Moving from lateral violence to lateral kindness practical nursing feb 15 2019

Working well with each other
Moving from LateralViolence
to Lateral Kindness
Practical Nursing
February 15th 2019

Honesty Change Hope
Prisoners, vacationers, keeners, experts
Communication is not easy, but we can all be better
Listen with all of your senses

Stories
• I will use some of my experiences working in health, in
the north, and as an male nurse, often an outsider,
working in different situations.
• You are a part of the story.

“What we see, we do not see.”
• ArchieWeenie

Objectives
 To broaden the understanding of the Platinum Rule.
 To describe how to apply the Platinum Rule.
 Compare the Golden and Platinum Rules.
 To explore cultural aspects of nursing care.
 To identify the unique challenges faced by care providers
working with diverse clients.

Invisible Backpack
“all of us carry an invisible ‘backpack’ of our culture,
experiences, beliefs, values and morals.Whenever we
encounter another person, our backpack is present with us
and influences how we interact with our patients and their
families”.
Scott Harrison
Invisible Knapsack Peggy McIntosh

We Don’t SeeThings AsThey Are,
We SeeThem AsWe Are
“It has been well said that we do not see things as they are,
but as we are ourselves. Every man looks through the eyes of
his prejudices, of his preconceived notions. Hence, it is the
most difficult thing in the world to broaden a man so that he
will realize truth as other men see it.”

LateralViolence
“Exists on a spectrum, from seemingly ordinary
behaviour such as gossiping or criticism, to
intimidation, racism and outright physical
intimidation or harm.”
Linda Rabyj, 2005

LateralViolence
LateralViolence (LV), also called Horizontal
violence, [bullying], incivility, and disruptive
behaviours, creates an unpleasant work
environment and has harmful effects on individual
nurses, patient safety, and health care
organizations.
Johnson, 2009 & Dimarino, 2011

How common is bullying and where
does it start?
• About 1 in 10 children have bullied others and as many as
25% of children in grades four to six have been bullied.
• About one in seven Canadian children aged 11 to 16 are
victims of bullying.
• Studies have found bullying occurs once every seven
minutes on the playground and once every 25 minutes in
the classroom.
• In the majority of cases, bullying stops within 10 seconds
when peers intervene, or do not support the bullying
behaviour.

Dealing with LateralViolence
Dealing with lateral violence is dealing with
poorly expressed anger. Poorly expressed anger
can be due to failure to recognize anger and take
constructive action when possible or failure to
find healthy ways to blow off some of the anger-
related stress or failure to discuss the
precipitating cause of the anger.
Expressing internalized anger is associated with
less stress and depression, more optimism, and a
stronger sense of self-efficacy.
(Thomas, 2003, 108).

Connections
“Humans are hardwired to connect. It’s an essential part of our
well-being, and, as the research shows, having strong social
connections is deeply important for our physical and mental
health.” Melanie Mannarino

Strength andWeakness
•Are bullies Strong?
OR
•AreVictimsWeak?

What are the characteristics of a
Bully/Victim?
In the eyes of a bully, those who display kindness
and compassion are weak, but in truth, it’s the bully
trying to hide their weakness by making others feel
weak.

What is Bullying?
• There are many ways that people bully each other, even if
they don't realize it at the time. Some of these include:
• Punching, shoving and other acts that hurt people physically
• Spreading bad rumours about people
• Keeping certain people out of a group - isolation
• Teasing people in a mean way
• Getting certain people to "gang up" on others
https://www.bullyingcanada.ca/what-is-bullying

Narcissistic Bully
They are grandiose and have dreams of breath taking
achievement.They feel they deserve power and position.
They can fly into a rage when reality confronts them.This
person is very destructive and manipulative, they don’t set
out in a callous way to annihilate any person – it is purely an
expression of their superiority.

Accidental Bully
This person is task orientated and just wants to get things
done, tends to panic when things are not getting done, and
goes into a rage about it.This person is basically decent,
they don’t really think about the impact of what’s
happening or what they have done.
They are responding to stress and it is believed that they
can be coached out of this behavior.

Serial Bully
Has a sociopathic and psychopathic personality.This type of bully is intentional,
systematic and organized and is often relentless.They usually get things done in
terms of self-interest.
They employ subtle techniques that are difficult to detect or prove. Coaching is often
ineffective.
They exhibit the following:
• Grandiose, but charming
• Authoritative, aggressive and dominating
• Fearless and shameless
• Devoid of empathy or remorse
• Manipulative and deceptive
• Impulsive, chaotic or stimulus seeking
• Master of imitation or mimicry

4 Most common types of Bullying
Behaviours

1 Social Bullying
• Social Bullying - mobbing, scapegoating, excluding
others from a group, humiliating others with public
gestures or graffiti intended to put others down.

2Verbal Bullying
• Verbal bullying - name-calling, sarcasm, teasing,
spreading rumours, threatening, making negative
references to one's culture, ethnicity, race, religion,
gender, or sexual orientation, unwanted sexual
comments.

3 Physical Bullying
• Physical Bullying - hitting, poking, pinching, chasing,
shoving, coercing, destroying or stealing belongings,
unwanted sexual touching.

4 Cyber Bullying
• Cyber Bullying - using the internet or text messaging to
intimidate, put-down, spread rumours or make fun of
someone.

Cyber Bullying
• Exclusion, Flaming
• Exposure, Sexting
• Email threats and Dissemination
• Harassment
• Phishing
• Password theft lockout
• Bash Boards, Griefing
• Chicanery
• Pseudonyms
• Impersonation
• Denigration
• Email/cell phone image and video
dissemination
• Pornography and marketing list
inclusion
• Cyber Stalking
• Website creation may include
Voting/polling booths
• Happy Slapping

High Conflict Personalities
• Lots of all of nothing thinking
• Intense of unmanaged emotions
• Extreme behaviour or threats
• A preoccupation with blaming others – Targets of Blame
• From Bill Eddy’s book 5Types of People who can RuinYour Life

How to Deal with High Conflict
Personalities
• Connect with empathy, attention, and respect
• Analyze alternatives or options
• Respond to misinformation or hostility
• Set limits on high-conflict behaviours
• From Bill Eddy’s book

Respectful & Responsible
Relationships – there’s no app for that . . .
• Bullying and cyberbullying happens inside and outside
the classroom, at home, at work, and in the community.
http://cyberbullying.novascotia.ca/

Hurt People Hurt People
When another person makes you suffer, it is because he
suffers deeply within himself, and his suffering is spilling
over. He does not need punishment; he needs help.
Tich Naht Hanh

Hurt People Hurt People
Abusive patterns get passed on,
Generation after generation,
But the chain can be broken.
Meet anger with sympathy,
Meet contempt with compassion,
Meet Cruelty with kindness,
Meet grimaces with smile.
When you forget about the fault, there is nothing to forgive. Love is the weapon of the future.
Yehuda Berg

victim/target?
• When we are the victim, we are made to feel weak, which
in turn makes us feel that we can’t do anything about it.
• But when something requires courage, that doesn’t show
we are weak, it shows that we are in fact strong.

victim/target?
• Sometimes bullies will even pretend they are victims to
escape blame, and to point the finger at someone else.

Victims
• Are you a victim of the victim syndrome?
• http://sites.insead.edu/facultyresearch/research/doc.cfm?did=50114

Are there benefits of being a victim?
1. The bully is out to get me, it is not my fault, avoid, avoid…
2. Can become a comfort zone, don’t take risks, feels safe
3. I'm right the bully is wrong, I get sympathy and support
4. Becomes an identity, if lost, who will you be?
5. It's not my fault, I'm not responsible, blame outlet

How to break out of being a victim?
1. I have it the worst, but do you? Challenge yourself
2. Be grateful, especially humble, especially if you are a nurse!
3. It's not all about you, think about the other person (the bully)
4. Meditate, chill, find balance, what stories are you creating?
5. Get up and get out, exercise, volunteer, mover from …..to ….
6. Forgive, accept, understand, learn

Bystanders
• It is the reaction and/or silence of the bystander that can
tip the power balance in favour for or against the bully
• It is also this reaction that supports the position that
bullying is acceptable and even “cool” behaviour or that
the behavior is not acceptable…
Bystander intervention is crucial in bullying situations, both in person
and in the cyberworld.

What is an Upstander?
• An “upstander” is someone who recognizes when something
is wrong and acts to make it right.
• When an upstander sees or hears about someone being
bullied, they speak up.
• Being an upstander is being a hero: we are standing up for
what is right and doing our best to help support and protect
someone who is being hurt.
• In some cases, the bully may be going through their own
issues, and you could inspire them to seek help from someone
to better themselves.

What is a Rescuer?There is a correlation between increased supervision and decreased
bullying.
Bullies stop when adults are around.

LateralViolence in Students
• The truth is that most of the violence in the world is committed not
by bullies but by victims!
• A student sees himself as a victim. He used to be the victim of the
kids who enraged him by calling him names. Now, in addition, he
feels himself to be the victim of the crooked adult society.
• Society takes his tormentors' side against him and punishes him for
trying to stop his bullies. He is now angrier and therefore more
dangerous than before the wise adults disciplined him for being a
bully!
• Victims Bullies Hero’s

Risk and Rewards
• We often face a risk acting, and we also face a risk when
we do not act.
• It’s difficult to know what to make of a teacher who
crosses the line from basic discipline to regularly
berating, intimidating, humiliating.

10 Most Common Forms of Lateral
Violence in
1. Non-verbal innuendo,
2. Verbal affront,
3. Undermining activities,
4. Withholding information,
5. Sabotage,
Griffin. 2004

10 Most Common Forms of Lateral
Violence in
6. Infighting,
7. Scapegoating,
8. Backstabbing,
9. Failure to respect privacy, and
10.Broken confidences.
Griffin. 2004

Mobbing
A group of coworkers gang up on another
• often with the intent to force them to leave the work group
• This is often a group of targets! Supporting each other, or so it seems
Five phases of Mobbing
1. Conflict
2. Aggressive acts
3. Management/Faculty Involvement
4. Branding as Difficult or Mentally ill
5. Expulsion

Bystander?
• If bullying isn't stopped, it also hurts the bystanders, as
well as the person who bullies others.
• Bystanders are afraid they could be the next victim.
• Even if they feel badly for the person being bullied, they
avoid getting involved in order to protect themselves or
because they aren't sure what to do.

Communication is about listening
• My job description does not say, Greg, you will have to
listen to a lot of your co workers bitching and complaining
about each other, they will want you to fix their conflicts,
and will want you to keep it a secret and tell no one.
• This will happen on a very regular basis, consider this
‘duties as assigned’

Lateral Kindness at work
• Listen closely when people introduce themselves.
• Have a conversation where you mostly listen.
• Smile at others as you walk down the hallway.
• Ask a colleague about their life outside work.
• Each day, make a connection with someone you
normally don’t spend much time with.
• Connect with yourself.

Why Don’tWe Stop Bullying?
“It’s not a problem where I work.”
“Everybody does it – just get used to it”
“If I say anything, I’ll be the next victim”
“We have policies but they aren’t enforced”
“She sets herself up for getting picked on”

In Conflict who are you:Victim,Villain, Hero
?
In conflict, each person feels
hit first.
The size of the villain
determines the size of the
hero.
“Without goliath, David is
just some punk, throwing
rocks.”
Billy Crystal, My Giant

Who else is involved?
• Bullying may change throughout the years, but the way
to combat bullying never changes as long as you don’t
confront the bully through violence or to try beat them at
their own game which could lead you to become the bully
next.

ZeroTolerance
• Should we be adopting and promoting zero tolerance
policies?

ZeroTolerance
• Zero tolerance policies – the APA has a resolution calling
for schools to modify this approach, as it ‘can actually
increase bad behaviour and also lead to higher drop-out
rates’

What do we do with bullies?
• Punishment and ZeroTolerance Policies
• Kick them out? Discipline? Isolate them? Dissocialize them?You're FIRED!
• Similar to a criminal, who has broken the law, punishment rarely has positive
consequences
• Dignity + Respect = no bullying
• We cannot eliminate all risk, all fear, or all bullying behaviour in society.

Dignity + Respect = no bullying
• The solution or approach to address bullying is to
promote its real enemy - dignity and respect;
• With these principles, bullying can not prevail.
• Bullying is ultimately about isolation - isolating
students and making them feel bad.

Bullies…Victims… or just people?
• Bullies are evil?? victims are innocent? Really???
• Who decides?
• What if there are no bullies?
• What would you do?
• What would teachers or parents do?

There is hope, and reality
• Effective anti-bullying practices must include a
statement of exactly what constitutes bullying.
• We need to work with everyone, bullies, victims,
targets, and bystanders…

DESC COMMUNICATION MODEL
Describe – the behavior
Explain – the effect the behavior has on you,
coworkers, patient care
State – the desired outcome
Consequences – what will happen if the behavior
continues?

Diversity, accommodation and
special treatment?

Who gets targeted?
Anyone who is different from the group norm on any major
characteristic
• Experience
• Education
• Race/ethnicity
• Gender
Targeted person’s gender
• 79% Female
• 21% Male

He said, She said, They Said
• Different genders and cultures communicate differently
• Indirect communication
• Direct communication
• Asynchronous communication – text, email, voicemail
• Cyber LateralViolence
• CAPS LOCK
We punish people for not being able to communicate properly as
opposed to helping them learn new skills..

Conflict It’s not all Bad
Functional Conflict is considered positive, as it can increase
performance, support change, and identify weaknesses or
areas that need to be supported.
Dysfunctional Conflict is harmful to people and the
organization.This type of confrontation does nothing to
support goals or objectives.

Safe place
• Where is the safe place in your organization?

Lateral Silence
• It is part of the culture.
• Everybody knows about it
• Everybody does it
• No body talks about it

Our Culture needs to change
• We do not accept bullying in our schools or other
workplaces so why is it ok in the workplace?
• In my profession, Nursing, this is the culture that was
learnt by nurses 30 years ago and has been taught to new
nurses.
• Change is often difficult, you go first!

Lateral Kindness
• Please be kind to each other
• Respectful and responsible relationships, there are no
apps for that.
• Be Grateful
• Be Great!

Civility and Respect
Civility and Respect means showing appreciation, care, and
consideration for everyone, whether they’re coworkers,
supervisors, customers, or clients. Creating a
psychologically safe and healthy workplace is up to all of us.
http://www.mentalhealthcommission.ca/...

Bullies andVictims or just people?
• Bullies are evil, victims are innocent? Really???
• Who decides?
• What if there are no bullies?
• What would you do?
• What would teachers or parents do?

There is hope and reality
• Effective anti-bullying practices must include a
statement of exactly what constitutes bullying.
• We need to work with everyone, bullies, victims,
targets, and bystanders…

I try to be skeptical (question things) and not cynical (dismiss ideas & find fault with them)

Bronze silver gold platinum rules
The culture ofWestern medicine places diagnosis as a
central goal
Aboriginal medicine, see diagnosis as less central and pay
more attention to finding a safe environment in which the
patient may recover.
For conditions such as mental disorders, this latter
approach may prove more effective than struggling to
attach a label to the disorder.

Bronze rule
Do unto others as they have done unto you

Silver
What you do not want done to yourself, do not do
to others

Gold
Do unto others as you would have them do unto you.

Platinum
Do unto others as they want done unto them

THE PLATINUM RULE.
TREAT OTHERS
HOW THEY WANT TO BE TREATED

Imbalance Creates Illness
 Holistic approach to address issues and factors that impact illness
targeting not just the disease, but also the social determinants of
health and economic circumstances.
 It is recognized that the whole family (broadly defined) is as
impacted by disease and needs healing just as the individual who is
‘sick’ requires care, treatment and support.

Physical Mental Emotional Spiritual
My perspective is that each
of these four parts can be
treated as its own body.
Each requires its own form
of sustenance and exercise
to be healthy

Lateral Kindness
• Ask yourself, if what I am saying or doing is helpful?
• If you can be kind to your patients, please be kind to each
other
• Respectful and responsible relationships, there are no
apps for that.
• Be Grateful
• Be Great!

Tips for Creating a HealthyWork
Environment by Kathleen Bartholomew
• Never be a “silent witness”. Never stand by and listen while others are
gossiping, criticizing or talking badly about someone else
• Be a team player. If you see someone in need of help, offer assistance.The
greatest safety net cast is to catch mistakes and this is only as strong as your
relationships
• Speak your truth – always say what’s on your mind. Start the conversation
by sharing your perception of what happened and then what you need
• Always stay client focused and problem solving focused (personally I want a
win-win)
• Address issues directly.Ask the manager or your mentor to help role model
difficult conversations with you

Chief Jo Mathias
“We walk into the future backwards because
we are looking to our Ancestors, listening to
our Elders, and learning our traditions and
cultures”

& DonT be arfaid
to kame mit
sakes
Ask questions, listen,
and then ask more
questions.

Discussion, questions,
comments!!!
Thank you for your participation

Contact information
Greg Riehl RN BScN MA
greg.riehl@saskpolytech.ca
gregriehl@sasktel.net
@griehl

Contact information
Greg Riehl RN BScN MA
Indigenous Nursing Student Advisor
Saskatchewan Polytechnic
Regina Campus
Email: greg.riehl@saskpolytech.ca
@griehl

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