Horizontal 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?

It can be:
◦ Verbal, physical, mental, emotional
◦ Obvious or hidden
 It is a Behavior that is:
◦ insulting, frightening & worrisome
◦ Unprofessional & unacceptable


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
Have I ever had this happen to me?
 Have I ever seen this happen?
 Have I ever been the one doing it?






Openly criticized
another
Kept someone out of
‘my’ group
Run the rumor mill
Blamed others
Complained about a coworker instead of
talking out the problem
Giver





Taken trouble home
Had trouble sleeping
Felt depressed because
of work relations
Thought about quitting
Questioned “who am I?”
Receiver

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
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

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.
Horizontal
Violence
Stress
Satisfaction
Turnover
Care
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

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
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