Navigating the Work Environment: Embracing Zero Tolerance for Bullying
Recorded on July 22, 2011 (60 minutes)

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“Sticks and stones might break my bones, but words can never hurt me.”  This nursery rhyme couldn’t be further from the truth.  Repeated exposure to negative, disruptive behavior can have a significant impact on you, your colleagues and your patients. 

What leads to such behavior in the health care environment?  When does bad behavior cross the line into bullying or other types of violence?  What can nurses do so that their health care organizations respond effectively and decisively to these threats?

Learning Objectives:

1.Define bullying, lateral violence and horizontal violence.
2.Discuss what leads to bullying in healthcare
3.Explain how healthcare organizations may implement zero tolerance policies and enforce them.

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1.  Define bullying, lateral violence and horizontal violence    
     a. Differentiation among the terms bullying, lateral violence and horizontal violence
     b. Behaviors associated with bullying
     c. The incidence of the behaviors

2. Discuss what leads to bullying in healthcare
    a. The relationship between hierarchical structures and bullying
    b. How the perpetuation of bullying infests a culture
    c. Lack of uniform reporting mechanisms

3. Explain how healthcare organizations may implement zero tolerance policies and enforcement them
    a. Definition of Codes of Conduct
    b. Appropriate steps that can be used to address breaches in Codes of Conduct
    c. Differentiating between breaches in the Codes of Conduct and raising safety issues
    d. Managerial and individual responsibilities related to zero tolerance policies
    e. Factors that hinder zero tolerance policies from being enforced.

Joy Longo, DNS, RNC-NIC, Assistant Professor at the Christine E. Lynn College of Nursing at Florida Atlanta University, is recognized on the local, national and international level for her research on horizontal violence.  Among her achievements, Dr. Longo received an American Nurses Foundation/Julia Hardy, RN grant in 2008, to develop and test a research instrument to measure horizontal violence, and was awarded an intramural grant to study nurse-to-nurse caring of which the results were published in Holistic Nursing Practice.  Dr. Longo co-authored a chapter on postmodern philosophy and qualitative research in Nursing research: A qualitative perspective (5th ed.) (Munhall, 2012).  Her work studying the phenomenon of horizontal violence as well as research involving mid-level managers continues.

Dr. Longo worked in a neonatal intensive care unit setting for 22 years as a staff nurse and an assistant nurse manager.  She is certified in neonatal intensive care nursing and is a hospital-based Neonatal Resuscitation Program (NRP) instructor.  During her master’s program, she became interested in the topic of horizontal violence and completed her thesis, Student Nurses Experiences of Horizontal Violence in the Clinical Setting:  Do Nurses Eat Their Young?  During her doctoral studies, she continued to research the phenomenon of horizontal violence and completed her dissertation examining the relationships among horizontal violence, oppressed group behavior, manager caring, peer caring, job satisfaction, intent to leave a position, and intent to leave nursing.  The results of this work were published in the International Journal of Human Caring.  In  2007, Dr. Longo worked with the Center for American Nurses in preparing a pamphlet on bullying and lateral violence in nursing.

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The American Nurses Association Center for Continuing Education and Professional Development is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation.

ANCC Provider Number 0023.

ANA is approved by the California Board of Registered Nursing, Provider Number CEP6178.