Spring is here and with it comes a reprieve from the cold, bitter winter weather we face here in the Mid-west. A new and fresh outlook on the world in general goes a long way toward improving and rejuvenating our spirits and motivation. Spring also means fresh new graduates entering the perioperative setting.
New employees in the workforce bring an enthu-siasm and eagerness to learn and participate in our unique setting. This time of year is a good opportunity to closely examine what we, the existing staff, are teaching our new staff. Are we portraying professionalism using effective communication techniques with our colleagues and team members? All too often, new employees tell me their observations of destructive dialogue and behavior among their new team members, commonly referred to as politics.
The bully factor
The worst thing I have heard when discussing this topic with other nurses is, "Nurses eat their young." Unfortunately, lateral violence among team members isn't uncommon. Lateral violence in the nursing profession, also known as horizontal violence or bullying, is defined "as intergroup conflict and nurse/nurse aggression."1
Behavior indicative of lateral violence includes withholding information, sabotage, coveting a surgeon's prized instruments, or gossiping. Nitpicking and comments such as, "He does it the same way every time," "Didn't they teach you that in orientation?," and my personal favorite, "When I started, it was see one, do one, teach one," serve to degrade and devalue the contributions of new employees. Is this the message we want to send to nurses just entering the profession?
Time to address the problem
While lateral violence isn't new in nursing, in the face of a looming nursing shortage, it becomes more im-portant to acknowledge its existence and to discuss potential interventions. Factors contributing to lateral violence are the patriarchal culture, generational differences, predominance of the female gender, and a highly demanding position with little autonomy. Lat-eral violence leads to a decrease in team efficiency, deprives new staff from using existing nurses as valuable resources, lowers retention, and increases stress in the work environment. All of this drama detracts from our primary focus: providing excellent patient care.
In this issue's Smart Management column (page 10), Lower offers some helpful advice on creating a culture of civility, including common challenges and current recommendations. Communication techniques, an organizational culture that supports and enforces a code of conduct, a management team that supports nursing autonomy, and an environment that fosters collaboration among all disciplines are some strategies suggested.
One important and often overlooked strategy is to choose good preceptors. Preceptors socialize, teach, and role model perioperative nursing and professionalism for new nurses. I recently attended an excellent lecture by Dr. Wayne Sotile2 in which he defined a hero as, "someone who creates a safe place for other people." The preceptor role creates a safe place for our new employees. New employees need an environment where they can feel comfortable asking questions, learning perioperative practice, and finding their own place on the perioperative team. Preceptors can't do this alone. A safe place, which addresses lateral violence, is created by all team members. Perhaps, what we need in perioperative nursing is more heroes.
Elizabeth M. Thompson, RN, CNOR, MSN
Editor-in-Chief, Nursing Education Specialist, Mayo Clinic, Rochester, Minn.
[email protected]
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