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"As such, the one caring and the one cared-for, both connect in mutual search for meaning and wholeness, and perhaps for the spiritual transcendence of suffering" (Cara 2010).
Support groups can be particularly effective in dealing with cultural and generational barriers that can exist between members of the organization. Older nurses often are impatient with younger nurses, and young nurses have historically bourn the brunt of lateral violence. Through informal dialogue, mediated by a trained facilitator, nurses can understand that they all have similar emotions, regardless of their duration in the profession. Supported dialogue can also open up channels of communication between nurses from different cultural backgrounds, creating a more integrated workplace.
As well as dealing with emotions, support groups can offer nurses training in more effective ways to frame and deal with conflict. For example, instead of making an issue focused on a person, by focusing upon an object-oriented problem nurses can reduce the level of unproductive emotions generated by disagreement. Focusing upon specifics can also encourage nurses to identify what aspects of the workplace can be changed by speaking with management as a unified group.
Change theory
Changing the way that staff members interact with one another can be extremely challenging, given that it requires a complete rethinking of how members relate to one another. Change theories tend to focus on either the individual or society: the need to change his or her capacity for change or the group. Theories such as social modeling suggest that individuals mirror their behaviors upon others -- someone who sees horizontally violent behavior in his or her colleagues will quickly learn to behave in such as manner, and assume it is the norm for nurses at the organization (Shapiro 2005). Socially-based theories tend to focus upon reformulating institutions to facilitate change.
Support groups allow for individuals to psychologically unburden themselves and to change from with, while still providing the social cohesion to support externally-driven change. They are based in personal experience, but can...
Having a formal facilitator can introduce workers to role playing or cognitive rehearsal strategies which allow participants to "practice how to manage a lateral violence situation and then critique each other" in a constructive fashion (Kelly 2010).
Conclusion: Steps to enacting change
Documenting the problem of horizontal violence is one of the first, critical aspects of instituting a preventative plan. Conducting exit interviews with departing nurses is one way to begin to measure the scope of the magnitude of the problem, given that these nurses may be less afraid of speaking their mind regarding the problem (Kelly 2010). Training counselors in-house or bringing outside staff to monitor the support group sessions and conduct conflict mitigation exercises may require bringing additional staff on board, or retraining existing staff. But while there may be some initial cost, the benefits reaped from the reduction in horizontal violence will be great, both for nurses on a personal level, and for the institution in terms of the improved coordination amongst staff members.
References
Cara, Chantal. (2010). A pragmatic view of Jean Watson's caring theory.
University of Montreal. Retrieved March 21, 2011 at http://www.humancaring.org/conted/Pragmatic%20View.pdf
CNAs and horizontal violence in the workplace. (2011). CNA Board.
Retrieved March 21, 2011 at http://www.cnaboard.com/2010/useful-cna-information/certified-nursing-assistants-and-horizontal-violence-in-the-workplace.html
Kelly, Barbara. (2011). Lateral violence. Indiana State Nurse's Association Bulletin. Retrieved March 21, 2011 at http://findarticles.com/p/articles/mi_hb6138/is_2_37/ai_n57052109
CANNT Journal. Retrieved March 21, 2011 at http://findarticles.com/p/articles/mi_m5PMC/is_3_18/ai_n30956560/
Shapiro, Iliana. (2005). Theories of change. Beyond Conflict. Retrieved March 21, 2011 at http://www.beyondintractability.org/essay/theories_of_change/
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