Ezzay Ezzay Lateral Violence Case Study Introduction: Lateral violence, a form of incivility or bullying is defined as a deliberate and harmful behavio

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Lateral Violence Case Study


Lateral violence, a form of incivility or bullying is defined as a deliberate and harmful behavior demonstrated in the workplace by one employee to another. The American Nurses Association (ANA) defines lateral violence as acts that occur between colleagues (distinguished from acts perpetrated by those in a position of authority), which includes withholding information, scapegoating, and gossiping. For decades, there have been complaints that nurses “eat their young” and commit violence against novice nurses. In this assignment you will respond to a case study about lateral violence.

In your response to this case study you will consider the assigned readings or viewings we have completed so far in this course.

At the end of this assignment you will:

· Address a case study involving lateral violence in the workplace

· Discuss leadership principles and how they apply to this case study

· Consider implications for your future nursing practice and identify resources to use when addressing lateral violence or work incivility

Criteria for successful completion of this case study:

· Effectively use frameworks from this course to address this case of lateral violence

· Correctly apply leadership principles to professionally navigate this conflict

· Develop a proposed plan of action for resolving this situation

· Perform a self-assessment on the work and answers provided using the three criteria above.


· Read the below case study below.

· Prepare answers to the case study questions presented on page 3. Include course readings or viewing we have done thus far. You may also bring other reputable related resources into this work (cite your sources please).

· Your answers may be bulleted if it is easier to compose your answer but should be in complete sentences.

· Perform a self-assessment of your work (presented on page 4) and return that page with your assignment.

Case Study:

Marla was on her last day of orientation as a staff nurse in a very large intensive care unit (ICU). She had been in the ICU for 6 months training. Prior to working in the ICU, she worked for six months on the hospital’s step-down unit. Because Marla’s assigned preceptor had called in sick, Sharon, a nurse with many years of experience was asked to assist Marla for the day.

Sharon had never worked with Marla before so before she began working with Marla, she explained her shift routine. Since Marla was on her last day of orientation, both nurses agreed that Marla was confident to take on the assignment, with Sharon observing and helping as needed. Sharon was an experienced preceptor, and throughout the day asked care-related questions to ensure Marla understood the complexity of the two assigned patients.

Mid-day, one of the patients unexpectedly became critically ill. Sharon became increasingly concerned that Marla was not picking up on the increased acuity and the need for quick intervention. She waited for several minutes to see if Marla would respond to the patient’s change in condition, but after 15 minutes Sharon became concerned about the patient and that Marla had not identified the change as a critical event. Sharon indicated to Marla that she would need to assume full care for this patient, which she did. The patient required immediate airway management and was taken to surgery with a diagnosis of ischemia to the bowel.

At the end of the workday Sharon debriefed with Marla on what transpired during the shift and why she felt she needed to fully take over the assigned patient. Sharon expressed concerns to Marla that she was not ready to work independently in the ICU based on this incident and suggested Marla ask the manager to extend her orientation. Sharon then offered to work with Marla more to help improve her assessment skills and confidence. After Sharon discussed her apprehensions, Marla became defensive and curtly accused Sharon of “picking on her” all day and “things were fine until you intervened.”

Sharon took her concerns to her manager, stating “Marla is not ready to be independently caring for critically ill patients.” She told her of the issue and recommended making Marla’s orientation longer to better prepare her for identifying changes in condition and caring for more critically ill patients. The manager indicated that Marla was “fine”, and the night shift nurses would complete the orientation, saying, “Because of tight staffing we need Marla to work nights now.”

Several weeks later, as Sharon was starting her day shift, she finds Marla crying in the locker room. “What’s wrong?” she asked. Marla tells her that one of her patients fell during the night, hitting his head and was sent for emergency surgery, “It was just a bad night. I’ll be fine.” Sharon asked if Marla wanted to talk about it, but she declined.

As Sharon walked into the ICU she overhears Dave and Mike, two night shift nurses, laughing and talking. “Boy we showed her, didn’t we?” Dave said. Sharon asks what is so funny. Mike stated, “Marla is such a know-it-all and she never wants our help. So tonight, we didn’t help her. She didn’t ask and we didn’t offer. She had two patients and one of them was really sick. We just heard one of her patients fell. Serves her right. She thinks she knows everything. She had a rough night all right.”


1. Apply professional principles and standards to the behaviors of the nurses; Marla, Sharon, Dave, and Mike.

a. Where did you see professional behaviors? What professional standards were applied when you saw that behavior?

b. Where did you see unprofessional behaviors?

2. Apply principles of delegation to this case study. What principles are applicable and why? How might these principles be used to address lateral violence?

3. Apply the AACN Standards for Creating and Sustaining a Healthy Work Environment to this case study. What standards are applicable and why? How might these standards be used to address lateral violence?

4. Apply the ANA Code of Ethics to this case study. How might the code be used to address lateral violence?

5. What implications are evident in this case study for patient care? In addition, imagine if a patient or family overheard the conversation between Mike, Dave and Sharon. What would that look like and what would the implications be?

6. Outline briefly how you would address this case.


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