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.

Stand up and be countedJust say “NO” to 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 & BlamingLewis (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 from previous incidents Lewis (2006)

Lateral Violence unchecked=

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

Prevalence and Effects 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

(Statistics Canada, 2005)(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)

Change begins with each individual

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).

Informal vs. Formal Resolution

Informal Resolution

- LV is quickly resolved

- No investigation or

disciplinary action

taken

- “No-blame” outlook

- Eased reestablishment

of working relationship

Formal Resolution

- Lengthy procedure

- Investigation and

disciplinary action are taken

- Difficulty in

reestablishment of

working relationship (OSACH, 2009)

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?

Congratulations for increasing your awareness of Lateral Violence

Have Enthusiasm for Nursing!!!