Horizontal violence is ruining my unit

[funmom]

I work on a chaotic progressive care unit. It's stressful enough without horizontal violence added to the mix. We can't keep anyone. All the new grads keep quitting because of it. Even two of our seasoned nurses switched departments because of all the in-fighting. Everyone else has to keep working short. Management is aware of the problem, but doesn't seem to care as long as the shifts are covered. It got so bad that one nurse said she couldn't take nursing anymore and left to become a real estate agent. She's been a nurse for 15 years! What do you do, keep switching jobs? I've been working on this unit for over 4 years. I like PCU and don't want to leave. If nurses keep treating each other like crud, then what is this shortage going to be like when we get old?

[zuzi]

Hi all,

Because I can't sleep but I drank toooooooo much coffe, loool, because I analyzed too much all the time and because I readed your inquires I have couple of information found it about "horizontal violence" for you.

Horizotal violence is a intergroup conflict is a hostile and aggressive behaviour by individual or group members towards another member or groups of members of the larger group(Duffy 1995).

It is behaviour associated with oppressed groups and can occur in any arena where there are unequal power relations, and one group's self expression and autonomy is controlled by forces with greater prestige, power and status than themselves (Harcombe 1999).

It may be conscious or unconscious behaviour (Taylor 1996). (That is very important, persons involved could not be consciousness about them behaviors...are only "how they used to be").Some groups of people within each particular workplace unconsciously adopt inflated feelings and attitudes of superiority.

It is, generally, psychologically, emotionally and spiritually damaging behaviour and can have devastating long term effects on the recipients (Wilkie 1996).

Horizontal violence includes:

All acts of unkindness, discourtesy, sabotage, divisiveness, infighting, lack of cohesiveness, scapegoating and criticism . For example:

Belittling gestures e.g. deliberate rolling of eyes, folding arms, staring into space when communication being attempted - Body language designed to discomfort the other

Verbal abuse including name calling, threatening, intimidating, dismissing, belittling, undermining, humorous 'put downs'

Gossiping (destructive, negative, nasty talk), talking behind the back, backbiting

Sarcastic comments

Fault finding (nitpicking) - different to those situations where professional and clinical development is required.

Ignoring or minimising another's concerns

Slurs and jokes based on race, ethnicity, religion, gender or sexual orientation

Sending to 'Coventry', 'freezing out' excluding from activities and conversation, work related and social.

Comments that devalue: people's area of practice; women; others that are different to the 'norm'.

Disinterest, discouragement and withholding support

Limiting right to free speech and right to have an opinion

Behaviours which seek to control or dominate (power 'over' rather than power 'with')

Elitist attitudes regarding work area, education, experience etc "better than" attitude

Punishing activities by management e.g. Repeatedly sending someone out of area; bad rosters; chronic under staffing; lack of concern with mental, emotional, spiritual and physical health of employees

Lack of participation in professional organisations (a subtle form of self-hatred) however, busy family lives can preclude participating in professional organizations.

Effects of horizontal violence - The effects of ongoing horizontal violence are progressive if not addressed and are explained in the following description of stress breakdown.

The following list is divided into three stages as described by William Wilke (1996 3 - 5)

Stage 1 (activation of the fight or flight response - circulating adrenalin)

Reduced self esteem

Sleeping disorders

Free floating anxiety

Stage 2 (neurotransmitters depleted with lack of sleep - fatigue - brain over stimulated and oversensitive)

Difficulty with emotional control - bursting into tears or laughter or irritable and angry in response

Difficulty with motivation - self-starter seems to be 'burnt out'.

Stage 3 (brain's circuit breakers activated)

A relative intolerance of sensory stimulation

A loss of the ability to ignore things that before were manageable

Changed response patterns which superficially resemble a change of personality (brain circuit breakers induce person to actively reduce incoming stimuli)

Horizontal violence can result in:

Sleep disorders

Poor self esteem

Hypertension

Eating disorders

Nervous conditions

Low morale

Apathy

Disconnectedness

Depression

Impaired personal relationships

Removal of self from workplace - psychologically, physically (sick leave, stress leave, resignation)

Suicide (successful or attempted)

Strategies for personal action to avoid horizontal violence and create a safe, happy workplace:

Name the problem - use the term 'horizontal violence' to refer to the situation.

Raise issue at staff meetings - break the silence about this issue

Ask about a process for dealing with this issue in your workplace

Engage in reflective practice - keep a journal, raise your self awareness about your own values, beliefs and attitudes and your own behaviour; begin or continue a path of personal growth - own your 'shadow' - ensure you are part of the solution, not part of the problem, (and we all are part of the problem at times - the important thing is to note and address it)

Ensure self caring behaviours, massage, counseling, peer support, good nutrition, adequate sleep, time out, meditation, exercise - do the things that help you to be healthy and happy in all aspects of your human ness.

Be willing to speak up when you witness it happening and name 'horizontal violence' for what it is.

Strategies for management to avoid horizontal violence and create a safe, happy workplace:

Successful strategies come from the top and require an ongoing commitment to culture change concerning horizontal violence!

Gain knowledge about Horizontal Violence and its causes, conduct regular meetings with a designated committee and institute a program to address this issue; supervise its operation and success

Undertake a formal thorough analysis of your unit's culture.

Ensure there is a process for dealing with this issue in your workplace and follow it

Have a policy about harmonious workplace relations, support and encouragement of students, new staff members and staff generally.

Foster an environment of open collaboration, exploring and healing of issues, rather than fault-finding and blame.

Support workers' autonomy and initiative and promote a learning culture

Provide education about processes to promptly report incidences of victimisation; support and encourage people to do so.

Monitor staff morale and address issues which negatively impact upon morale

Ensure that staffing is adequate, that rosters are fair and allocation to areas is fair within your unit/institution; ensure that all staff have equal opportunity for advancement and education.

Engage in self-awareness activities and in reflective practice. Ask for feedback from staff about your management practices and not just from close associates

Institute open, honest and supportive dialogue through peer review - strategies which are process based, not personality based.

Revise and articulate core values of institution and health care, make one core value a topic at each team meeting

Engage in self care activities as above

Access to appropriate counseling services in the workplace is essential for staff involved in this issue. Information about these services should be displayed in an easily observed place.

What to do if you are subject to horizontal violence

Address the behaviour immediately with the perpetrator - most people have no idea they are doing it. Horizontal violence is usually a product of unconscious dysfunctional patterns. These are patterns that fit the 'victim, rescuer, persecutor' triangle model of unhealthy human behaviour . Use conflict management strategies; say "I feel ... (whatever you are feeling) when you...(whatever they are doing)..." Use the broken record approach - repeat the process if the other person makes excuses, denies or dismisses incident. Accept their statement and repeat, saying "that may be so and I feel (whatever you feel) when you...(whatever they do or say that is an issue for you). Feel the fear and do it anyway. Respond with a clear intent. Ensure you are willing to engage in uncontaminated communication.

If you don't get any positive response, or if the behaviour continues:

Take comprehensive notes regarding the incidences - this can be in diary form.

Name it - refer to it as Horizontal Violence

Speak to your supervisor about the incident(s)

Obtain counseling support

If your health is adversely affected, you may be able to claim WorkCover.

I attached is a study may be could helps at the end you will find a lot of references, try to write her and discuss with her your problem is seems that is specialist in domain.

http://nursingworld.org/mods/mod440/lateralfull.htm

Hoping that your in your world nursing will start to be better, and you will be HAAPPPPYYYYYYY lots of hugs Zuzi, muaaah :icon_hug:

[Jeffthenurse]

To me, work is fun, enjoyable, and very emotionally rewarding and if it becomes a "chore", it's no fun for me. Therefore, whenever I face a colleague or a mob of negative backstabbers, I confront them, usually one at a time in the break room or in the hallway and let them know that I'll make it just as miserable for them as they make it for me. I'll involve the manager as soon as I realize that talking to the problem people didn't work. Whenever I work, as much as I use humor in the workplace, I'm serious about patient care, teamwork, and doing a great job and I won't tolerate poor patient care or a lack of teamwork from anyone. I'm not afraid of standing up for what I think is right. Making cookies and giving birthday cards are things you do for people you like and respect, not for people you would quit your job over. Cause a ruckus---don't be afraid to take the matter to the Director of Nursing but use the chain of command. I was a nurse manager in the past and valued my staff more when they came to me over stuff like this. When we solved the problems together, we made the unit better for everyone and kept the turnover rate way down. Don't quit when you like the unit.

[lynny4]

Hi I am a nursing student awaiting graduation in 9 weeks. I have been given a special project about Horizontal Violence. I plan on making a video which will depict new nurses experiencing the abuse and how they can handle the abuser. I was hoping that some of you would share with me some of your experiences either when you were the victim or you were a witness to it. Thanks for your help.