Lateral Violence and Uncivil Behavior in a Nursing Home

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Introduction Lateral violence in nursing is a topic that is beginning to attract a lot of attention. One study showed that the higher the incidence of workplace incivility, the lower the rate of productivity (Leiws, 2011, p. 44). Others have shown a correlation in the occurrence of lateral violence and decreased productivity and increased turnover, making this an important issue to address in the field of nursing (Ostrofsky, 2012, p. 20). Lateral Violence Experience My experience with nursing incivility began when I became a certified nursing assistant (CNA). I was hired at a local nursing home as a float CNA, but being that five out of the seven assignments on my unit has permanent CNAs, there were only two assignments I floated to. Both happened to be heavy assignments, with nine patients on each, and almost all patients being incontinent. Half of each assignment had patients requiring sit-to-stand or hoyer lifts for transfers, which facility policy states is to be done with two staff present for patient safety. The five other assignments on the unit had noticeably lighter assignments, with many independent patients assigned to them and few, if any, patients needing mechanical lifts for transfers. Unlike a hospital environment where patients lay in bed much of the day in a hospital gown, at my facility it is expected that CNAs get patients dressed in street clothes and out of bed for at least each meal, along with toileting patients and repositioning them every two hours. This requires CNAs at my facility to spend much of their time transferring patients to complete these tasks, and this time is significantly lengthened if patients require a mechanical lift to transfer. Due to having so many patients requiring hoyer an... ... middle of paper ... ... outcomes, greater satisfaction among CNAs, which would thus lead to an overall better morale on the unit. That would lead us to Lewin’s final stage, refreezing (Shirey, 2013, p. 70). This is an important stage in the change process, as this is where the changes made are enforced so that they are upheld over time. If management does not continually enforce expectations about behavior, or goes back to the old way of creating CAN assignments, then discord amongst staff would likely result again. Conclusion To conclude, lateral violence is, unfortunately, experienced by many nurses. It has direct effects on the nurses involved, fellow staff, the unit as a whole, and most importantly, the patient. It is vital that nurse managers recognize and address lateral violence and uncivil behaviors to best promote an environment of staff and patient safety and well-being.

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