2. Lateral Violence Exists on a spectrum, from seemingly ordinary behaviour such as gossiping or criticism, to intimidation, racism and outright physical intimidation or harm. Many have firm views on the necessity for younger nurses to endure what they themselves had to endure in their "training" for the profession. Tackling the nursing shortage requires action on both attracting recruits and making it easier for them to stay.
3. Signs of workplace violence Workplace violence and harassment experts identify the following behaviours related to workplace lateral violence: aggressive or mocking body language such as raising eyebrows or making faces verbal retorts, abrupt responses, vulgar language undermining behaviour such as ignoring questions, constantly criticizing or excluding individuals from discussion withholding needed information or advice sabotage such as setting up a new hire for failure infighting and bickering scapegoating blaming and gossiping behind a colleague’s back failure to respect privacy, and broken confidences shouting, yelling or other intimidating behaviour judging others on age, gender, sexual orientation, ethnicity or size physical violence
4. Lateral Violence and Nurses A 2003 study in the Journal of Advanced Nursing found that half of newly qualified nurses report first-hand experience with lateral violence. Many senior nurses expect graduates to hit the ground running," says Judith Tompkins, chief of Nursing Practice and Professional Services and executive vice-president of Programs at the Centre for Addiction and Mental Health (camh) in Toronto. "When there is a lack of collegiality and mentoring from peers, young nurses are thrown into the workforce and are left feeling unsupported."
5. Workload and Nursing Culture "One of the real challenges is that most nurses are being worked off their feet. Lateral violence may be due to nurses displacing stress and aggression on one another." Despite attempts over the past few decades to raise the profile of nursing and attract more men, "nursing is still a pink ghetto, and often doesn't have enough support from human resources in the organization."
6. Oppressed Groups Connection of lateral violence in nursing to the behaviours of oppressed groups, where inter-group conflict is seen in the context of being excluded from the power structure. Nurses generally don't have sufficient control over their work environment and have a high degree of accountability coupled with a low degree of autonomy
7. Paulo Freire Methodology SEE the problem or situation lived by clients ANALYZE the factors (personal, cultural, institutional) that contribute to the problem ACT to change the problem or situation
8. What to do? "When nurses don't have control but must be accountable, you can see where they might not be happy with one another." Other unhealthy coping strategies include taking up smoking, using alcohol excessively and abusing prescription medication. Anti-harassment and diversity initiatives can make a big difference.
9. Who else is involved? "Lateral violence cannot thrive when employers become ethically and legally responsible." Patients also may unwittingly contribute to the situation, says Porto. They may accept bad behaviors they witness because they believe professionals who display disruptive behaviors are very skilled, really care, and are aggressively advocating in their best interest.
10. Nursing Culture New nurses personalize their experiences and assume they are unique to themselves," she says. "Our program empowered nurses to advocate for themselves. As it liberated them, retention rates improved. We attribute this to recognition of lateral violence. Newer nurses can learn from those who've gone before."
11. Bystanders and Managers Sometimes staff witness lateral violence events but are not prepared to support their colleague for fear that they might be the next victim. Ignoring the victim’s behavior and distress seemed to be the way both staff and the organization responded to the issue. There may be a style of management within nursing at various levels and institutions that is based on fear rather than respect.
12. Culture of Silence “Because we set ourselves up to be healers, this kind of behaviour is in the shadows. We don’t know what to do about it, so we try to disown it.” In practice, this means Nurses can’t stay silent when another nurse’s actions “makes them cringe”. Having the conversation is what matters . . . it shows that both professionals share responsibility for behaviour affecting staff and patients.
13. What can you do? Dialogue is ultimately far more effective than pointing fingers Health care professionals across the spectrum working together more effectively, and patients receiving better care.
14. Confront Behaviour If one speaks critically or takes a questioning stance then one may be positioned as disloyal, ungrateful or a bad nurse. The way forward is to focus on implementing strategies to reduce the opportunities for bullying behavior to occur Take personal responsibility for the situation
15. Confront Behaviour Confront behavior and acknowledge if it has been there for a long time but was never discussed. Take personal responsibility for the situation Try to reach consensus to actively bring about change by developing, publishing, and implementing strategies. Some people are shocked to discover that they actually contribute, either inadvertently or otherwise, to a bullying culture by their actions or inactions.
16. Teamwork and Communication Teamwork in this area involved many staff in solving problems related to these issues. A policy document on bullying and intimidation was developed. Specify the sorts of behavior that would not be tolerated, and instead the policy referred to the general "rights" of individuals to be treated fairly and with respect. Effective anti-bullying practices must include a statement of exactly what constitutes bullying Issues such as this, within both organizations and professions, need to be brought out into the open in a non-blaming way with a focus on the future
17. Tackling a Culture of Intimidation Developing more open communication and increased access to nursing senior management Ensuring that nursing supervisors receive adequate nonclinical training for their role Ensuring that competency standards refer specifically to managing bullying and that these standards are maintained through an effective performance management system Providing accessible professional development opportunities for all staff Developing policy on bullying/lateral violence in the work-place and conflict resolution mechanisms.
