Weinand M R 2010 Horizontal violence in nursing

Weinand, M. R. (2010). Horizontal violence in nursing: history, impact, and solution. JOCEPS: The Journal Of Chi Eta Phi Sorority, 54(1), 23 -26.

Why susceptibility among nurses • Antagonistic behaviors among oppressed people i. e. : women • Nursing predominately women • Antagonistic behaviors, a form of self-hate • Demonstrated in the classroom with faculty dominating student nurses. • Nurse managers and supervisors cited as frequent users of bullying culture & top down style

End Product from HV • Overwhelming sense of negativity cultivated • Aggression breeds aggression • Low morale • High turnover • Increased absence • Low productivity

Formal training in teamwork, positive feedback, conflict management and confrontation skills Reward resolution vs. identification of problems

King-Jones, M. (2011). Horizontal Violence and the Socialization of New Nurses. Creative Nursing, 17(2), 80 -86. • overt and covert nonphysical hostility, • criticism, sabotaging, undermining, infighting, scapegoat, and bickering • unkindness, discourtesy, divisiveness, and lack of cohesiveness • belittling gestures, verbal abuse, gossiping, sarcastic comments, faultfinding, devaluing comments, • disinterest and discouragement, and controlling behaviors

Knowledge is power -- a cycle of power and resistance To resolve HV, address the dynamics of power and conflict

Hahn, J. A. (2011), Managing Multiple Generations: Scenarios From the Workplace. Nursing Forum, 46(3), 119 -127. • Increased numbers of generations working together creates more opportunity for misunderstanding • Veterans, [born before 1945] • Baby Boomers, [born 1946 -1964] • Generation X, [1965 -1976] • Gen Y/Millennials [1977 -1997]

Generation Veterans <1945 Generational styles Stable Reliable Practical Loyal Baby Boomers 1946– 1964 Generation X 1965– 1976 Millennials 1977– 1997 Involvement Personal growth Optimism Mentors Think globally Techno-literacy Pragmatic Asynchronous communication Skeptical Multitasking Technologically savvy Outcome driven Determined

Kupperschmidt, B. (2006). Addressing multigenerational conflict: mutual respect and carefronting as strategy. Online Journal Of Issues In Nursing, 11(2), • Kupperschmidt argues that professional nurses must care enough about their patients, profession, colleagues, and themselves to ‘carefront’ disrespectful behavior

Carefronting, a model of communication used when professional nurses care enough about themselves and their patients to confront disrespectful behavior face-to-face

The goal is the ability to work together to provide safe patient care in an environment based upon mutual respect Kean Univ ersity Graduate s

Yvonne Bivins MSN RN Nadia Primus MSN RN

16 14 12 7 10 8 6 5 4 2 0 Associate Degree Bachelor's Degree Number of Participants Graduate Degre Pre-test Post-test Baby Boomer RNs 7 4 Generation X RNs 17 8

Yvonne Bivins MSN RN Nadia Primus MSN RN • A paired t test compared pre and post mean scores of the participants’ perceived ability to utilize Carefronting • pre-test M= 40. 75, SD=4. 15 • post-test M= 43. 08, SD=3. 08 • Highest possible score being 50 and the lowest 10 • Alpha set at p<0. 05 • There was no significant difference t(11) = -2. 17, p = 0. 053. The 95% confidence interval for the mean difference between the two means was -4. 70 to 0. 03.

Yvonne Bivins MSN RN Nadia Primus MSN RN compared Baby Boomer to Gen X mean scores on perceived ability to utilize Carefronting • No significance difference in the Baby Boomer & Generation X mean scores • pre-test t(24) =. 992, p =. 33 • post-test t(11) =. 154, p =. 88

Carefronting Techniques based on Kupperschmidt (2006) q When you called me a rookie and said I jumped to a conclusion (what was the action). I felt humiliated (your reaction). q Because it portrays me as someone in a rush (what does it look, sound or feel like). q Was it your intention to embarrass or humiliate me? (repeat what the action was, STOP! wait for a response) q In the future talk to me in private (what behavior you want to see). q Are you committed to treating me as respected colleague? (What you want them to do? ) q If there isn’t a change, I will arrange a meeting with the supervisor to discuss your actions (what is the consequence).

Take home Message Carefronting