Why Do Nurses Eat Their Young?

Nicki CroelFerris State University

NURS 450

Objectives1.Define horizontal hostility2.Discuss theories related to horizontal hostility3.Assessment of the health care environment4.Root Cause Analysis5. Inferences, Implications & Consequences6.Recommendations for quality and safety improvements

Horizontal Hostility• What is it?• Overt and Covert Behaviors• Examples

Overt Behaviors Covert BehaviorsName-calling, bickering, fault-finding, backstabbing, criticism, intimidation, gossip, shouting, blaming, using put-downs, raising eyebrows

Unfair assignments, sarcasm, eye-rolling, ignoring, making faces behind someone’s back, refusing to help, sighing, whining, refusing to work with someone, sabotage, isolation, exclusion, fabrication.

Oppression Theory

• Paulo Freire

The Theory of the Walking WoundedDr. Marion Conti-O’Hare

 

Conti-O’Hare’s AssumptionsAll human being experience violence/trauma in their lives.Trauma may be of a personal or professional nature, or both.Pain/fear from traumas experienced can frequently be carried throughout life. Trauma does not automatically resolve without intervention. The ability to cope with trauma has a profound effect on one’s ability to care for others. Trauma can be transformed and transcended; only then can the experience of healing be used to help others. Healing involves moving from being a ‘walking wounded’ to being a ‘wounded healer.’Therapeutic use of self is dependent of the degree that trauma has been transformed and transcended in a person’s life. The wounded healer represents the highest level of using self-therapeutically. Professions in which there are many walking wounded need to heal themselves in order to survive.

(Christie & Jones, 2013)

Assessment of the Health Care Environment

PoliciesANA PositionThe Joint Commission

ResourcesANA

Assessment of the Healthcare Environment

• Quality and Safety

Root Cause Analysis

Inferences, Implications & Consequences

Various Points of View• Nurse• Increased Stress• Burnout• Poor Health Outcomes

• Manager• Turnover• Budget

• Hospitals• Poor patient outcomes• Increased cost

Recommendations

• Education• Training• Conflict Management• Teambuilding• Documentation

ANA & QSEN Standards

ANA Standards• Professional Practice

Evaluation • Leadership• Communication

QSEN Standards• Teamwork & Collaboration• Safety• Quality Improvement

References

American Nurses Association. (2006). 2006 House of delegates resolution: Workplace abuse and harassment of nurses. In American Nurses Association.

American Nurses Association. (2010). Nursing scope and standards of practice (2nd ed., pp. 32-62). Silver Spring, MD: Nursebooks.org.

Barton, S. A., Alamri, M. S., Cella, D., Cherry, K. L., Curll, K., Hallman, B. D.,… & Zuraikat, N. (2011, August). Dissolving clique behavior. Nursing

Management, 42(8). doi:10.1097/01.NUMA.0000399677.43428.73

Bartholomew, K. (2006). Ending nurse-to-nurse hostility: Why nurses eat their young and each other. Marblehead, MA: HCPro.

Christie, W., & Jones, S. (2013, December 9). Lateral violence in nursing and the theory of the nurse as the wounded healer. OJIN: The Online Journal of Issues in

Nursing, 19(1). doi:10.3912/OJIN.Vol19No01PPT01

CRC Press. (2012). Epidemic of medical errors and hospital-acquired infections (). In W. Charney & . (Eds.). Boca Raton, FL: Taylor & Francis Group.

Dellasega, C. A. (2009, January). Bullying among nurses [Electronic version]. American Journal of Nursing, 109(18).

Griffin, M. (2004, November). Teaching cognitive rehearsal as a shield for lateral violence: An intervention for newly licensed nurses [Electronic version]. The

Journal of Continuing Education in Nursing, 35(6). doi:10.1097/NHL.0b013e3182861503

References

Longo, J. (2013, August). Bullying and the older nurse. Journal of Nursing Management, 21. doi:10.1111/jonm.12173

QSEN Institute. (n.d.) Pre-licensure KSAS. Retrieved from http://qsen.org/competencies/pre-licensure-ksas/

Sauer, P. Do nurses eat their young? Truth and consequences. Journal of Emergency Nursing, 38(1). doi:10.1016/j.jen.2011.08.012

The Joint Commission. (2008, July 9). Sentinel event alert, issue 40: Behaviors that undermine a culture of safety. In The Joint Commission. Retrieved April 18, 2014

Townsend, T. Break the bullying cycle. American Nurse Today, 7(1). Retrieved from CINAHL.

Vogelpohl, D. A., Rice, S. K., Edwards, M. E., & Bork, C. E. (2013, November). New graduate nurses' perception of the workplace: Have they experienced

bullying? Journal of Professional Nursing, 29(6). doi:http://0-dx.doi.org.libcat.ferris.edu/10.1016/j.profnurs.2012.10.008

Wilson, B. L., & Phelps, C. (2013, January). Horizontal hostility: A threat to patient safety. JONA'S Healthcare Law, Ethics, and Regulation, 15(1).

Yoder-Wise, P.S. (2011). Leading and managing in nursing, St. Louis, MO: Elsevier Mosby