Violence Among Nurses

Horizontal violence in nursing refers to the constant fights and antagonism among nurses in their course of duty. The violence involves conflicts among nurses and those people that they closely work with for instance physicians and medical supervisors. Examples of chaotic ways highly experienced are bullying, sarcastic comments and withdrawn support the effects lower the dignity of those involved in the violence. Horizontal violence has specific effects to the student nurses and those who are still new in the profession (Howe, 2001). The violence discourages new nurses in their professional growth because their capacity to learn and develop is slowed down. The focus of our group work is to find out the cause of this violence and the effects on nurses and patients they attend

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.

It may surprise many student nurses that most horizontal violence in school and the workplace does not entail physical violence. New graduate nurses need an understanding of what horizontal violence is and have the skills to prepare them for the likelihood of being not just a victim of, but the perpetrator of this behavior. Intimidating behavior distracts from patient care and can ultimately place the patient at risk for harm. Recognizing the behaviors that are considered horizontal violence, showing respect for peers, and having the tools to intervene will foster positive working relationships and a safer patient environment.

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.

As other careers, nursing profession is also not remain untouched with the conflict or violence between the same levels of staffs. Nurses working in health care organizations face several issues like sarcasm or intimidation between the coworker, which is called lateral or horizontal violence (Purpora, Blegen, & Stotts, 2013). The writers’ purpose of doing this research is to find out how does horizontal violence affect peers relations, quality of cares and the errors and adverse events on patients cares. Teamwork is essential for taking care of patients in health care facilities. Each members of the team plays equal and important role to achieve outstanding goals.

The Bureau of Labor Statistics (2000) shows that 48% of all non-fatal work related assaults and acts of violence have occurred in health care and social service settings. Violence against mental health and health care workers has the potential to cause major physical injuries and psychological trauma. In return this poses serious consequences on employers such as increased turnover, medical and psychological care, increased absenteeism, decreased morale, job dissatisfaction, legal issues, and worker burn-out. Agencies and clinicians are encouraged to evaluate and identify the risks that are potential barriers in their agencies. Safety plans need to be implemented and strategized along with re-evaluations on a continuous basis (Taylor, H. 2013).

Lateral workplace violence is described as aggressive, destructive, or harassment behavior in the workplace between nurses or other members of the interprofessional team (Yoder-Wise, 2015). This type of behavior can occur within every aspect of life including professional, social, and personal life. The behavior can include gossiping, withholding information, or ostracism extending outside of the workplace and can occur in person or in cyberspace (American Nursing Association, 2011). Lateral workplace violence is very common among nursing students and new graduates due to the lack of confidence and skill set these individuals possess during the learning process. These new nurses are forced to rely on nurse managers and leaders to prevent interprofessional conflict from peers with equal power (Yoder-Wise, 2015).

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).

Lateral violence (LV), is described as one or more secretly or blatantly targeting their discontentment towards each other, themselves or those weaker than themselves. Some may classify it as bullying, aggression, horizontal violence (HV) or professional terrorism, and it 's characterized by facial expressions, spiteful comments, hindering of important information, criticism, blaming, and disregard in all degrees with some so severe they 've resulted in suicide. Lateral violence has been in literature for 20 years and still vastly exists today (Griffin, 2014). Due to the traumatic effect bullying has on a nurse physically and psychologically, along with the safety of the patients she cares for, interventions must take place immediately to bring it to an end. If LV is allowed to continue, the effects it has on the nursing profession are critical such as nursing shortages, staff burnouts, elevated nurse resignation rates and a decline in the amount and quality of work one performs accompanied with a high potential for patient related errors (Becher & Visovsky, 2012). Organizations, managers and nurses are all responsible for eliminating lateral violence in the nursing workplace because each role directly impacts this major issue through education, tolerance and interactions.

In today’s world violence can be expected anywhere at any time. This includes what was considered at one time a low risk area, the medical facility. Today the incidence of violence is increasing. There are two types of violence the first is lateral violence or aggression which is amongst hospital or medical personal. The other is external factors consisting of patients or visitors instituting violence or aggression among themselves or against healthcare workers. This is known as a code grey in my facility and all male staff not currently engaged in patient care are supposed to respond.

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.

Nurses continually strive to bring holistic, efficient, and safe care to their patients. However, if the safety and well-being of the nurses are threatened or compromised, it is difficult for nurses to work effectively and efficiently. Therefore, the position of the American Nurses Association (ANA) advocate that every nursing professional have the right to work in a healthy work environment free of abusive behavior such as bullying, hostility, lateral abuse and violence, sexual harassment, intimidation, abuse of authority and position and reprisal for speaking out against abuses (American Nurses Association, 2012).

Essentially, the term abuse is an issue facing the nursing profession today. Many unreported cases of encountered verbal and physical abuse have been found to be ample in acute and complex care settings. These cases are amongst professional individuals (nurse-nurse and nurse-physician abuse) and also among the patient abusing the nurses. Effectively, abuse is not only a Canadian issue. It has been reported internationally as well. Thus, many nurses today are lobbying for the decrease of abuse within health care settings in order to ameliorate the working conditions. Nursing abuse may lead to other issues which will be discussed in this study. This paper will address the nurse-nurse, nurse-physician and nurse-patient abuse. In addition,

Each day thousands of employees are subject to threats, harassment, intimidation, and verbal or physical attacks. According to OSHA, workplace homicide is the leading cause of death for women and the 2nd leading cause of death for men. This growing problem has mangers as well as employees uneasy about their safety at work. It also has employers concerned about the tremendous liability associated with incidents of workplace violence. Therefore, it would be beneficial to employers, managers and employees to have some knowledge of workplace violence. Additionally, employers have a legal and moral obligation to provide a safe working environment for their employees.

Workplace violence is the main issue in the United States expressed influencing a large number of American consistently. Working environment violence is any demonstration or danger of physical savagery, provocation, terrorizing, or other undermining problematic conduct that happens at the work site. It ranges from dangers and verbal mishandle to physical ambushes and even murder. It can influence and include workers, customers, nurses, patient, clients, and guests. Workplace violence can be discovered anywhere in every field we may accept the fact that it can happen in our workplace too, but the fewer people speak which is encouraging these criminals to prepare of making more atrocity. The occupational safety and health organization (OSHA) have created rules and suggestions to decrease laborer presentation to this deplorable scourge but still many people are being victimized their hands are tied up mouths are taped out to face the reality of what they are living through (OSHA 2015). OSHA’s paradigm incorporates the following elements: management commitment and employee involvement, hazard analysis or assessment, hazard controls, employee training, and recordkeeping and evaluation (McPhaul, London, & Lipscomb, 2013). As mentioned, these elements are basic guidelines in constructing a program, but more specific measures are needed to address specific precursors that contribute to the occurrence of violence and bullying. This would assist in forming the best strategies to remedy workplace violence and incivility.