Creating a Culture of Zero Tolerance for Lateral Violence in the Workplace

Purpose:
Identified lateral violence as an issue in the Pediatric Intensive Care Unit, Pediatric Progressive Care Unit and throughout Child Life Services. The goal of strategies implemented was to create an awareness and "zero tolerance" policy for these types of disruptive behaviors.

Significance:
Lateral violence and behaviors associated with it lead to poor morale and nurse dissatisfaction, which we know then impacts the care we deliver to our patients. Addressing the behaviors lead to a high performing team working in a positive work environment.

Strategy and Implementation:
We started by identifying the specific behaviors staff experienced in the units and then surveyed how often they occurred. The results demonstrated the behaviors were prevalant in all areas. We then realized, due to the negative behaviors there were staff who were not comfortable approaching others and it limited the amount of support necessary to provide our patients with the appropriate quality of care. The behaviors were putting the quality care and patient safety at risk. We provided training to all staff about lateral violence, the behaviors and the potential negative outcomes associated with it. We then turned to learning about each individual and how best to change our communication to become a more effective team. All staff completed a color code personality test as a fun way to understand each individuals motivation. Finally, we have moved to a strengths based leadership approach to appreciate each individual's unique abilities and how they each add value to our team.

Evaluation:
We measure success based on RN turnover, annual RN satisfaction survey, specific survey related to lateral violence and our nurse sensitive indicators.

Implications for Practice:
Working in a healthy and positive culture promotes teamwork, patient safety and high level quality care.