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Learning Objective 1: 1. The learner will be able to discuss models of action regarding bullying and lateral violence in nursing.
Learning Objective 2: 2. The learner will be able to discuss perfomance improvement and quality initiatives to reduce workplace violence in nursing.
Introduction: Bullying and lateral violence continue the aggressive assault on nurses and patient safety. Toxic workplace behaviors of bullying and lateral violence adversely affect unit culture and markers of quality patient care. Workplace bullying and lateral violence are complex, multilayered phenomena contributing to moral distress, dysfunctional work environments, and adverse patient outcomes.
Purpose: This presentation describes a conceptual model for bullying and lateral violence. It addresses negative behavior etiologies as well as treatment measures and strategies to overcome barriers in order to effect culture change in hospitals. Organizational theory stresses the multiple levels of determinants of organizational culture change. Key types of theory concepts such as change theory, situational awareness, social influence theory, and transformational leadership as the foundation for leadership interventions are utilized. Moral distress, ethical climate and levels of organizational distress are discussed with the ecological model serving as the framework for multiple level pathways for leadership initiatives.
The model addresses organizational culture change and organizational transformation and the relationship to optimizing a productive and healthy work environment as a risk reduction strategy to diminish the detrimental effects of bullying and lateral violence. A conceptual foundation for understanding bullying, lateral violence is delineated with a synthesis of the evidence regarding patterns and effects of theory regarding sustaining culture change to effectively reduce levels of bullying and lateral violence.
The conceptualization illustrates the viability, utility, and challenges of using theory-based interventions to initiate and evaluate effects on bullying and lateral violence in hospitals and concludes by identifying cross cutting themes and important future directions for bridging the gap between theories, practice, and research. Evidence-based response patterns, competencies, cultural change schema for bullying and lateral violence management processes are embedded within the model. Management strategies and associated risks inherent when establishing a culture and capacity change for safe and healthy work environments are presented.
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