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September 2012, Volume 42 Number 9 , p 1 - 2


  • Kathleen R. Amrein MSN, BS, BSN, RN, CCRN-CMC


VIOLENCE AND ABUSE between healthcare workers in the workplace, also known as horizontal violence, isn't new. Offensive and aggressive behavior in healthcare settings had become so disruptive that on January 1, 2009, The Joint Commission (TJC) established unique standards that address belligerent and inappropriate behavior in a Sentinel Event Alert.1New guidelines have been established requiring more than 15,000 accredited healthcare facilities to formulate a code of conduct focusing on horizontal violence. These codes of conduct define appropriate and unacceptable behaviors, and establish a formal process for managing inexcusable conduct.2Intimidating and undisciplined behavior in the healthcare industry results in more than just hurt feelings. It contributes to medical errors and poor patient satisfaction.3 This article looks at how horizontal violence impacts nursing care and what you can do to improve conditions where you work.In the position paper Zero Tolerance for Abuse, the American Association of Critical Care Nurses (AACN) defines "abuse" as intimidating behaviors such as condescending language, impatience, angry outbursts, reluctance or refusal to answer questions, threatening body language, and physical contact.3 The International Council of Nurses (ICN), representing nurses in more than 128 countries, strongly denounces acts of horizontal violence in the health workplace, including verbal abuse. The ICN's position statement on abuse and violence against nurses firmly states that this behavior threatens the effective and safe delivery of patient care.4In January 2005, the AACN published national standards for establishing and maintaining healthy work environments. These standards state that communication, collaboration, support for continuing education and certification, effective decision making, and recognition are key measures of a healthy workplace.5These principles support the American Nurses Association (ANA) Code of Ethics for Nurses and Institute

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