Transcript Why Do Nurses Eat Their Young?

Why Do Nurses
Eat Their Young?
Nicki Croel
Ferris State University
NURS 450
Objectives
1. Define horizontal hostility
2. Discuss theories related to horizontal hostility
3. Assessment of the health care environment
4. Root Cause Analysis
5. Inferences, Implications & Consequences
6. Recommendations for quality and safety improvements
Horizontal Hostility
• What is it?
• Overt and Covert Behaviors
• Examples
Overt Behaviors
Name-calling, bickering, faultfinding, backstabbing, criticism,
intimidation, gossip, shouting,
blaming, using put-downs, raising
eyebrows
Covert Behaviors
Unfair assignments, sarcasm, eyerolling, 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 Wounded
Conti-O’Hare’s Assumptions
Dr. Marion Conti-O’Hare
All 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 selftherapeutically.
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
Policies
ANA Position
The Joint Commission
Resources
ANA
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
QSEN Standards
• Professional Practice Evaluation
• Leadership
• Communication
• 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