Relational Harassment In Nurses: A Case Study

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.

Nurse bullying is not limited to the new nurses being the victims. Bully behavior is a learned process and a choice. A new nurse might observe and embrace the bully behavior in hopes to fit in a little bit more (Rocker, 2008). Cliques may form on nursing floors which are the vehicles for nurse bullying. Cliques help a bully hide and gain support. It seems easier for people to join the group instead of fighting against it (Rocker, 2008). This is why workplace bullying is a growing statistic.

“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

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.

“Paradoxically, the job sector with the mission to care for people appears to be at the highest risk of workplace violence. Nurses are among the most assaulted workers in the American workforce “ (NACNEP, 2007).Nurses Exposure to bullying, physical and nonphysical violence is commonly seen in the nursing profession globally and historically. Bullying and abuse against nurses results in low morale, job satisfaction, and can negatively impact nurse turnover and quality of patient care.

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

There has been much research done on the prevalence of bullying in the nursing workplace. Smith, Andrusyszyn, and Laschinger (2010) report that up to 90% of nurses encounter bullying in the workplace. Because this has become so commonplace within the nursing environment, many nurses turn a blind eye, or passively participate in bullying, accepting it as a normal occurrence in the workplace

The prevalence of workplace bullying within the nursing profession remains unclear because there have been relatively few complete studies conducted about the subject. For example, one systematic review of the

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

Hayward, Bungay, Wolff, and Macdonald (2016) performed qualitative interviews on twelve registered nurses averaging sixteen years of experience that represented diverse areas of acute care, to investigate the factors that contribute to turnover. Three themes that influenced the nurses’ decision to leave nursing were challenging workplace environments, limited leadership support, and personal health issues. (Hayward et al.) Furthermore, Hayward et al.’s theme of challenging workplace environments detailed the nurses’ insight on harassment, negative behaviors, and bullying that resulted in nurses’ impaired job performance. Wilson, Diedrich, Phelps, and Choi (2011) investigated the quantitative prevalence of incivility related to the intent to leave nursing by obtaining the results of surveys replicated from the American Academy of

Bullying can be categorized into two classifications, cover or overt. Overt is a behavior that is easily seen by other individuals such as name calling, physical threats, screaming, etc... Covert is not as easily seen amongst individuals. Some examples of covert bullying in the nursing world are getting an unfair assignment or another nurse withholding information from the new employee. This type of intimidation is also seen amongst students in their clinical setting. Covert treatment can be ignoring a student when he or she has a question about his or her patient, “freezing the individual out”. These many behaviors mentioned previously are what mainly take place in the hospital. A new nurse dealing with overt or covert bullying is very challenging and makes for a hostile environment. A fresh worker who is welcomed by his or her new staff is more likely to thrive in their job position. In Renee Thompson’s article, she gives the fact “newly licensed nurses who start their careers in supportive, nurturing environments are

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

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.

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.

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.