distress, apathy, rage, disappointment, helplessness, anxiety, self-doubt, and insecurity of healthcare workers. (Öztunç 360-365)Hence, their entire job performance is decreased and absenteeism is increased. This results in

The nursing profession is no stranger to workplace violence. Violent displays of behavior can come down from those that hole managerial positions to subordinate staff through a top down hierarchy in a vertical manner. This can occur through such actions as with holding raises or promotions, unequal distribution of resources, unfair staffing assignments, among others. There is also nurse to nurse violence through interactions with peers of the same staff position. The display of lateral violence in nursing is an issue that is hurting the profession as a whole.

Police and prosecutors tend to downplay the violent assaults on health care workers unless someone is severely injured, even though 30 states have felony laws against it (Jacobson, 2014, p. 4). According to a descriptive study conducted by Lisa Wolf there were many instances in, which the legal, judicial system was unwilling to pursue charges against patients, or family members who assaulted nurses. Thus the focus on legislation to make an assault on health care workers a felony crime may have limited efficacy unless efforts are made to address society’s complacency toward violence against nurses (Wolf et al., 2014, p. 3).

How sad it is that nursing leaders allow, much less participate in such acts. The stress and responsibilities this author was subjected to are not fair nor safe.  The ANA Code of Ethics addresses occurrences as in this scenario.  Provision 4.1 states nurses are responsible and accountable for the nursing care he or she provides to patients (p473).  By the author accepting the responsibility of x number of patients, she became legally liable.  Also, Provision 4.2 addresses the fact that all nurses are accountable for decisions and actions taken in the course of the nursing practice (P473).  Although no harm was done, nursing professionals must learn from wrongful acts and stand up for what we know and believe is ethically

Health and social care provisions must have polices in place to deal with all forms of bullying or harassment. In accordance with the law if this occurs within the provision it can be dealt with by legislation, as laws are enforced to prevent bullying/harassment from happening. However, the health and social care establishment should still be able to effectively deal with cases like these.

On Thursday 10/22/15, at 1837 hours, FHEO Security Officers were dispatched to the Special Care Unit room # 38 for a disorderly patient (51D) who was verbally aggressive towards nursing staff. Security Officers Jason Peterman (404), William Miller (406), McCoy Collins (409), Carlos Ayuso (415) and I,, Steven Evans (407) responded and met with ED Nurse Shane Prather who stated that the patient, Williams, Warren B (MRN: 721948/FIN: 84737836), was physically aggressive towards him, banging on his bed, on the wall and wanting to leave. Security personnel approached and spoke to the patient and he became irate and threaten to hit Officer Jason (404. Mr. Williams began to insult us and using profane language towards the ED staff and stating that

“While working at a hospital as a Registered nurse, I was being bullied every day at work I became withdrawn, severely depressed, I would break down and cry every day after work. It was a nightmare,” explained Nurse Jackie. Horizontal bullying should not be neglected it is a life-threatening problem affecting the healthcare. Nurse to nurse bullying in the workplace can have an impact on new nurses, the treatment of the patients, and lack of job satisfaction.