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Tanisha Cartledge RN,BSN
Kaplan University
April 10, 2012
The purpose of this unit is to learn about lateral
violence; costs, contributing factors, effects, and
interventions.
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.
Bloom’s Taxonomy Category                Objective

Creating                       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.
Lateral Violence in nurse-on-nurse aggression
Griffin (2004) describes lateral violence as
nurses who covertly or overtly directing their
dissatisfaction inward toward each other,
toward themselves, and toward those less
powerful then themselves.
Horizontal Violence
Bullying
Aggression
“Nurses Eating Their Young”
Development of oppressed group behavior
Conflicting work values and leadership styles
(Hallberg, 2007)
Martin et al. 2008
Adapted from Demarco & Roberts, 2003
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)
1 st   Example of Lateral Violence
2nd Example of Lateral
Violence
Gender
   Generational Differences
   Enabling behaviors
   Complacency
   Fear of Retaliation


(Stanley, 2010)
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)
Patients
Families
Administration
Physicians
Department Managers
Nursing Staff
Ancillary Staff
Griffin (2005) one in three nurses will leave a
position because of lateral violence.
Bartholomew (2006) 60% of recently graduated
nurses leave their first position within six
months partly as a result of lateral violence and
bullying.
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)
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)
Create a 1-3minute skit on lateral violence and
upload it on blackboard
Please complete evaluation at this link:
   http://www.surveymonkey.com/s/L8YHGGR
Bartholomew, K. (2006). Ending nurse-to-nurse hostility. Marblehead, MA: HCPRO, Inc..

Bartholomew, K. (2012). Lateral violence in nursing: breaking the spell. Retrieved from
    http://www.nursetogether.com/DesktopModules/EngagePublish/printerfriendly.aspx?itemId=262
    1&PortalId=0&TabId=102

DeMarco, 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
    https://www.birthinternational.com/articles/midwifery/69-horizontal-violence-in-the-workplace

Pendry, P. (2007). Nursing Economics, 25(4): 217-221.
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.

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Lateral violence in nursing

  • 1. Tanisha Cartledge RN,BSN Kaplan University April 10, 2012
  • 2. The purpose of this unit is to learn about lateral violence; costs, contributing factors, effects, and interventions.
  • 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. Bloom’s Taxonomy Category Objective Creating 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. Lateral Violence in nurse-on-nurse aggression Griffin (2004) describes lateral violence as nurses who covertly or overtly directing their dissatisfaction inward toward each other, toward themselves, and toward those less powerful then themselves.
  • 7. Development of oppressed group behavior Conflicting work values and leadership styles (Hallberg, 2007)
  • 8. Martin et al. 2008 Adapted from Demarco & Roberts, 2003
  • 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. 1 st Example of Lateral Violence
  • 11. 2nd Example of Lateral Violence
  • 12. Gender Generational Differences Enabling behaviors Complacency Fear of Retaliation (Stanley, 2010)
  • 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)
  • 15. Griffin (2005) one in three nurses will leave a position because of lateral violence. Bartholomew (2006) 60% of recently graduated nurses leave their first position within six months partly as a result of lateral violence and bullying.
  • 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. 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. Create a 1-3minute skit on lateral violence and upload it on blackboard Please complete evaluation at this link: http://www.surveymonkey.com/s/L8YHGGR
  • 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 http://www.nursetogether.com/DesktopModules/EngagePublish/printerfriendly.aspx?itemId=262 1&PortalId=0&TabId=102 DeMarco, 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 https://www.birthinternational.com/articles/midwifery/69-horizontal-violence-in-the-workplace Pendry, P. (2007). Nursing Economics, 25(4): 217-221.
  • 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.

Notes de l'éditeur

  1. 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).
  2. 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).
  3. Explain the diagram
  4. Discuss overt and covert forms and give examples.
  5. 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)
  6. 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
  7. Lateral violence affects everyone on the healthcare team as well as patients and their families.