Lateral Violence among Nurse in the Workplace

LateralViolence among Nurse in the Workplace

LateralViolence among Nurse in the Workplace

Healthcaresystems are fundamental social establishments that aim at maintainingthe safety of patients as well as bettering their spiritual,emotional and physical needs (Broome et al., 2011). The success ofhealthcare organizations depends on the efforts of healthcareprofessionals in enhancing productivity. Nurses have a unique role ofspearheading operations in healthcare organizations because of theirpatient-focused duties (Trudy &amp Dave, 2015). Therefore, it isparamount that nursing professionals maintain stable relationshipsamong themselves to promote constructive engagements aimed atimproving the delivery of health services. Destructions such ashorizontal and lateral violence within the workplace impede theexecution of nursing duties, thereby compromising the essence ofhealthcare organizations (Broome et al., 2011).

  1. The Problem

Lateralviolence among nurse in the workplace

Lateralviolence among nurses in their workplace has devastating consequencesfor the individual nursing professionals as well as negativerepercussions for the safety of patients. Therefore, it is importantto educate influence nursing professionals not to accept the statusquo regarding the perpetration of lateral violence in the workplace.In tackling this problem, I will address the 5thstudent learning outcome i.e. “applyingpractice guidelines to improve nursing practice and the careenvironment.”This research seeks to provide answers to the nature and extent oflateral violence among nurses in their workplace.


Toapply practice guidelines in improving nursing practice and the careenvironment

  1. Review of the Literature

Thischapter presents the analysis of literature related to lateralviolence among nurses in the work environment. The chapter willreview recent relevant studies on the subject as well as exploretheir findings. It will aim at highlighting the most notable aspectsof workplace violence among healthcare professionals. Moreover, thischapter fosters the understanding of the presence of lateral violenceby exploring the degree as well as the nature of violence. Thischapter will address the 1ststudent learning objectives i.e. it will aim at “Integratingtheory, research, clinical judgment as well as inter-professionalperspectives evidence, clinical judgment, research, andinter-professional perspectives to improve practice and associatedhealth outcomes for patient aggregates.

  1. The prevalence of lateral workplace violence in the nursing profession

TheUS registers a high degree of workplace violence among healthcareprofessionals, more specifically lateral violence among nurses. Common examples of lateral violence among nurses include nonverbalmanifestations, blockage of learning and training opportunities,verbal manifestations, withholding of information as well as sabotage(Trudy &amp Dave, 2015). A study by Burkhardt &amp Nathaniel (2014)showed that the healthcare setups have a higher probability ofnon-fatal acts of violence than other private sectors. Workplaceviolence involving nurses is worldwide problem, despite the growingawareness about the negative effects of workplace violence,healthcare systems continue to grapple with the problem. In 2008, theUnited States conducted a national survey that aimed at highlightingthe working conditions in specific areas of healthcare organizations,there were significant increases in workplace violence incidentsrelated to hostility, sexual harassment as well as physical violence(Trudy &amp Dave, 2015).

  1. The agents of workplace violence against nurses

Nursesare targets of violent acts committed by individuals seekinghealthcare services as well as current or former employees (Trudy &ampDave, 2015). Samnick(2015) conducted a survey on workplace violence involving nurses andfound that the majority of violent acts against nurses were committedby the relatives of patients as well as their friends. In othercases, nurse managers, doctors and even patients also contributedtowards the perpetration of violence against nurses, therefore,demonstrating the presence of lateral violence. Embree (2011) carriedout a study, which showed that female nurses were more likely toexperience sexual violence from male nurses, male nursing heads aswell as male doctors. However, the study showed that colleagues withunstable family lives were likely to subject female nurses to sexualand physical harassment compared to those with stable families.

Hill&amp Gardner (2014) conducted a study among nursing professionals inFlorida, which showed that unsatisfied nurses were more likely toengage in lateral violence, especially when they think that certainindividuals are favored within the hospital. Moreover, the studyshowed that hospitals that have poor working conditions are likely toexhibit higher rates of lateral violence, compared to hospitals thatare well-equipped. Finally, Hill &amp Gardner (2014) showed thatnurses with previous or current drug problems were more likely toperpetrate violence physical, verbal and mental sexual violenceagainst their colleagues.

  1. The Implications of Workplace Violence among Nurses

Lateralviolence has implications for the individuals as well as theworkplace environment. This section addresses the 6thSLO i.e. performingrigorous critique of evidence derived from databases to generatemeaningful evidence for nursing practice.Victimsof lateral violence usually experience immediate, short term or longterm trauma. Such trauma is exacerbated among nurses that experienceincreased frequencies as well as severities of violent incidents(Trudy &amp Dave, 2015). In other cases, victims suffer physicalinjuries that may impede their effectiveness in offering nursingservices. Broome &amp Williams (2011) carried out a study amongnurses in Philadelphia, which showed that non-physical abuse is themost common form of lateral violence experienced among nurses. Thistype of abuse leads to emotional and physical symptoms, thus exposingnurses to distress. In a survey yielding about 300 registered nurserespondents across the US, the results indicated that bullying led tosignificant emotional and physical reactions and distress. In thestudy, 95% of respondents said they experienced anxiety, while 72%said they experienced headaches as well as gastrointestinal symptomsbecause of bullying (Burkhardt &amp Nathaniel, 2014). Furthermore,verbal abuse leads to emotional responses such as embarrassment,anger, and hopelessness.

  1. Contributions and Roles the Nurse Holds in Healthcare

Thischapter will address the 3rd student learning objective i.e.articulatingto a variety of audiences the evidence base for practice decisions.Nurses are among the largest pool of executives in the healthcaresystem. Their executive skills are crucial in formulating andimplementing healthcare policies across the globe (Melnyk&amp Fineout, 2011).The National Nursing Centers Consortium lists the nursing professionas the fastest growing primary care professionals. Nurses offerimportant contributions in hospital and healthcare boards whenformulating measures to improve the effectiveness of governance aswell as implement workable healthcare reforms (Melnyk&amp Fineout, 2011).Nurses are known for their credibility with health planadministrators, policy-makers, physicians and executives. Nurses arefamiliar with governance frameworks, healthcare policy goals, andlegal requirements in healthcare, healthcare financial systems aswell as strategies. Therefore, they are important assets hospital andhealthcare ministry boards (Melnyk&amp Fineout, 2011).

Becauseof their wide range of skills and practical engagement in thehealthcare environment, nurses have an upper hand in identifying andtriaging problems in healthcare systems (Salanova,et al., 2011).Nursing executives are good in determining psychosocial issuesaffecting healthcare services as well as applying motivationalinterviewing skills to promote healthcare. When carrying out localjoint needs assessments, nurses deliver the best solutions that servethe healthcare needs of local populations (Salanova,et al., 2011).Therefore, nursing executives contribute immensely towards improvinghealthcare service delivery because of their wide practicalknowledge.

Nursesare among the most compassionate healthcare professionals. They playa big role in reducing healthcare costs for patients, as well asreducing the rates of unnecessary mortality among patients admittedto hospital (Loweet al., 2012).Nurses reduce the healthcare costs for patients by reducing thenumber of days spent in the hospital through quality patient care.Studies show that patients that have been admitted with health issuessuch as congestive heart failure, pneumonia, and heart attacksrecuperate faster in hospitals that have high nurse staff ratios(Loweet al., 2012).Hospitals that grapple with low nursing staff ratios register highercases of fall among patients. Nurses help reduce the frequency aswell as the severity of accidents among admitted patients. Therefore,they contribute towards advancing quality healthcare and providing asafe environment for the recovery of patients (Loweet al., 2012).

Nurseshave spearheaded the greatest innovations in healthcare. Suchinnovations have enabled the expansion of access to healthcareservices by reducing costs especially in rural areas and in thedeveloping economies (Loweet al., 2012).Innovative healthcare models such as healthcare clinics under themanagement of nurses have enabled more people to access healthcareservices. Nurses pioneered and are still the key players in homevisiting healthcare programs designed to help individuals who cannotaccess hospitals. This service has been helpful in deliveringhealthcare services to the elderly and chronically ill patients (Loweet al., 2012).Transitional Care Models (TCMs) have helped reduce hospitalizationsfor chronically-ill patients and senior citizens. These innovationshave helped individuals achieve stable long-term health at reducedcosts. Nurses have led the way in developing systems that minimizethe level of medical errors through the provision of betterhealthcare coordination. Nursing professional continue toparticipate in enhancing the practicality and effectiveness ofinnovations in healthcare through recommendations and auditing theefficiency of healthcare infrastructure (Loweet al., 2012).

Finally,nurses play the fundamental role of patient education as well ascoaching. Nurses, together with healthcare teams engage patients inhelping them develop better ways of managing their health, especiallyfor patients with long-term lifestyle health conditions such asdiabetes, hypertension, and HIV (Salanova,et al., 2011).They are the primary patient advisors in areas such as lifestylechoices, emerging problems personal health, signs and symptoms ofvarious conditions as well as helping patients to cope with adiagnosis. Moreover, nurses are important components in advancedpractice healthcare teams. Examples of nursing professionals inadvanced nursing include clinical nurse specialists, registered nurseanesthetists, as well as certified nurse midwives (Salanova,et al., 2011).

  1. Ethical Issues and Decisions Faced in Healthcare

Thereare various ethical issues and decisions that face contemporaryhealthcare. Various factors such as regulatory changes, technologicalinnovations, and new healthcare conditions contribute to the ethicaldilemmas that healthcare professionals face each day (Gunn&amp Taylor, 2014).This chapter will address the 2ndstudent learning objective i.e. advocatingfor the ethical conduct of research and translational scholarshipwith particular attention to the protection of the patient.Thefollowing are the most notable decisions and ethical issues thathealth care professionals face today:

  1. Disagreements between healthcare professionals and families/patients

Themajority of these disagreements touch on the treatment decisions thathealthcare professionals may advise to be used to treat patients. Inmany cases, patients or their families may reject the decisions ofhealthcare personnel to use certain treatments for their patients(Gunn&amp Taylor, 2014).A good example is the use of chemotherapy in cancer treatment.Chemotherapy has the good side and the bad side of it. On the goodside, it is effective in eradicating cancer cells in the affectedtissues, however, on the bad side patients go through a lot ofemotional and physical strain throughout the treatment process (Gunn&amp Taylor, 2014).This therefore can lay a foundation for confrontations betweenpatients, their families and healthcare professionals. Moreover,patients and families might also push for complimentary treatmentoptions that are unacceptable according to the healthcareprofessionals (Gunn&amp Taylor, 2014).

  1. Waiting lists

Anotherimportant ethical dilemma is the waiting list issue. In recent years,there has been an increased demand for quality healthcare services.The increased demand has increased pressure on the already strainedhealthcare systems (Gunn&amp Taylor, 2014).Studies show that waiting for healthcare services may worsen thehealth conditions of patients and reduce the effectiveness of medicalintervention (Gunn&amp Taylor, 2014).Moreover, patients on the waiting list go through psychologicaldistress because of the pain that they go through as well as theirfamilies.

Anothernegative contribution of waiting lists is that they lead toinefficient use of critical resources such as the use of ICU beds totreat chronic care patients (Doherty&amp Purtilo, 2015).Additionally, waiting lists raise questions about geographic equalityregarding the patients as well as health centers. This issue becomesincreasingly complicated when considering the strain that patientsrequiring organ transplants go through. Some patients stay on thewaiting list for years before getting a matching donor. In somecountries, cancer patients requiring chemotherapy are put on thewaiting list for months, therefore reducing their chances ofrecovering from the disease (Doherty&amp Purtilo, 2015).

  1. Access to health care for marginalized groups

Accessto healthcare for mentally ill, chronically ill and the elderly isanother important issue in healthcare today. On component of thisissue highlights the marginalization of the defined populations infunding allocations. Traditionally, governments allocate the majorityof healthcare funding in managing acute illnesses, provision oflife-saving patient care and countering the spread of contagiousdiseases such as Ebola (Doherty&amp Purtilo, 2015).However, governments continue to allocate very small proportionstowards mental healthcare, rehabilitation care, and long-term care.Therefore, it is important to promote social advocacy foreconomically and socially disadvantaged patients as well asmentally-ill persons to enjoy high-quality healthcare like all otherpersons (Gunn&amp Taylor, 2014).In some cases, governments have used excuses such as lack ofself-care and patient compliance to minimize allocations towards thedisadvantaged populations. Therefore, governments and healthcareprofessionals have the responsibility to acknowledge as well aschallenge beliefs that discriminate based on age, mental illness andculture. Such advocacy will be instrumental in reducing physical and,emotional harm to the affected populations (Doherty&amp Purtilo, 2015).

  1. Medical errors

Medicalserror is another ethical issue that continues to linger incontemporary healthcare. One of the challenges in healthcare is thepromotion of the appropriate use of pain medication, especially amongterminally ill patients (Doherty&amp Purtilo, 2015).Moreover, another issue concerns the use of palliative care aspatients approach the end of their lives. In many cases, healthcareprofessionals have trouble determining the right medication to usefor pain management (Gunn&amp Taylor, 2014).For example, in patients that are terminally ill, treat the painassociated with their health condition may hasten their death. Manyhealthcare professionals are careful to avoid this mistake,therefore, opt to undertreat pain among these patients. Finally,healthcare professionals make mistakes when determining the righttime to switch from curative to palliative care, therefore exposingpatients to dangers (Gunn&amp Taylor, 2014).

  1. Evaluation of Global Healthcare Delivery Systems and Policies

TheUnited States

Thischapter will address the 4thstudent learning objective i.e. participatingin collaborative teams to improve care outcomes and support policychanges through knowledge generation, knowledge dissemination, andevaluating knowledge implementation.&nbspBeinga capitalist society where people access services and goods inexchange for monetary equivalents, the healthcare system in thecountry replicated the characteristics of capitalist economies(Schoenet al., 2015).However, in recent years, there have been an increased number ofprivate as well as public insurance systems. The most popular one isthe Obamacare insurance facility that aims at providing universalhealthcare services for every citizen (Schoenet al., 2015).However, most Americans are unable to meet the costs of improvedmedical technology, thus reducing access to medication. The countryhas about 86% insurance coverage from private and public insuranceproviders.

Individualsabove the age of 65 enjoy medical cover from the Medicare system(Schoenet al., 2015).The system also covers persons below 65 years who suffer fromdisabling injuries and illnesses. On the other hand, Medicaid coversthe medical costs for persons who are too poor to afford insurancefrom private institutions. The American healthcare industry allowsfor freedom of choice where patients chose their doctors and doctorsdetermine where they would like to practice medicine. However, thecountry has the most outrageous healthcare costs, with medicalexpenses accounting for significant proportions of the GDP (Prus,2015).The high administrative costs of healthcare are the majorcontributing factors to the runaway medical costs.


Canadaoperates within the capitalist framework just like the United States.The difference in the Canadian healthcare system is that it utilizesthe fee-for-service system in providing services (Prus,2015).The system is under the government’s administration, therefore, itis able to monitor and regulate the healthcare costs. The systemallows for the Universal coverage of every person who is a Canadiancitizen. The country has 10 provinces, with each having the autonomyto manage its healthcare system (Schoenet al., 2015).However, there exist some differences in the administration anddelivery of health services in the provinces. Provincialadministrations in the country cater for the healthcare costs throughtaxation as well as subscriber premiums. Any additional fundsrequired in the system are provided through injections from thecentral government. However, controls in the country’s healthsector have led to lengthy waiting lists in critical surgicalprocedures such as cardiac surgery (Prus,2015).

  1. Program Level Student Learning Outcomes

Thisresearch was able to achieve all the student learning outcomes ashighlighted in the specific sections of the paper. Some of the mostnotable lessons learnt from the research are as follows:

  • Healthcare systems are fundamental social establishments that aim at maintaining the safety of patients as well as bettering their spiritual, emotional and physical needs

  • Lateral violence among nurses in their workplace has devastating consequences for the individual nursing professionals as well as negative repercussions for the safety of patients.

  • Lateral violence has implications for the individuals as well as the workplace environment. Victims of lateral violence usually experience immediate, short term or long term trauma.

  • Hospitals that have poor working conditions are likely to exhibit higher rates of lateral violence, compared to hospitals that are well-equipped.

  • Waiting lists raise questions about geographic equality regarding the patients as well as health centers.

  • Healthcare professionals make mistakes when determining the right time to switch from curative to palliative care, therefore exposing patients to dangers.

  1. Conclusion

Lateralviolence among nurses in their workplace has devastating consequencesfor the individual nursing professionals as well as negativerepercussions for the safety of patients (Samnick,2015).Therefore, it is important to educate influence nursing professionalsnot to accept the status quo regarding the perpetration of lateralviolence in the workplace. Lateral violence has implications for theindividuals as well as the workplace environment. Victims of lateralviolence usually experience immediate, short term or long termtrauma. Such trauma is exacerbated among nurses that experienceincreased frequencies as well as severities of violent incidents. Inother cases, victims suffer physical injuries that may impede theireffectiveness in offering nursing services.

Nursesparticipate in practical engagements in the healthcare environments,they have an upper hand in identifying and triaging problems inhealthcare systems. Nursing executives are good in determiningpsychosocial issues affecting healthcare services as well as applyingmotivational interviewing skills to promote healthcare. When carryingout local joint needs assessments, nurses deliver the best solutionsthat serve the healthcare needs of local populations. Therefore,nursing executives contribute immensely towards improving healthcareservice delivery because of their wide practical knowledge. It isparamount to increase awareness about the negative effects of lateralviolence among nurses in the workplace to be able to realize all thebenefits that nurses bring to the healthcare system


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