January 10th, 2018
Lateral violence in nursing – Incidence and Susceptibility to Lateral Violence
Despite the ability to control the vice, the incidence of LV in the nursing fraternity seems to be advanced. CAN (2008) position statement for instance assert that LV is becoming a toxin for the nursing profession that could aggravate nurse shortages crisis through increased turnover. In a Joint Commission survey it was further noted that despite of the main cases of nurse bullying being perpetuated by physicians, nurse-to-nurse antagonism was not a rare occurrence (as cited in Bigony et al., 2009, pp. 688-689). Hoban (2004) had earlier noted that as much as 85 percent of the nursing fraternity in the UK health care were experiencing or had experienced LV at their work places (Cited in Lewis, 2006, p. 53). The Joint Commission survey noted such cases of disruptive behavior involving the nursing fraternity to be 65 percent (Bigony, et al., 2009). Internationally, various studies have noted the cases of self-reported victimization to bullying behaviors in hospital nurses to range between 17%-76% (reviewed in Vassey, Demarco, Gaffney & Budin, 2009). Such cases have mainly been noted among staff registered nurses with the main perpetrators being identified to be senior nurses (Vassey, et al. 2009). Other bullying perpetrators in the nursing profession are noted to be charge nurses, nurse managers and physicians (Vassey, et al, 2009).
With the implication of various nurses as perpetrators of LV questions to the groups that are at a higher risk of falling victims arise. Sheridan-Leos (2008) identify new graduates to be at a higher risk of being victims. As students advance their quest for knowledge and skills LV may be one of the obstacles that they have to overcome (Sheridan-Leos, 2008). One study in New Zealand noted that majority of the newly registered graduate nurses experienced a form of LV (McKenna, et al. 2003, as cited in Sheridan-Leos, 2008). Vassey et al. (2009) study reinforces such findings with their observation that most cases of bullying were meted on individuals whose experience in units was less than five years (p. 302). A review by Pellico, Brewer, and Kovner, (2009) supports this observation. Despite such suggestions nurses at higher positions could also experience bullying behavior though in milder and smaller numbers (Vassey, et al, 2009, p. 302). However the majority of LV victimization cases are experienced while one is at junior nursing positions (70%, in Vassey, et al, 2009, p. 302).
A different aspect of susceptibility relates to departments where LV may be widespread. McKenna et al. (2003) study in this respect found out that LV was generally evident across all kinds of clinical settings (as cited in Sheridan-Leos, 2008). Vassey et al. (2009) however provides an indicator of the departments where LV may be a vehemently practiced culture. Bullying in their study was observed to be most predominant in medical-surgical units with 23% of the victimization cases; critical care units were second with 18% bullying cases while emergency departments made up the top three with 12% of the cases (Vassey, et al, 2009, p. 302). Other high susceptible departments were operation room and post anesthesia care units that recorded 9% of the cases and obstetrics units whose incidences contributed 7% (Vassey, et al, 2009, p. 302). On the lower end of the bullying survey was a group that comprised 21% of the staff RN respondents (Vassey, et al, 2009). These included units such as chemical dependency treatment (.1%), neonatal intensive care (.2%), psychiatric (.2%) and diagnostic [.5%] (Vassey, et al, 2009, p. 302). Such indications may imply LV victimization risk may be higher with regard to some hospital functions than others. Outcomes of victimization may however not be segregated according to department but rather on frequency of abuse. Go to part 4 here.