Nursing Incivility Case Study

Effectively, interpersonal conflict was found to be one of the major sources of stress for nurses. Fudge (2006) affirmed overt and covert types of horizontal and vertical violence. Overt violence is obvious for everyone to see whereas covert is the complete opposite while still encouraging cruelty to one’s peers (Fudge, 2006). However, partnerships within health care settings may be declining due to the fact that some nurses may feel overworked and stressed. Jacoba Leiper (2005) stated that nurses are under pressure to complete their workload during their shift. Thus the nurse who’s having trouble completing her work on time, may skip breaks or stay late to avoid the ire of those on later shifts. But if she doesn’t take these steps and regularly fails to complete her tasks during her shifts, she may irritate her peers or take her anger out on her peers as well. Thus, the

“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

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

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 2009 unspecified electronic survey was conducted with factors such as type, frequency, perpetrators, and professional/personal concerns on bullying identified (Quine, 2001). The results revealed that out of 330 RN respondents, 72% reported positive to bullying at various occasions in line of their career. Of this segment, clear hostility seemed most frequent in surgical/medical, operational rooms, emergency, obstetrical areas of care and adolescent residential behavioral/ mental health units. The main culprits to these act are non-other than; charge nurses, senior nurses, physicians and nurse managers. This is impartial research among others that have been

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.

Workplace bullying is a growing problem in the American workplace and the Nursing Profession no exception. Addressing workplace bullying and its impact on the nursing profession is paramount to upholding patient safety and decreasing nursing attrition rates. Defining the problem is the first step in addressing it. In the past, workplace bullying was referred to as “Nurses eating their young.” There are many names for the various levels of workplace bullying like horizontal and lateral violence, hostility, mobbing, and verbal abuse. Bullying actions can take place overtly or covertly. Nurse-to-Nurse bullying is known to occur during interaction communications and manifests by withholding information, intimidation, threats, verbalizing harsh innuendo and criticism, and undermining personal values and beliefs (Rocker, 2008). Power disparities are also a source of bullying. For example, using charge position for controlling staff assignments, reporting coworkers for perceived lack of productivity, placing others under pressure to achieve impossible deadlines, and withholding knowledge for policies and procedures (Rocker, 2008). Outright actions of yelling at coworkers and refusing to mentor new staff with their practice are also considered bullying behavior.

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

Lateral violence also known as horizontal violence, incivility, or bullying has been a phenomenon researched for over three decades according to nursing researchers. This paper aims to discuss the impact that lateral violence has on the work environment, teamwork, self esteem, and patient care. Lateral violence is a phenomenon that has negative implications on the nursing profession due to the fact it can be avoided but still occurs. Lateral violence has been defined as any unwanted abuse or hostility within the workplace and “nurses covertly or overtly directing their dissatisfaction inward towards each other, towards themselves, and toward those less powerful than themselves (Griffin, 2004, p. 257), as quoted by (Roberts, 2014, p.36). According to Sanner-Steieh and Ward-Smith (2014) “lateral violence may be verbal consisting of persistent criticism, gossiping, yelling or berating; or nonverbal consisting of behaviors of undermining, sabotaging, clique formation, failure to respect privacy or confidences, and assigning unmanageable workloads”. Lateral violence has negative implications that directly affect patient care because it creates high incidents of nurse turn-over which results in hospitals often being short staffed, the nurses on shift work longer hours with bigger caseloads, and the patient’s are the ones who experience an unsatisfactory quality of care. Studies estimate that 44% to 85% of nurses are victims of lateral violence and up to 93% of nurses report

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.

Professionalism is a very important key in the nursing profession. It is what paints a good image for a business or, in this case, an organization, people will most likely choose the professional organization over the unprofessional, because with the nurses that are professional they have great quality in customer service. Examples being, nurses that are professional aren’t rude or disruptive, they handle business in a kindly manner, following directions and policies etc. Unprofessionalism in nursing practice continues to hinder the expansion of the field. There are many things that nurses do that are highly unprofessional at the workplace. A few major unprofessional mistakes nurses tend to do is, bullying, breaking HIPPA, and behavior. To me, these are the biggest mistakes that really pop out at me.

Medical facilities have to start paying more nurses to stay late for work because without adequate staffing the job duties tend to get behind. Facilities have to pay nurses more money to keep them on call or higher contracting nurses. Hospitals, clinics and other patient care facilities continue to lose money every day when nurses are bullied because it also effects patient satisfaction. “Occupational exposure to bullying decrease job satisfaction”(Ceravolo, Schwartz, Foltz-Ramos, & Castner, 2012, p. 600). Being a nurse who is a victim of bulling on a day-to-day basis will cause stress in the nurse’s life. If the bulling does not cease in the facilities, nurses will not be completely satisfied with their job and retention will remain a problem for many hospitals and clinics. Nurse retention is another problem that patient care facilities deal with because losing a nurse only means the facility will have to pay more money to replace another nurse. In a retrospective analysis the cost of hiring a new nurse average around $62,000 to $ 67,000 to recruit, orient and hire a r.n. (Wilson, Diedrich, Phelps, & Choi, 2011). In the end, the cycle will continue and the result will be nurse retention if bullying does not stop and is address within a hospital or a clinic.

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.

Furthermore, there has been increasing correlation of lateral violence to poor leadership or management. In response to this, the Joint Commission on Accreditation of Healthcare Organization created a new standard in the “Leadership” chapter that tackle disruptive and inappropriate behaviors (American Nurses Association, 2012). This “Leadership” chapter, will further aid in seeking and preventing lateral violence.