Violence Among Nurses

If those who witness horizontal violence taking place or if the nurse being targeted does not speak up, it can keep occurring until the situation starts to have a negative impact on the targeted nurse. The effects can start to show up in the nurse’s work and in patient satisfaction. It can also lead to the nurse leaving their hospital for a new hospital to work for and it can even lead to the nurse leaving the nursing profession for good. Some nurses deal with this type of stress by seeing it as a challenge that they must endure in order to be become hardy and resilient

Indeed, Fudge (2006) describes this as vertical violence, which means that the act of violence is between senior and junior colleagues. Horizontal violence is across peer groups and similar levels of staff. The most common aggressors or bullies are nurse-managers and supervisors (Leiper, 2005). Certainly, education is very influential in terms of the respect seen among health care professionals, because it has been an ongoing issue as to understanding the hierarchy in the health care profession. The bridge between education and collaboration is still suffering today and it is an issue to address.

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 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 Examples of chaotic ways highly experienced are bullying, sarcastic comments and withdrawn support the effects lower the dignity of those involved in the violence.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

The QSEN competences which are affected are the focus on patient safety and teamwork and collaboration. QSEN defines teamwork and collaboration as the “ability to function effectively within nursing and inter-professional teams, fostering open communication, mutual respect, and shared decision making to achieve quality patient care.” (Pre-Licensure KSA 's). QSEN defines patient safety as “Minimizes risk of harm to patients and providers through both system effectiveness and individual performance” (Pre-Licensure KSA’s). Failure to work with and collaborate with each other can break down morale and communication which in turn can negatively affect the patient. It is important to continue research and studying this topic, because the lasting effects of lateral violence can affect the health of the nurse and the patient long term and affect the revenue and budget of the hospital.

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.

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.

According to Purpora and Blegen, approximately 60% of actual errors in patient care result from poor and ineffective communication (para. 3). Horizontal violence causes a decrease in effective communication between caregivers which places the patient’s safety in jeopardy. Horizontal violence decreases staff morale which leaves room for error in the workplace (Longo & Smith, 2011).

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.

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.

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 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).

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).

The problem of interest that I chose to discuss is lateral violence (LV) in nursing. LV is a deliberate and harmful behavior demonstrated in the workplace by one employee to another, it is a significant problem in the nursing profession (Christie, 2014). LV is the same thing as bullying someone. Studies estimate that 44% to 85% of nurses are victims of LV; up to 93% of nurses report witnessing LV in the workplace (Christie, 2014). LV can affect the victim’s physical and mental health, it can affect patient care and safety, and can be detrimental to the work environment. LV is often perpetrated by nurse managers and some nurses are afraid to report the LV for fear of retaliation or losing their jobs (Christie, 2014).

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).