Why Do Nurses Eat Their Young Nicki Croel
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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 • • Turnover • • Poor patient outcomes Burnout Poor Health Outcomes • Manager Budget • Hospitals 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
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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