Workplace Violence in Long-Term Care

V. Baker RN-BC, CDONA

What is horizontal violence? Why is it happening to me? What can I do about it? What should I expect?

Horizontal Violence

It can be:◦Verbal, physical, mental, emotional◦Obvious or hidden

It is a Behavior that is:◦ insulting, frightening & worrisome◦Unprofessional & unacceptable

What is Horizontal Violence?

Verbal◦ Gossip, nasty remarks, rude responses, criticism

Physical◦ Refusing to help, isolating, making faces

Mental◦ Not sharing information, disrupting work

Emotional◦ Complaining about to others, sharing secrets

A Horizontal Violence Experience

Have I ever had this happen to me? Have I ever seen this happen? Have I ever been the one doing it?

Think about it

Have I ever?

Giver Receiver

Openly criticized another

Kept someone out of ‘my’ group

Run the rumor mill Blamed others Complained about a

co-worker instead of talking out the problem

Taken trouble home Had trouble sleeping Felt depressed

because of work relations

Thought about quitting

Questioned “who am I?”

Horizontal Violence Happens

When people ◦Feel bad about themselves◦Don’t know how to cope◦Don’t know how to communicate◦Are unhappy with their lives◦Have control issues◦Choose to act mean

Understand you have a CHOICE◦Choice to be mean or nice◦Choice to accept or address the issue◦Choice to let it make you better or bitter

Follow the “Golden Rule”◦Do unto others as you would have done to

you

Respect yourself and don’t let others bring you down

What can be done?

How do I do that? Know what Horizontal Violence looks like

Practice looking at myself Identify it when it happens Call it what it is Learn how to deal with it Stand up for each other Seek help or report it if needed

Not what you say but HOW you say it Take ownership STOP! Let’s talk calmly in private Refocus on the patient “I feel…..” Be respectful

2 wrongs don’t make a right

Communication

Remember Kindergarten◦Share◦Play fair◦Wash your hands◦Say your sorry if you hurt someone◦When you go out in the world, watch out for traffic, hold hands and stick together.

Back to basics

Nice Matters

Horizontal Violence

StressSatisfaction

TurnoverCare

Horizontal Violence has NO place in LTC◦Increases stress, burnout & risk for errors

◦Decreases Quality of Care, teamwork & happiness

Horizontal Violence has consequences◦It will be investigated, addressed & disciplined

No Tolerance

Review Been there Done that Look in the mirror Make the right choice Practice what I’ve learned Help others Expect support

Chapman,R., Perry, L., Styles,I., Combs,S., (2009). Consequences of Workplace Violence. British Journal of Nursing. Vol.18 (20), pp. 1256-1261

Danish,V., Malvey,D., Fottler,M., (2008) Hidden Workplace Violence: What your nurses may not be telling you. The Healthcare Manager. Vol.24 (4), pp. 357-363

Fulgum, R. (1988) All I really need to know I learned in Kindergarten. Random House Publishing Inc. New York

Healy, G. (2010) Creating a Culture of Civility takes a Team. Journal of Perioperative Registered Nurses. Vol 93 (1), pp. 106-114

Longo, J. & Sherman, R. (2007) Leveling Horizontal Violence. Nursing Management. Spring, pp. 34-51

References