The Disruptive Force of Lateral Violence in the Health Care Setting
The Disruptive Force of Lateral Violence in the Health Care Setting
Given the ascending role of NPs as leaders in the health care workforce, with more than 192,000 NPs employed in the United States serving as role models, mentors, and supervisors, NPs arguably hold a responsibility to understand the nature of lateral violence, its impact, promising preventions, and interventions. Given the theoretical base of the oppressed group model, NPs must work to change the culture of the health care workplace so that nurses are valued as equal partners in health care with physicians and health care administrators. This involves organizational analysis of the work environment, practices, policies, and normed behaviors with appropriate systemic changes, so the organization is not an incubator of lateral violence. Furthermore, NPs need to work within the health care organization to ensure their immediate subordinates are not subjected to or perpetrating lateral violence through careful and consistent evaluation.
Although changing a monolithic organization is certainly daunting, helping members of the oppressed group understand the forces that create the context within which lateral violence occurs as well as assisting nurses in understanding their own responses or those of their colleagues as a result of oppression will reduce patterns of lateral violence. NPs acknowledging their responsiveness to oppression can change patterns of behavior through self-reflection. Sheridan-Leos suggests a form of cognitive behavioral training in which nurses participate in a special session that focuses on understanding, identifying, and responding to lateral violence, followed by role-playing in which members of the team strategize and rehearse responses to the violence. Elsewhere, Ceravolo et al call for nurses to be trained in conflict resolution as a means of reducing the incidence of lateral violence predicated by the stress and chaos of crises in the health care workplace.
Given the incidence of lateral violence visited on newly minted nurses, and the resultant high attrition rate of such nurses in health care organizations, schools of nursing should provide their students with education on understanding lateral violence and how to prevent and respond to lateral violence. Such education has been shown to be effective in the prevention of lateral violence for new nurses. NPs serving as preceptors must be aware of the real threat lateral violence poses to students during clinical practica. The student must be protected from such abuse and, importantly, trained to prevent lateral violence as an NP.
Although NPs have not sought legal redress for acts of lateral violence, there is some case law that shows lateral violence in the workplace is an old problem, in all settings, but particularly in hospitals. Recognition of lateral violence as harmful and unacceptable in the workplace has grown. However, our review found that laws do not deal directly with this problem. Victims who want to take a lateral violence case to civil court or file a criminal complaint have no clear pathway in the courts. Responding law enforcement officials must decide whether and how to approach a criminal report. The victim is in the role of witness, has little control after reporting, and is not positioned to ask for compensation or damages because crimes are wrongs against society. Civil courts and some administrative courts address wrongs among individuals. In these courts, the victim must look for parts of the law that may apply to acts in their particular situation. Here are the most recently published case examples from US courts.
Prevention
Given the ascending role of NPs as leaders in the health care workforce, with more than 192,000 NPs employed in the United States serving as role models, mentors, and supervisors, NPs arguably hold a responsibility to understand the nature of lateral violence, its impact, promising preventions, and interventions. Given the theoretical base of the oppressed group model, NPs must work to change the culture of the health care workplace so that nurses are valued as equal partners in health care with physicians and health care administrators. This involves organizational analysis of the work environment, practices, policies, and normed behaviors with appropriate systemic changes, so the organization is not an incubator of lateral violence. Furthermore, NPs need to work within the health care organization to ensure their immediate subordinates are not subjected to or perpetrating lateral violence through careful and consistent evaluation.
Although changing a monolithic organization is certainly daunting, helping members of the oppressed group understand the forces that create the context within which lateral violence occurs as well as assisting nurses in understanding their own responses or those of their colleagues as a result of oppression will reduce patterns of lateral violence. NPs acknowledging their responsiveness to oppression can change patterns of behavior through self-reflection. Sheridan-Leos suggests a form of cognitive behavioral training in which nurses participate in a special session that focuses on understanding, identifying, and responding to lateral violence, followed by role-playing in which members of the team strategize and rehearse responses to the violence. Elsewhere, Ceravolo et al call for nurses to be trained in conflict resolution as a means of reducing the incidence of lateral violence predicated by the stress and chaos of crises in the health care workplace.
Given the incidence of lateral violence visited on newly minted nurses, and the resultant high attrition rate of such nurses in health care organizations, schools of nursing should provide their students with education on understanding lateral violence and how to prevent and respond to lateral violence. Such education has been shown to be effective in the prevention of lateral violence for new nurses. NPs serving as preceptors must be aware of the real threat lateral violence poses to students during clinical practica. The student must be protected from such abuse and, importantly, trained to prevent lateral violence as an NP.
Although NPs have not sought legal redress for acts of lateral violence, there is some case law that shows lateral violence in the workplace is an old problem, in all settings, but particularly in hospitals. Recognition of lateral violence as harmful and unacceptable in the workplace has grown. However, our review found that laws do not deal directly with this problem. Victims who want to take a lateral violence case to civil court or file a criminal complaint have no clear pathway in the courts. Responding law enforcement officials must decide whether and how to approach a criminal report. The victim is in the role of witness, has little control after reporting, and is not positioned to ask for compensation or damages because crimes are wrongs against society. Civil courts and some administrative courts address wrongs among individuals. In these courts, the victim must look for parts of the law that may apply to acts in their particular situation. Here are the most recently published case examples from US courts.