When one goes into the profession of nursing it is usually not for the money, job security or the glamour of the job. Those of us who chose nursing as our profession generally care for others and want to make a difference in the world. New nurses are excited to become licensed and to start working in the profession of nursing. When new nurses enter the field of nursing, they are often met with more experienced nurses who have practiced longer and subsequently has more experience. This maybe an opportunity for the new graduate to learn and grow or it can lead to horizontal violence in the work place. Horizontal violence decreases patient safety and job satisfaction drastically.
Horizontal violence is unfortunately not new to the
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The physician began screaming and cursing in the middle of the unit. He questioned her education by stating, “where did you go to medical school”. The nurse became really upset and began to cry. The behavior exhibited by the physician iss a textbook example of horizontal violence.
Behaviors of horizontal violence include name calling, spreading rumors and making threats to someone (Echevarria, 2013). These activities may cause mayhem for the victim of horizontal violence and can drastically reduce patient safety. When a nurse is being bullied through horizontal violence, a patients’ safety is put at a great risk of being affected. Effective communication is necessary for nurses to provide safe and reliable care.
According to Purpora and Blegen, approximately 60% of actual errors in patient care result from poor and ineffective communication (para. 3). Horizontal violence causes a decrease in effective communication between caregivers which places the patient’s safety in jeopardy. Horizontal violence decreases staff morale which leaves room for error in the workplace (Longo & Smith, 2011).
Nurses are more likely to make errors in caring for their patients when they do not have the appropriate support from their coworkers. The demeaning behavior causes the person being bullied not to ask questions or seek assistance when they are unsure of a task. This leads to making assumptions in the care of the patient and unfortunately
Indeed, Fudge (2006) describes this as vertical violence, which means that the act of violence is between senior and junior colleagues. Horizontal violence is across peer groups and similar levels of staff. The most common aggressors or bullies are nurse-managers and supervisors (Leiper, 2005). Certainly, education is very influential in terms of the respect seen among health care professionals, because it has been an ongoing issue as to understanding the hierarchy in the health care profession. The bridge between education and collaboration is still suffering today and it is an issue to address.
Safety is an important factor and is a high priority in healthcare. Kelly, Fenwick, Brekke, and Novaco (2015) shared that workplace violence impairs the staff perceptions of safety. However, both patients and staff are affected by workplace violence in many ways, from physical to emotional aspects. There are many reasons why violence occurs, that will be explained later in this paper. The purpose of this paper is to explain the reason and importance of the chosen phenomenon of interest. Moreover, primary and opposing philosophic viewpoints will be discussed, as well as ways of recognizing and utilizing them in nursing. The ways of knowing patterns in nursing and the utilization of these patterns will be explained, pertaining to nursing care.
Horizontal violence is a negative phenomenon that is increasing significantly in the hospital setting. It is defined as bullying, verbal and physical aggression that occurs to employees in the workforce. Horizontal violence has harmful effects on nurses as it lowers their self- esteem, and makes them feel as if they have no power in their career. This phenomenon also negatively impacts patient centered care and safety as nurses are more vulnerable to making medication errors and careless mistakes. Horizontal violence can be decreased in the hospital setting if interventions are implemented by members of the health care team. Education is key to decrease the occurrence of horizontal violence as it enables health care workers to
Bullying can produce and maintain a poisonous work environment. Nurses who bully can wear down the job satisfaction of their co workers which can result in a loss of productivity and increased absences in the workplace (Stokowski, 2010). Victims of bullying often have a feeling of impending doom and dread when they think about their upcoming work days. Each time the bullying reoccurs, the victims usually
23). These actions are all negative, and it is obvious how horizontal violence can have damaging effects on its victims. In addition, with such a wide variety of acts that classify as horizontal violence, it is understandable why it is such an inescapable issue in the nursing profession.
In 2009 unspecified electronic survey was conducted with factors such as type, frequency, perpetrators, and professional/personal concerns on bullying identified (Quine, 2001). The results revealed that out of 330 RN respondents, 72% reported positive to bullying at various occasions in line of their career. Of this segment, clear hostility seemed most frequent in surgical/medical, operational rooms, emergency, obstetrical areas of care and adolescent residential behavioral/ mental health units. The main culprits to these act are non-other than; charge nurses, senior nurses, physicians and nurse managers. This is impartial research among others that have been
In a profession where caring is the epicenter of the job, it is disconcerting to see a high occurrence of bullying in the nursing environment. Lateral bullying and lateral violence are terms used to describe bullying, uncivil behavior, disrespect, social devaluing, peer control and verbal, physical and emotional abuse occurring between nurses and or colleagues (Ceravolo et al., 2012). Abusive behaviors from a superior are considered vertical or hierarchal violence and are commonly seen when the superior attempts to control or bully the nurse using their superiority, often leaving the nurse feeling defenseless due to an imbalance in power and control (Broome & Williams-Evans, 2011). Some examples of bullying include harsh criticism, unfairly blaming others for mistakes, and withholding patient care information (Simons et al., 2011). In a recent study measuring workplace bullying, Simons, Stark and DeMarco (2011) found that the most common behaviors those feeling bullied experienced included being assigned workloads they felt were unmanageable, and being ignored or excluded by their peers.
Workplace bullying is a growing problem in the American workplace and the Nursing Profession no exception. Addressing workplace bullying and its impact on the nursing profession is paramount to upholding patient safety and decreasing nursing attrition rates. Defining the problem is the first step in addressing it. In the past, workplace bullying was referred to as “Nurses eating their young.” There are many names for the various levels of workplace bullying like horizontal and lateral violence, hostility, mobbing, and verbal abuse. Bullying actions can take place overtly or covertly. Nurse-to-Nurse bullying is known to occur during interaction communications and manifests by withholding information, intimidation, threats, verbalizing harsh innuendo and criticism, and undermining personal values and beliefs (Rocker, 2008). Power disparities are also a source of bullying. For example, using charge position for controlling staff assignments, reporting coworkers for perceived lack of productivity, placing others under pressure to achieve impossible deadlines, and withholding knowledge for policies and procedures (Rocker, 2008). Outright actions of yelling at coworkers and refusing to mentor new staff with their practice are also considered bullying behavior.
The lateral violence comes in many forms and in many ways, such as abuse in the workplace that occur between colleagues, it can be verbal or nonverbal aggression, intimidation, bullying, harassment, discrimination, stereotyping, gossiping, criticism, and other related mistreatment behavior at work. Institutional lateral violence also happens between manager and subordinate where they can use their higher position to perpetrate assault to their subordinate such as acts of lasciviousness, shouting, anger outburst, forced overtime request, giving work beyond the job description, work overload, over blaming or insulting a staff and more. All these happen occasionally because of the lack of respect in the workplace and it comes without notice, especially in healthcare practices where the nature of work is tough and decision making must be made immediately.
Even though workplace politics exists in every profession, the effects of horizontal violence, or bullying, in nursing is a costly behavior. Nurses feel devalued in the workplace and experience psychological effects. Patients are likely to experience less favorable outcomes, and
Bullying is a serious problem in the nursing profession, it decreases nurse productivity, creates adverse patient outcomes, and overall lack of job satisfaction. It can be seen anywhere in the nursing profession. Bullying includes emotional and physical abuse as well as, putting others down, intimidation, spreading rumors, etc. “Research findings suggest that bullying frequently occurs among RNs [6] to the extent that up to 40% of nurses report an intent to leave because of it [7]; this is significant especially for new nurses, in that new RNs reported being bullied at work which resulted in 30% of
Civility in the work place, or the lack thereof, has been identified as a growing problem within many professions in today’s society. Often referred to as lateral violence, this occurrence is no exception in the nursing profession. It is also known as ‘horizontal violence’ or ‘workplace bullying (Coursey, Rodriguez, Dieckmann, & Austin, 2013). In this evidenced-based paper, information will be provided in an effort to identify causes of lateral violence in the workplace and how to encourage civility.
In today’s world violence can be expected anywhere at any time. This includes what was considered at one time a low risk area, the medical facility. Today the incidence of violence is increasing. There are two types of violence the first is lateral violence or aggression which is amongst hospital or medical personal. The other is external factors consisting of patients or visitors instituting violence or aggression among themselves or against healthcare workers. This is known as a code grey in my facility and all male staff not currently engaged in patient care are supposed to respond.
Several models and concepts arose in preventative measures to workplace violence in nursing. One conceptual model, according to Covert Crime at Work, is “a conceptual model derived from 370 surveys show working conditions conducive to bullying, thus helping to identify risks early and to prevent unhealthy environments from developing.” After recognition of these research and studies, organizations such as Occupations Safety and Hazard Association, American Nurses Associations, and etc, have implemented guidelines to prevent workplace violence in nursing.
Your presentation was sleek and easy to read and follow. Horizontal violence is a longstanding issue in the nursing community, but awareness of the issue is now being brought to light. Although, all nurses are aware of what horizontal violence is and its negative impact on the work environment it may have been helpful for you or the authors to include defined parameters. Horizontal or lateral violence has been described broadly as any unwanted abuse or hostility within the workplace (Becher, & Visovsky, 2012). This broad definition encompasses verbal abuse, physical abuse, or even the 'side-eye'. This range of uncomfortable exchanges can be interpreted by different individuals in various ways. You did a wonderful job at reviewing the articles