Lateral Workplace Violence Among Student Nurses

Even though workplace politics exists in every profession, the effects of horizontal violence, or bullying, in nursing is a costly behavior. Nurses feel devalued in the workplace and experience psychological effects. Patients are likely to experience less favorable outcomes, and

Typically, when someone thinks of a bully, childhood memories of scuffles on the playground come to mind. Bullies are not usually people that are associated with adult life. However, nursing has changed this stereotypical view. For many nurses, bullying may be as great a threat every day at work as it was when they were in grade school. This threat is because of what is termed as horizontal or lateral violence in the workplace, and it is a surprisingly, prominent issue in the field of nursing. Furthermore, horizontal violence is a detrimental problem in nursing due to its damaging and negative effects on nurses and the nursing profession as a whole.

Safety is an important factor and is a high priority in healthcare. Kelly, Fenwick, Brekke, and Novaco (2015) shared that workplace violence impairs the staff perceptions of safety. However, both patients and staff are affected by workplace violence in many ways, from physical to emotional aspects. There are many reasons why violence occurs, that will be explained later in this paper. The purpose of this paper is to explain the reason and importance of the chosen phenomenon of interest. Moreover, primary and opposing philosophic viewpoints will be discussed, as well as ways of recognizing and utilizing them in nursing. The ways of knowing patterns in nursing and the utilization of these patterns will be explained, pertaining to nursing care.

Horizontal violence is a hidden pattern of individual behavior in controlling other individual that risk health and safety (Hinchberger, 2009). According to Roche, Duffield and Catling-Paull, violence can be describe as emotional abuse, threat, or actual violence in any health care setting. Although the definition varies according to situations and practice settings, there is agreement that workplace violence has a negative impact on the health and wellbeing of nurses and the delivery of quality nursing care (Hinchberger, 2009). Violence mostly occur in any health care setting, However, it mostly occur in emergency department, waiting room, psychiatric ward and geriatric unit on which people involved psychological situations.

The lateral violence comes in many forms and in many ways, such as abuse in the workplace that occur between colleagues, it can be verbal or nonverbal aggression, intimidation, bullying, harassment, discrimination, stereotyping, gossiping, criticism, and other related mistreatment behavior at work. Institutional lateral violence also happens between manager and subordinate where they can use their higher position to perpetrate assault to their subordinate such as acts of lasciviousness, shouting, anger outburst, forced overtime request, giving work beyond the job description, work overload, over blaming or insulting a staff and more. All these happen occasionally because of the lack of respect in the workplace and it comes without notice, especially in healthcare practices where the nature of work is tough and decision making must be made immediately.

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.

Typically, when someone thinks of a bully, childhood memories of scuffles on the playground come to mind. Bullies are not usually people that are associated with adult life. However, nursing has changed this stereotypical view. For many nurses, bullying may be as great a threat every day at work as it was when they were in grade school. This threat is because of what is termed as horizontal or lateral violence in the workplace, and it is a surprisingly, prominent issue in the field of nursing. Furthermore, horizontal violence is a detrimental problem in nursing due to its damaging and negative effects on nurses and the nursing profession as a whole.

In a profession where caring is the epicenter of the job, it is disconcerting to see a high occurrence of bullying in the nursing environment. Lateral bullying and lateral violence are terms used to describe bullying, uncivil behavior, disrespect, social devaluing, peer control and verbal, physical and emotional abuse occurring between nurses and or colleagues (Ceravolo et al., 2012). Abusive behaviors from a superior are considered vertical or hierarchal violence and are commonly seen when the superior attempts to control or bully the nurse using their superiority, often leaving the nurse feeling defenseless due to an imbalance in power and control (Broome & Williams-Evans, 2011). Some examples of bullying include harsh criticism, unfairly blaming others for mistakes, and withholding patient care information (Simons et al., 2011). In a recent study measuring workplace bullying, Simons, Stark and DeMarco (2011) found that the most common behaviors those feeling bullied experienced included being assigned workloads they felt were unmanageable, and being ignored or excluded by their peers.

Teamwork, collaboration, and empowerment are descriptive terms that many current and future nurses expect to be incorporated within their working environment. It is not unusual for nurses to work as a team with other health care professionals as well as one another to provide the best care for a patient. Therefore, one would think that a primary goal among nurses would in fact be collaboration. Yet, as a general step towards attacking all types of violence, many researchers have exposed violence in the healthcare setting. Also referred to as workplace bullying, lateral violence, is a specific type of workplace violence that is exceedingly present in the nursing profession. Lateral violence could be considered an antonym of the terms spoken

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.

Bullying is a serious problem in the nursing profession, it decreases nurse productivity, creates adverse patient outcomes, and overall lack of job satisfaction. It can be seen anywhere in the nursing profession. Bullying includes emotional and physical abuse as well as, putting others down, intimidation, spreading rumors, etc. “Research findings suggest that bullying frequently occurs among RNs [6] to the extent that up to 40% of nurses report an intent to leave because of it [7]; this is significant especially for new nurses, in that new RNs reported being bullied at work which resulted in 30% of

Civility in the work place, or the lack thereof, has been identified as a growing problem within many professions in today’s society. Often referred to as lateral violence, this occurrence is no exception in the nursing profession. It is also known as ‘horizontal violence’ or ‘workplace bullying (Coursey, Rodriguez, Dieckmann, & Austin, 2013). In this evidenced-based paper, information will be provided in an effort to identify causes of lateral violence in the workplace and how to encourage civility.

Nursing is a profession that is based on the principles of caring and ethics. For years nursing has been continuously ranked as the most trusted profession (Riffkin, 2014). Nurses advocate for patients even if it means standing up to doctors and hospital administrators. Shockingly, for a job rooted in compassion, horizontal violence is a devastatingly common occurrence in the nursing profession. Horizontal violence, or workplace bullying, is defined as repeated incidences of aggressive behaviour intended to intimidate, degrade, humiliate, and offend a person or group of people (Ontario Nursing Association, 2012). Nurse-to-nurse aggression can range from yelling, withholding information, refusing to help, undermining a fellow nurse 's work ability and threatening unnecessary disciplinary action (Rocker, 2008). In Canada, 50% of nurses reported being verbally abused and 46% experienced hostility or conflict with colleagues (Statistics Canada, 2005). While many nurses are victims of bullying, many do not report the incidents and develop poor coping strategies. When a nurse does not report a bully, they are putting their mental health at risk. Nursing programs must implement educational programs for student nurses. They rely on safe clinical placements to develop and practice essential nursing skills. However, the toxic environment that bullying creates jeopardizes not only their education but their mental health as well, spurring on ramifications that last a lifetime.

Several models and concepts arose in preventative measures to workplace violence in nursing. One conceptual model, according to Covert Crime at Work, is “a conceptual model derived from 370 surveys show working conditions conducive to bullying, thus helping to identify risks early and to prevent unhealthy environments from developing.” After recognition of these research and studies, organizations such as Occupations Safety and Hazard Association, American Nurses Associations, and etc, have implemented guidelines to prevent workplace violence in nursing.

“The first step in teaching nurses how to decrease bullying by others is to help them understand what to do and what not to do when confronted by a bully” (Rocker, 2008, Education, para. 13). Nurses need to be aware of how to recognize horizontal violence, and how to be able to stop it. Furthermore, Baltimore (2006) explained that nurses need to try and resist the temptation of participating in gossip which could ultimately result in people losing respect for nurses (p. 35). Nurses also need to be respectful and value differences among other nurses. Each nurse is unique and may have different ways of implementing his/her type of care. Therefore, it is crucial that nurses respect these differences (Rocker, 2008, Policy, para. 14). If nurses are able to be consciously aware of these small things, it can make a huge difference on how they treat other coworkers, and how others view them. Not only is it important for nurses to understand what horizontal violence is, but managers of hospitals need to be well educated of this as well. Brunt (2011) stated that managers have a key role in preventing and altering horizontal violence in the workforce. It is important that managers create an environment where staff members feel comfortable coming to the managers with concerns. Managers need to be educated about how to deal with the negativity of horizontal violence (p. 7). Managers can improve relationships, trust, and productivity and reduce tension by