Lateral violence in nursing


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  • The following are all terminology used for lateral violence. Horizontal Violence “Hostile and aggressive behavior by individuals or group members toward other members or groups of members within larger group. The behavior may be conscious or unconscious and is typically non-physical”(Task Force on the Prevention of Workplace Bullying, 2001,pg. 10).Bullying: An “offensive abusive, intimidating, malicious or insulting behavior, or abuse of power conducted by an individual or group against others, which makes the recipient feel upset, threatened, humiliated or vulnerable, which undermines their self confidence and which may cause them to suffer stress. Bullying is behavior which is generally persistent, systematic and ongoing” (Skinner,2011).
  • Nurses are dominated by a patriarchal system headed by doctors, administrators, and nurse managers, therefore some began to lower down the hierarchy of power to aggression among themselves (Griffin, 2004).
  • Explain the diagram
  • Discuss overt and covert forms and give examples.
  • Gender: Socialization of girls, Gendered Health Organizations (Stanley, 2010)Generational Differences: Work Style, Communication Style, Approach to meetings and activities, Finding information and learning new things (Stanley, 2010)
  • Morale Issues: Unhealthy work environment, distrust, increased absenteeismPatient Safety Issues: negative reports about nursing care to family/friends/community decreasing amount of people to come to healthcare organizationLoss of productivity: One person taking on multiple tasks, inability to train new staff
  • Lateral violence affects everyone on the healthcare team as well as patients and their families.
  • Lateral violence in nursing

    1. 1. Tanisha Cartledge RN,BSNKaplan UniversityApril 10, 2012
    2. 2. The purpose of this unit is to learn about lateralviolence; costs, contributing factors, effects, andinterventions.
    3. 3. By the end of this unit, you should be able to: Describe the term lateral violence nursing. Discuss the contributing factors of lateral violence in nursing. Evaluate the costs of lateral violence. Describe the effects of lateral violence on nurses. Discuss effective interventions to reduce lateral violence.
    4. 4. Bloom’s Taxonomy Category ObjectiveCreating Develop a 1-3 minute video presentation on any form of lateral violence.Evaluating Evaluate the costs of lateral violence.Analyzing Differentiate the various forms of lateral violence.Applying Demonstrate a preventative intervention to reduce lateral violence.Understanding Discuss the effects that lateral violence have on the profession of nursing.Remembering Define lateral violence terminology.
    5. 5. Lateral Violence in nurse-on-nurse aggressionGriffin (2004) describes lateral violence asnurses who covertly or overtly directing theirdissatisfaction inward toward each other,toward themselves, and toward those lesspowerful then themselves.
    6. 6. Horizontal ViolenceBullyingAggression“Nurses Eating Their Young”
    7. 7. Development of oppressed group behaviorConflicting work values and leadership styles(Hallberg, 2007)
    8. 8. Martin et al. 2008Adapted from Demarco & Roberts, 2003
    9. 9. Covert (Not Openly Acknowledged) Overt (Done Openly) Name Calling Unfair assignments Bickering Refusing to help someone Fault Finding Ignoring Criticism Making faces behind someone’s Intimidation back Gossip Refusing to only work with certain Shouting people or not work with others Blaming Whining Put Downs Sabotage Raised Eye Browns Exclusion Fabrication Failure to Respect Privacy Broken Confidences( Bartholomew, 2012)
    10. 10. 1 st Example of Lateral Violence
    11. 11. 2nd Example of LateralViolence
    12. 12. Gender Generational Differences Enabling behaviors Complacency Fear of Retaliation(Stanley, 2010)
    13. 13. Recruiting, hiring, and orienting a single medical/surgical nurse => $92,000 Replacing a specialty nurse =>$145,000 Patient safety issues Costly medical errors and harmful patient outcomes Significant increase in the costs of delivering patient care Revolving door orientation Continuation of nursing shortage Morale Issues Loss or productivity(Pendry, 2007); (Rosenstein & O’Daniel, 2008); (The Joint Commission, 2008)
    14. 14. PatientsFamiliesAdministrationPhysiciansDepartment ManagersNursing StaffAncillary Staff
    15. 15. Griffin (2005) one in three nurses will leave aposition because of lateral violence.Bartholomew (2006) 60% of recently graduatednurses leave their first position within sixmonths partly as a result of lateral violence andbullying.
    16. 16. Psychological affects Physical affects Sleep disorders Fatigue Low morale Headaches Apathy Weight loss Feelings of disconnectedness Angina Irritability PTSD Burnout Hypertension Impaired interpersonal Eating disorders relationships Intention or unintentional works absences, resignations(Hastile, 2002)
    17. 17. Scenario planning Extend orientation Develop policies and procedures to address negative behaviors Consistently hold everyone accountable for their behavior by setting consequences (Zero tolerance policy) Provide staff training in conflict management and confrontation skills(Rowell, 2007), (Stanley, 2010)
    18. 18. Create a 1-3minute skit on lateral violence andupload it on blackboardPlease complete evaluation at this link:
    19. 19. Bartholomew, K. (2006). Ending nurse-to-nurse hostility. Marblehead, MA: HCPRO, Inc..Bartholomew, K. (2012). Lateral violence in nursing: breaking the spell. Retrieved from 1&PortalId=0&TabId=102DeMarco, R., Roberts, S. (2003). Negative behaviors in nursing. American Journal of Nursing, 103(3), 113-116.Griffin, D. (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), 257-263.Griffin, M. (2005). Awareness of ‘nurse-on-nurse; abuse helps resolve problem. AORN, 1(5), 3.Hallberg, L. (2007). The origin of workplace bullying: experiences from the perspective of bully victims in the public service sector. J Nurse Manage. 15. 332-341.Hastie, C. (2002). Horizontal violence in the workplace. Retrieved from, P. (2007). Nursing Economics, 25(4): 217-221.
    20. 20. Martin, M., Stanley, K., Dulaney, P., Pehrson K. (2008). The role of the psychiatric consultation liaison nurse in evidence based approaches to lateral violence in nursing. Perspectives in Psychiatric Care, 44(1), 58-60.Rosenstein, A., O’Daniel, M. (2008). A survey of the impact of disruptive behavior and communication defects on patient safety. The Joint Commission Journal of Quality and Patient Safety, 34(8),464-471.Rowell, P. (2007). Lateral violence: nurse against nurse. ANA Online Continuing Education. Silver Spring, MD: American Nurses Association.Stanley, K. (2010). The high costs of lateral violence in nursing. Sigma Theta Tau International Leadership Summit.Skinner, T. (2011). Lateral violence in nursing. Nursing News & Views. 6(1), 13-14.Task Force on the Prevention of Workplace Bullying, (2001). Report of the task force on the prevention of workplace bullying: Dignity at work the challenge of workplace.The Joint Commission (2008). Behaviors that undermine a culture of safety. Sentinel Event Alert, Issue 40.