The center for American nurses calls for an end to lateral violence and bullying in nursing work environments: new position statement offers information and recommended strategies.

Silver Spring, MD. -- February 27, 2008--Research has consistently shown an unacceptable level of violence in the workplaces of registered nurses (RNs). The sources of this violence include patients and their significant others, physicians, other healthcare personnel, and--perhaps most disconcerting--other RNs. Lateral violence and bullying specifically have been extensively reported and documented among healthcare professionals, with serious negative outcomes for registered nurses, their patients, and healthcare employers.

It is the position of the Center for American Nurses that there is no place in a professional practice environment for lateral violence and bullying among nurses or between healthcare professionals. All healthcare organizations should implement a zero tolerance policy related to disruptive behavior, including a professional code of conduct and educational and behavioral interventions to assist nurses in addressing disruptive behavior.

Background

Lateral violence (also known as horizontal violence, horizontal hostility, and intergroup conflict) is a specific type of violence that occurs between individuals at the same level of the organizational hierarchy. In nursing, it is nurse-to-nurse aggression. Lateral violence may be verbal or non-verbal and either overt or covert. The most common forms of lateral violence include non-verbal innuendo, verbal affront, undermining, withholding information, sabotage, infighting, scapegoating, backstabbing, failure to respect privacy, and broken confidences.

Bullying is generally associated with individuals at different levels of power and authority, but can also occur nurse-to-nurse. Examples of bullying include undermining an individual's right to dignity at work, humiliation, intimidation, verbal abuse, victimization, exclusion and isolation; intrusion by pestering, spying, and stalking; repeated unreasonable assignments to duties which are obviously unfavorable to one individual; repeated requests giving impossible deadlines or impossible tasks; and implied threats.

"Lateral violence and bullying have profound and measurable negative effects on nurses, healthcare organizations, and patients," said Carrie Houser James, MSN, RN, CNA, BC, CCE, President of the Center for American Nurses. "The Joint Commission has recognized the negative effects of disruptive behavior on staff morale and turnover as well as on patient care and has proposed new standards for 2009 that will require organizations to have a code of conduct that defines disruptive and inappropriate behaviors and require a process for dealing with them. We applaud The Joint Commission for this effort and support the proposed standards."

Lateral violence and bullying affect the nurse as an individual, the nurse's colleagues, and ultimately patient care. Nurses who are the target of the violence and bullying as well as their colleagues may experience decreased job satisfaction, increased stress, and both physical and psychological effects. This can lead to negative outcomes for organizations including increased absenteeism and turnover. The problem of lateral violence and bullying is broad reaching and has clear implications in the current and future projected shortage of nurses, as well as the safety and quality of patient care.

Solutions

The Center for American Nurses has adopted a position statement which includes recommended strategies that nurses, employers/organizations, continuing education and academic programs, and nursing researchers can employ to eliminate lateral violence and bullying. A template for a zero tolerance policy and procedure has been developed as a part of the position statement.

"Zero tolerance must become a reality," said Dennis Sherrod, EdD, RN, President-Elect of the Center for American Nurses. "This issue demands the immediate attention of every healthcare organization and every nurse."

Additional Information

A copy of the position statement is attached. It can also be accessed online at www.center foramericannurses.org/positions/lateral violence.pdf

For interviews with Carrie Houser James or Dennis Sherrod, please contact Terri Gaffney at 703-655-2872 or by email at Center@GannettHG. com.

This position statement has been approved by a majority of the delegates who represent the Center's 42 organizational members which include 41 state nursing associations and by the Center's Board of Directors.

Lateral violence and bullying are also topics which will be addressed at the Center for American Nurses national meeting which will take place in Washington, DC on June 23-24, 2008. Additional information can be found at www.LEADSummit2008. org.

The Center for American Nurses is a national professional nursing organization that educates, equips, and empowers nurses to advocate for themselves, their profession, and their patients. The Center offers evidence-based solutions and powerful tools to navigate workplace challenges, optimize patient outcomes, and maximize career benefits. Established in 2003, the Center partners with its 42 organizational members, comprised of over 47,000 registered nurses nationwide, to develop resources, strategies, and tools to help nurses manage evolving workforce issues and succeed in their careers. Additional information about the Center can be found at www.centerforamericannurses.org