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10 Lateral Violence of New Graduate Nurses in the Workplace Name School Class Instructor Date Lateral Violence of New Graduate Nurses in the Workplace Lateral violence describes behaviors intended to demean, undermine and/or belittle a targeted individual working at the same professional level (Sanner-Steihr & Ward-Smith, 2017). It includes withholding information, scapegoating, and gossiping. Lateral violence, horizontal violence, incivility in nursing, and disruptive behavior are one in the same and a quite common topic in the workplace that is widely debated. Horizonal Violence in nursing is defined as “hostile, aggressive, and harmful behavior by a nurse or a group of nurses toward a co-worker or group of nurses via attitudes, actions, words, and other behaviors” (Taylor, 2016, p. 1). Incivility is defined as “disrespectful, rude, or inconsiderate conduct” (Association for Perioperative Registered Nurses [AORN], 2015, p. 3). Bullying or disruptive behavior is defined as “repeated, unwanted harmful actions intended to humiliate, offend, and cause distress in the recipient” (American Nurses Association [ANA], 2015, p. 3). The effect of lateral violence negatively impacts the work environment, the ability to perform a job correctly, and the self-esteem of the individual mistreated. Despite attempts by ANA and state nursing organizations to address this issue and encourage workplaces to adopt a zero-tolerance policy, lateral violence continues (Germann & Moore, 2019). A common lateral violence issue that influences health care delivery is the unfair treatment and taking advantage of new graduate nurses. An incident happened where there was a newly graduated nurse that was recently released off of orientation two weeks prior. She was working on her time management skills and learning the rope of her new role as a registered nurse (RN). This day the shift started out with five nurses on the floor. It was the new nurse, the charge nurse and three other staff nurses. Each nurse started the shift with four patients each. As the day went on each nurse discharged between one to two patients. The new nurse discharged one of her patients, leaving her with three patients. The charge nurse discharged two patients, leaving her with two patients. One of the other nurses discharged three patients, leaving her with only one patient. The last two nurses had two discharges, leaving them each with two patients. As quickly as the discharges went out, the admittance of new patients came in. The new nurse got an admission, which put her back at four patients. One nurse got two admissions and a transfer, putting her at four patients. The other two nurses received a admit as well, which put both at three patients each. The charge nurse did not pick up any admittance and kept her two patients the full shift.  Out of the two patients the charge nurse provided care for, there was one patient who have been placed in the hospital for a few months because there was no placement for her. The patient was familiar to everyone including the charge nurse and there was no care plan in place for this patient. The other patient the charge nurse provided care for was the husband of one of the other staff nurses on the floor, who is also a familiar patient to everyone consisting of his medical condition. Two hours before the end of the shift, the nursing supervisor notified the charge nurse of another admittance to the floor. The charge nurse assigned the new patient to the new nurse. This new admittance put the new nurse patient load at five patients on a critical care floor. The charge nurse kept her two patients. The other staff nurse’s patient load was four, three, and three. The other three staff nurse were considered competent nurses after reading the article by Patricia Benner defining different levels of nursing: Novice, Advanced Beginner, Competent, Proficient, and Expert. The competent level of nursing is typically a nurse with 2-3 years of experience on the job in the same area or in similar day-to-day situations. They are also said to be more aware of long-term goals and gains perspective from planning own actions based on conscious, abstract, and analytical thinking and helps to achieve greater efficiency and organization (Current Nursing, 2020). The charge nurse was considered more of a proficient nurse, while the new nurse was considered an advance beginner. The new nurse questioned the reason for her getting a fifth patient when everyone of the more experienced nurses had less. The charge nurse replied with they just received the other admissions prior to the current one. Next, the new nurse asked the charge nurse for clarity on why she as the charge nurse could not take the new admission. She also expressed that she felt like she was being taken advantage of. The charge nurse replied that she had a million things to do and could not take the admission, but if the nurse needed any help, she would be willing to help. The charge nurse displayed ineffective communication by ignoring the new nurse concerns and not providing a therapeutic response. The other staff nurses quietly voiced their concerns and expressed how that was unfair to the new nurse. The disappointing treatment of the new nurse quickly disperse because during shift change a night shift nurse pulled the new nurse aside and apologized for the treatment she had endured. The night shift nurse told the new nurse to stand up for herself and to reach out to the department director and inform her of the issue that went on. She also told the new nurse that she must stop this type of treatment now because if she does not, they will keep taking advantage of her, and nothing will change. Everyone including the charge nurse went home and the new nurse was left on the floor an hour after her shift was supposed to end. That night the new nurse sent an email to the department director in detail of what went on. She voiced her concerns on working with this charge nurse in the future. The department director thanked the new nurse for bringing the issue to her attention. She said she agreed with the new nurse’s concerns and will meet with the assistant director to produce a plan. The new nurse has not been contacted for a follow up and no changes has been made.  This incident displays lateral violence because the new nurse was given an unfair assignment. After the new nurse expressed her concern the charge nurse continued to be inconsiderate. The new nurse felt that the other nurses should have been helping her, not taking advantage. The charge nurse only looked out for herself, and her previous colleagues. Many nurses are presented with the barrier of being overworked. Becoming overworked increase’s role stress and role overload which can have many negative effects on both physical and mental health. Nurses’ roles are influenced by the environment in which they work. Role overload stems from situations in which time and resources are less than the nurses’ roles and responsibilities (Friberg, 2020). As a team, no team player should feel devalued or less of a team player than anyone else. Managers play an important role in holding staff accountable for lateral violence behaviors and several authors examined various factors related to leadership style, as well as specific interventions (Brunt, 2019). The issue needs to be faced by nursing professional because with no accountability for their actions this type of behavior will continue. Different recommendations were suggested to help combat lateral violence. These recommendations included preparation of nurses for supporting newly graduated nurses, training newly graduated nurses how to deal with lateral violence, holding sessions with nurses and newly graduate nurses, ensuring access to support and evaluation of behaviors of staff toward them by leaders, and identifying and resolving causes of violence such as staff shortages, and improper management (Brunt, 2019). The National Institute for Occupational Safety and Health and the Centers for Disease Control and Prevention also offers a free online course awarding 2.6 contact hours to help nurses better understand the scope and nature of violence in the workplace. The course describes essential components of a comprehensive prevention program, how to apply individual strategies, and ways to develop skills for responding to workplace violence (CDC, 2013). Awareness is the key to prevention for all staff members. Managers need to hold staff accountable, being persistence and consistent with their responses. Organizations need a coordinated approach to this issue. Enacting a twofold model is the most effective approach that managers can take to enact change at the organizational level. Individual nurses need to assess the role they play in ending or perpetuating lateral violence and take an active role in addressing instances of lateral violence (Brunt, 2019). Lateral violence from coworkers on an everyday basis, could negatively affect the level of care provided. Every nurse has one job to do, and that is to provide quality care to your patients. All of us as nurses need to be aware of the problems related to lateral violence and implement strategies as individuals and in our practice settings to combat this problem. The incidence is not decreasing, despite numerous studies and strategies to combat it. Lateral violence is detrimental to patient safety and should not be allowed to continue. This is serious problem, and it is imperative that the profession addresses this problem. Nurses, individually and collectively, must enhance their knowledge and skills in managing conflicts and promote workplace policies to eliminate lateral violence (Brunt, 2019). These issues supporting the action of lateral violence should be addressed and ended at every place of employment not just within the healthcare profession. References American Nurses Association. (2015). Position statement on incivility, bullying, and workplace violence. https://www.nursingworld.org/~49d6e3/globalassets/practiceandpolicy/nursing-excellence/incivility-bullying-and-workplace-violence–ana-position-statement.pdf Association for Perioperative Registered Nurses. (2015). Position statement on a healthy perioperative practice environment. https://aornjournal.onlinelibrary.wiley.com/doi/epdf/10.1002/aorn.13535?saml_referrer Brunt, B. (2019). Combatting lateral violence. ISNA Bulletin, 45(2), 10–15. Centers for Disease Control and Prevention. (2013). Workplace violence prevention for nurses. http://www.cdc.gov/niosh/topics/violence/training_nurses.html Current Nursing. (2020, November 29). From Novice to Expert. https://https://www.currentnursing.com/nursing_theory/Patricia_Benner_From_Novice_to_Expert.html Friberg, E. E., & Creasia, J. L. (2016). Conceptual foundations: The bridge to professional nursing practice (sixth). Elsevier/Mosby. Germann, S., & Moore, S. (2019). Lateral violence, a nursing epidemic? Reflections on Nursing Leadership, 45(2), 47–51. Sanner-Stiehr, E., & Ward-Smith, P. (2017). Lateral violence in nursing: Implications and strategies for nurse educators. Journal of Professional Nursing, 33(2), 113-118. http://dx.doi.org/10.1016/profnurs2016.08.007. Taylor, R. (2016). Nurses’ perceptions of horizontal violence. Global Qualitative Nursing Research, 3, 1-9. https://journals.sagepub.com/doi/epub/10.1177/2333393616641002

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