Are Leadership Mentoring Programs Beneficial? Increasing Patient Care Outcomes?

As Finkelman (2006) stated, “Mentoring, and important career development to that can be used by nurses any type of set or specialty, can be used to develop the critical leadership skills needed by nurses. All successful leaders have had mentors are our mentors” (Finkelman,2006, p. 390).

The purpose of this integration paper is to educate about lateral violence in the professional setting, more specifically within the nursing profession. Lateral violence is defined as “profound and pervasive source of occupational stress with physical and psychological and organizational consequences.” (Cervalolo, D). Types of lateral violence include rude comments, verbal attacks, condescending language, sexual misconduct, lack of collaboration, professionally attacking a person integrity and reputation, blaming others for your own mistakes in front of others and family members of the patient, withholding important information and other non-professional behaviors.

Key words and terminology in the article search included hostility, nursing turnover, nursing attrition, nurse aggression, bullying, and nurse hostility. Specific key words that were used to narrow down the search included incivility, nurse turnover, lateral violence (LV), horizontal violence (HV), disruptive behavior (DB), and horizontal hostility (HH). The publication date range was adjusted to 2012 through 2017. The following literature review probes into the research of incivility to explore the connection with nursing turnover and patient care.

Acts of incivility such as bullying, lateral violence, or harassment in the work place negatively affects nursing performance, mental health, and retention within an organization or even the profession of nursing (Warrner, 2016). A policy in the American Nurses Association (ANA) proclaims that the nursing profession will not tolerate violence of any kind from any source (ANA, 2015b). The Code of Ethics for Nurses by ANA requires nurses to promote an ethical environment and culture of civility with an emphasis on treating all parties with dignity and respect (ANA, 2015a). A study conducted in a rural Kentucky hospital’s medical- surgical units concluded that educational trainings in itself did not reduce the frequency of experiencing incivility in their unit (Armstrong, 2017). Nevertheless, nurses in the study reported that educational trainings increased their ability to recognize and appropriately respond to workplace incivility (Armstrong, 2017).

Moreover, another type of violence which nurses experience is horizontal violence. Horizontal violence is described as “hostile, aggressive, and harmful behavior by a nurse or group of nurses toward a co-worker or group of nurses via attitudes, actions, words, and behaviors” (Becher & Visovsky, 2012, p. 210). Horizontal violence not only involves nurse-nurse violence but includes nurse-physician and nurse-supervisor violence. The perpetrator displays behaviors associated with horizontal violence which may include refusing to lend assistance, criticizing, intimidation, gossiping, name-calling, and ignoring (Becher & Visovsky, 2012). The American Nurses Association sets the expectations for nursing standards. According to the American Nurses

Thesis • Horizontal violence among nurses reduces the quality of care patients receive and influences whether students remain in the nursing profession based on clinical experiences during placement. • The Canadian Nurses Association (2005) defines horizontal aggression “as aggressive behaviour that one registered nurse commits against another in the workplace.” • Tolerance of horizontal violence is connected with hierarchical nature of abuse and continues to be unreported and overlooked because in many incidents the perpetrator involved is a supervisor, nurse manager or charge nurse. “In order to succeed, [nurses] must accept that their role is defined by those with power and authority (pitts, 1985).

The third and last section of the IOM report that will be discussed is on “transforming leadership” key message # 3 of the IOM report states, “Nurses should be full partners, with physicians and other health professionals, in redesigning healthcare in the United States.” The committee is calling for a new type of leadership, one that involves collaborating with others and working together as partners showing mutual respect. This style of leadership has been shown to improve patient outcomes, reduce staff turnover, and reduce medical errors. (Gardener, 2005; Joint Commission, 2008; Pearson, 2007) For the needed changes in the U.S. healthcare system to take place all nurses from nursing students through Chief Nursing Officers must develop competencies in leadership and become partners with physicians and others to improve our healthcare system and delivery of care.

The themes of horizontal violence will be discussed among the nursing profession. Current practice trends and potential resolutions will be discussed. Common Themes Horizontal violence in nursing is more prevalent in nurses who have advanced degrees, and work in specialized care units causing oppression and strain on relationships. Having strain on intraprofessional relationships impedes communication among colleagues creating a hostile work environment (IN TEXT CITATION).

The article by Bally Jill (2007) identifies that nursing leadership can use mentoring culture to achieve professional and career development in nursing, and increase the quality of care given, especially for acute care nurses. This is because the article finds that nurses often have low morale, heavy workloads, high patient acuity, apathy towards professional collegial support, and reduced resources. The article identifies that mentoring in

Clinical Nurse Leaders: Fulfilling the Promise of the Role. MEDSURG Nursing, 26(1),

Nursing is a profession founded on caring, compassion and collaboration. I believe that all nurses come to work with good intentions, but sometimes something happens along the way. “Horizontal violence can exist to some extent in any institution, with the potential to disrupt the integrity of the nursing profession and ultimately compromise patient care” (Becher&Visovsky, 2012, P. 213). I think that its important for us as professional nurses to acknowledge the “existence of horizontal violence, confront horizontal violence, and take appropriate actions to mitigate it (Becher&Visovsky, 2012, P. 213).

Iheduru-Anderson, K. (2014). Educating senior nursing students to stop lateral violence in nursing. Australian Nursing & Midwifery Journal, 22(1), 15. http://web.b.ebscohost.com/ehost/pdfviewer/pdfviewer?vid=4&sid=210287e6-d95e-4272-8087-f7117316497d%40sessionmgr104

It has been noted that many nurse managers move up the ranks from bedside nurse to nurse manager without ever having any formal training or orientation to their new leadership role. According to Sherman, Bishop, Eggenberger & Karden (2007), many new nurse mangers report feeling overwhelmed and ineffective in their new role, yet their role is fundamental to connecting the overall goals and visions to bedside practice. When a leader lacks leadership or education and skills to lead, his/her subordinates lacks faith and respect for the leader. Several evidenced-based strategies have been proposed to enhance staff nurse retention by improving nursing leadership. These strategies emphasize the importance of leader preparation and organizational structure.

Lateral violence in the professional practice of nursing is an old phenomenon born out of the construct of nurses being oppressed by their mentors from the early unset of their nursing

Despite the rapidly expanding volume of literature on lateral violence in the nursing profession, it is apparent that those behaviours still occur (Croft & Cash, 2012; Roberts, 2015). Lateral violence is a systemic problem that still persists among our nursing professionals despite previous attempts to address it. Lateral violence causes serious negative outcomes for nurses, their patients, and health care organizations (Brunt, 2011; Johnson & Rea, 2009) and needs to be efficiently addressed. The purpose of this article is to generate an understanding of horizontal violence in nursing and explore the negative outcomes so that effective strategies can be found to finally address this problem. This literature review will be of interest to leaders,