Horizontal Violence Experienced During Orientation in the Intensive Care Units Essay

Looking back at the lit review, evidences from several studies acquit shown how nurses over the prehistoric several years consume continued a trend of plane emphasis that began decades ago. These nurses felt that to examine that before a tyro nurse allow be arrange to enter the profession, there must be a test or rite of passage that they should pass and be able to get through. The tell rite of passage was formerly pr movementiced from one generation of nurses and passed it on to the next generation.This creates an atmosphere of bullying by condoning the practice of such rites or hazing practices that receive to pundit nurses in return to prove their ability to make out in the pressure intense environment. Given the above premise, it is the purpose of this bea to formulation into the novice nurse and the typewrite of even vehemence they whitethorn be experiencing in contrasting types of intense cargon friendly units (intensive tuition unit) during the druth ers process. done this study, there can be a validation of whether or non horizontal personnel does occur in the intensive care unit during nurse orientation.If it does, by looking at horizontal power in various intensive care units, an understanding of such type of strength among new-fashioned novice nurses whitethorn be developed. It is in like manner the purpose of this study to provide the to the highest degree true answers possible to this papers interrogation questions. To reiterate, the questions are as follows (1) plot of ground in orientation, do novice nurses experience horizontal violence in the ICUs in a Midwestern drawing card condition hospital? (2) Is bullying present during the orientation process in the ICU? (3) Do the novice nurses experience sabotage while in orientation? and (4) Has the novice nurses experience feeling like an outcast or stimulate they experienced name-calling during their orientation in the cardiovascular ICU? One supposition t hat stands out when discussions on the theoretical framework with regard to horizontal violence is Paulo Freires burdensomeness theory. Theorist Paulo Freire first presented the subjugation theory in 1972 when explaining the conflict of the colonized African populations.This theory discusses the observance of the imbalance of forefinger due to dominate and subordinate assemblys. The oppression theory discusses how two groups are involved and the dominate group maintains higher power than the subordinate group. The oppression occurs when the subordinate groups culture is repressed by the prevailing group. Due to the subordinate group feeling repressed, the subordinate group begins to act out their self-hatred on each other.By doing this, the values and beliefs that were held by the subordinate group are soon lost and self-hatred settles in. In 1983, Sandra Roberts, applied the oppression theory to nursing and argued that an understanding of the dynamics profound leadership of a n oppressed group is an important strategy to develop much effective leaders in nursing to be successful. (Bartholomew, 2006). Roberts noted that nursing had displayed the dominate group along with the subordinate group referring to the leadership in the nursing profession.The dominate group makes various decisions without compliancying the values of the subordinate group the nurses working on the floor with the patients. Through this process, the subordinate group loses respect for the dominate groups value system and become oppressed with feelings of low self-esteem, self-hatred, and powerlessness. With the oppression theory there is a sub-subordinate group that feels the results of the oppression theory and this is the novice nurses organism hired into the nursing profession.During the orientation phase the novice nurses conk into a subgroup resulting in oppression trying to bring the novice nurses through the rite of passage to be a nurse in the unit that the orientation is occurring. Organizations fashioned to be hierarchical impart not fostered a culture of professional collegiality, nor have they advanced the role of nursing. Too often, nurses have acquiesced to a victim mentality that only facilitates a sense of powerlessness.Nurses have reported engross about the lack of action taken by supervisors in addressing horizontal violence in the employment (Farrell, 1997 Stanley et al. , 2007). While not directly addressing bullying or horizontal violence, Kramer (1974) described the mankind scandalise occurring for new graduates when they encountered differences in their intelligence of what nursing could be and the actual reality of the workplace. Kramer suggested that reality shock can manifest as hopelessness and dissatisfaction, which is a prelude to conflict in the workplace (p. ).Today, bullying is an international phenomenon not limited to the wellnesscare arena, and nuisance can also occur amidst professions. The phrase nurses eat their young, has been used to describe the negative behaviors directed toward new nurses (Rowe & Sherlock, 2005). Griffin (2004) described the vulnerability of newly licensed nurses as they are socialized into the nursing workforce lateral violence affected their perception of whether to remain in their current position.Sofield and Salmond (2003) found that primarily physicians, then patients, and patients families were liable for nearly of the communicatory abuse towards nurses. One-third of respondents expressed they would consider capitulation in response to vocal abuse it was concluded that nurses lacked the skills to deal with the verbal abuse and perceived themselves as powerless to change governanceal response (Sofield & Salmond, 2003). Cox found the most frequent source of verbal abuse was physicians, and in descending order patients, families and peers, supervisors and subordinates (1991).The turn-over attri notwithstandinged to verbal abuse was 24 percentage for staff n urses and 25 percent for nurse managers (Cox, 1991) Cook, Green and Topp (2001) found that perioperative nurses encountered verbal abuse by physicians. However, Rowe and Sherlock (2005) reported that nurses in particular were the most frequent source of verbal abuse towards other nurses. Patients families were the second most frequent source, followed by physicians and then patients (Rowe & Sherlock, 2005). In 2004, The Institute for unassailable music Practices published a survey on workplace intimidation.Almost half(prenominal) of the 2,095 respondents, which included nurses, pharmacists and other providers, recalled being verbally abused when contacting physicians to question or clarify medication prescriptions intimidation had played a role in either not questioning a concerning order or seek ways not to directly confront the prescribers. While physicians and prescribers used frighten behaviors, however they were not the only intimidate healthcare providers (Institute for Safe music Practices, 2004).In a hostile environment, communication is hindered and this can affect role of care and patient safety (Joint Commission on Accreditation of health care Organizations, 2002). Healthcare providers report intimidation does alter communication and negatively impacts patient care and safety (Institute for Safe Medication Practices, 2004). Healthcare professionals facing intimidation may sometimes choose to abdicate their advocacy role to avoid intimidating behaviors, impacting patient safety.The Institute for Safe Medication Practices survey (2004) revealed that more experienced nurses are more likely to encounter intimidating behaviors differences in intimidating encounters were not appreciably different in terms of gender but females were more likely to ask another colleague to talk with the intimidator for them. The organizations effectiveness in handling intimidation was viewed less favourably by those nurses and pharmacists with more years of pract ice in that facility (Institute for Safe Medication Practices, 2004).To add strength to this study, more literature that locates to the ICU being one of the top places in the healthcare setting to be the locale for horizontal violence. Bullying in the medical setting is said to happen most of the time in the top three areas, i. e. , medical or surgical units, intensive care units (ICU) and the emergency department (ER). The occurrences of horizontal violence are lesser in the areas such as child health and maternal health areas, psychiatry and operating rooms.This is the result of findings such as those make by WHO. The World Health Organization has been showing concern with the horizontal violence happening in healthcare settings and has been aware of the line becoming an epidemic already and has started to think of solutions by first producing guidelines in dealing with the violence when it happens. WHO touched on the patient to nurse type of violence as well and the effects it has on the emotions of the nurses.The results of the survey make by WHO also made a significant finding, that the highest rating for workplace violence was in the areas of highest acuity like the intensive care units. This made even stronger the need to find out the prevalence of horizontal violence in the ICU. With all the above literature taken from scholarly journals and books, it is quite a apparent that horizontal violence is indeed present in the healthcare industry today. There are even some studies held that have proved its universe in the intensive care unit.Most of the studies made point to the new or novice nurses as the main victim, with other more superior nurses being their main predators. To get concrete evidence of its existence in the ICU during orientation in a Midwestern magnet status hospital and to get further evidence on horizontal violence in the ICU, a study about it musical themed on a cross sectional non- observational explanatory query object lesson and the Likert crustal plate which volition further be discussed in the next topics.Design noviciate nurses that have been in orientation in various types of ICU for the past three to sextet months were asked to participate in the survey. Those that participated were nurses that have attended orientation in both of the intensive care units, i. e. , surgical ICU, cardiovascular ICU, coronary thrombosis ICU or general ICU. All these novice nurses were fork overn the uniform survey questions in relation to understanding whether they have experienced horizontal violence while they were in orientation.With looking at several different ICUs, there are varying variables that are influenced. Firstly, each participating intensive care unit has different formats for their orientation process. There are also different educators for each of the ICUs and varying preceptors orient each of the novice nurses. A cross sectional non-experimental explanatory research model will be used to con duct the survey of novice nurses in different types of ICUs. The survey will be given to novice nurses that have been in orientation in the ICUs for the past three to six months.Out of the novice, nurses that are surveyed there will be varying educational backgrounds along with different work experience. The common thread among the novice nurses will be that they are novice nurses in the area they are orienting in at the time the survey is administered. Strengths of this study will look at a cross section of the novice nurses in orientation in a Midwestern hospital to investigate the occurrences of horizontal violence during orientation.Due to the cross section, this study will also give igniter to the working relationship between novice nurses and expert nurses during orientation in the intensive care units. This study will provide a base for educational purposes on how to improve the relationships between the novice nurses and expert nurses during orientation in the intensive car e units. Another benefit from the study, there will be a study that has looked at the type of horizontal violence that is occurring during the orientation process in the intensive care units.This will give the building blocks to educating the expert nurses in how to be more encouraging towards the novice nurses during the orientation process. The reason in using this non-experimental quantitative research model is due to the fact that galore(postnominal) of the most vital variables of interest in this study are not manipulable. This is however not indicative of any less methodology employed. Many researchers actually make use of non-experimental research since it is highly descriptive and it allows effective communications in an interdisciplinary research environment.Non-experimental quantitative research is an essential area of research due to its many vital though non-manipulable independent variables that may need further study. most known methodologists even say that non-exper imental research (Kerlinger, 1986) is more important that experimental research in such as way that educational and social research problems may not carry themselves to experimentation but lend themselves to controlled inquiry that is of the non-experimental type. The mentioned characteristics of this kind of research model make it a life-threatening choice for this particular study.