1. Tanisha Cartledge RN,BSN
Kaplan University
April 10, 2012

2. The purpose of this unit is to learn about lateral
violence; costs, contributing factors, effects, and
interventions.

3. By the end of this unit, you should be able to:
Describe the term lateral violence nursing.
Discuss the contributing factors of lateral violence
in nursing.
Evaluate the costs of lateral violence.
Describe the effects of lateral violence on nurses.
Discuss effective interventions to reduce lateral
violence.

4. Bloom’s Taxonomy Category Objective
Creating Develop a 1-3 minute video
presentation on any form of lateral
violence.
Evaluating Evaluate the costs of lateral
violence.
Analyzing Differentiate the various forms of
lateral violence.
Applying Demonstrate a preventative
intervention to reduce lateral
violence.
Understanding Discuss the effects that lateral
violence have on the profession of
nursing.
Remembering Define lateral violence terminology.

5. Lateral Violence in nurse-on-nurse aggression
Griffin (2004) describes lateral violence as
nurses who covertly or overtly directing their
dissatisfaction inward toward each other,
toward themselves, and toward those less
powerful then themselves.

6. Horizontal Violence
Bullying
Aggression
“Nurses Eating Their Young”

7. Development of oppressed group behavior
Conflicting work values and leadership styles
(Hallberg, 2007)

8. Martin et al. 2008
Adapted from Demarco & Roberts, 2003

9. Covert (Not Openly
Acknowledged)
Overt (Done Openly)
Name Calling Unfair assignments
Bickering Refusing to help someone
Fault Finding Ignoring
Criticism Making faces behind someone’s
Intimidation back
Gossip Refusing to only work with certain
Shouting people or not work with others
Blaming Whining
Put Downs Sabotage
Raised Eye Browns Exclusion
Fabrication
Failure to Respect Privacy
Broken Confidences
( Bartholomew, 2012)

10. 1 st Example of Lateral Violence

11. 2nd Example of Lateral
Violence

12. Gender
Generational Differences
Enabling behaviors
Complacency
Fear of Retaliation
(Stanley, 2010)

13. Recruiting, hiring, and orienting a single medical/surgical nurse
=> $92,000
Replacing a specialty nurse =>$145,000
Patient safety issues
Costly medical errors and harmful patient outcomes
Significant increase in the costs of delivering patient care
Revolving door orientation
Continuation of nursing shortage
Morale Issues
Loss or productivity
(Pendry, 2007); (Rosenstein & O’Daniel, 2008); (The Joint Commission, 2008)

14. Patients
Families
Administration
Physicians
Department Managers
Nursing Staff
Ancillary Staff

15. Griffin (2005) one in three nurses will leave a
position because of lateral violence.
Bartholomew (2006) 60% of recently graduated
nurses leave their first position within six
months partly as a result of lateral violence and
bullying.

16. Psychological affects Physical affects
Sleep disorders Fatigue
Low morale Headaches
Apathy Weight loss
Feelings of disconnectedness Angina
Irritability PTSD
Burnout Hypertension
Impaired interpersonal Eating disorders
relationships
Intention or unintentional works
absences, resignations
(Hastile, 2002)

17. Scenario planning
Extend orientation
Develop policies and procedures to address
negative behaviors
Consistently hold everyone accountable for
their behavior by setting consequences (Zero
tolerance policy)
Provide staff training in conflict management
and confrontation skills
(Rowell, 2007), (Stanley, 2010)

18. Create a 1-3minute skit on lateral violence and
upload it on blackboard
Please complete evaluation at this link:
http://www.surveymonkey.com/s/L8YHGGR

19. Bartholomew, K. (2006). Ending nurse-to-nurse hostility. Marblehead, MA: HCPRO, Inc..
Bartholomew, K. (2012). Lateral violence in nursing: breaking the spell. Retrieved from
http://www.nursetogether.com/DesktopModules/EngagePublish/printerfriendly.aspx?itemId=262
1&PortalId=0&TabId=102
DeMarco, R., Roberts, S. (2003). Negative behaviors in nursing. American Journal of Nursing,
103(3), 113-116.
Griffin, D. (2004). Teaching cognitive rehearsal as a shield for lateral violence an intervention for
newly licensed nurses. The Journal of Continuing Education in Nursing, 35(6), 257-263.
Griffin, M. (2005). Awareness of ‘nurse-on-nurse; abuse helps resolve problem. AORN, 1(5), 3.
Hallberg, L. (2007). The origin of workplace bullying: experiences from the perspective of bully
victims in the public service sector. J Nurse Manage. 15. 332-341.
Hastie, C. (2002). Horizontal violence in the workplace. Retrieved from
https://www.birthinternational.com/articles/midwifery/69-horizontal-violence-in-the-workplace
Pendry, P. (2007). Nursing Economics, 25(4): 217-221.

20. Martin, M., Stanley, K., Dulaney, P., Pehrson K. (2008). The role of the psychiatric consultation
liaison nurse in evidence based approaches to lateral violence in nursing. Perspectives in
Psychiatric Care, 44(1), 58-60.
Rosenstein, A., O’Daniel, M. (2008). A survey of the impact of disruptive behavior and
communication defects on patient safety. The Joint Commission Journal of Quality and Patient
Safety, 34(8),464-471.
Rowell, P. (2007). Lateral violence: nurse against nurse. ANA Online Continuing Education. Silver
Spring, MD: American Nurses Association.
Stanley, K. (2010). The high costs of lateral violence in nursing. Sigma Theta Tau International
Leadership Summit.
Skinner, T. (2011). Lateral violence in nursing. Nursing News & Views. 6(1), 13-14.
Task Force on the Prevention of Workplace Bullying, (2001). Report of the task force on the
prevention of workplace bullying: Dignity at work the challenge of workplace.
The Joint Commission (2008). Behaviors that undermine a culture of safety. Sentinel Event Alert,
Issue 40.