Published on December 13, 2013
Welcome to Today’s Webinar Zero Tolerance for Lateral Violence: Changing the Culture of Nursing Practice
Lori Ingram MSN, RN, CNOR, CNML • • • Lori Ingram is the Nurse Manager of PeriOperative Services at Novant Health Matthews Medical Center, in Matthews, NC. Her responsibilities include overall accountability for operations of the OR, Admission & Discharge Area, PACU, Sterile Processing, Endoscopy, Lithotripsy and Pain Management services. During her perioperative career, Lori has held the positions of Nurse Manger, Clinical Nurse Specialist, Educator and staff nurse. Lori holds specialty certification in the OR (CNOR) and in Nursing Management & Leadership, (CNML). Lori is an active member of the Dogwood Chapter of AORN, is the immediate past president and is the Chair– Elect for the North Carolina Council of PeriOperative Registered Nurses, where she is actively involved in the legislative efforts focused on the RN Circulator Bill passage. Lori has presented at AORN Congress and presented two research posters at Congress. Lori was a member of the AORN National Congress Planning committee for three years and is currently a member of the AORN National Committee on Education. She is also a member of Sigma Theta Tau, the American Organization of Nurse Executives (AONE), and the American Society of PeriAnesthesia Nurses (ASPAN). Lori has received the NC Council and the Georgia Council of OR Nurses, Perioperative Nurse of the Year Award and was selected as one of the “Great 100” Nurses in NC. She is a recipient of the Novant Health Circle of Excellence Award. Lori had a research article published in Journal for PeriAnesthesia Nursing and received the third place editor’s award for research articles in 2012. She has another research article accepted for publication in 2014. She enjoys participating with her perioperative colleagues in research and evidence based practice initiatives, along with mentoring new nurses in the OR and encouraging their career growth.
Judith Seltzer, MS, BSN, RN, CNOR • • • • • Judith Seltzer is the Surgical Clinical Director, National Accounts for Molnlycke Health Care. Her responsibilities include education, program development, and research facilitation regarding latex allergies, glove powder, barrier protection issues and antiseptic agents. This includes planning, producing and implementing clinical education for nurses and other health care professionals. Judi also serves as an expert clinical specialist for acute and non-acute healthcare facilities, and hospital administrative professionals. Judi is based in the Mid-Atlantic, and provides clinical expertise for the US Surgical Molnlycke Health Care team. Judi received both her Bachelor’s and Master’s degrees in Nursing Informatics from the University of Maryland School of Nursing. During her career as a perioperative nurse, she has held the position of Nurse Manager of Cardio-thoracic Services, Clinical Educator of Perioperative Services and Professional Development Coordinator. During her tenure, Judi was responsible for the development of many educational offerings. She was awarded the University of Maryland Medical Center’s President’s Award in 2001 for the implementation of a Surgical Technology program working in partnership with the University of Maryland Medical Center and the City of Baltimore’s Office of Employment Development within the Mayor’s Office. She is a member of the Baltimore, Maryland chapter of the Association of periOperative Registered Nurses (AORN) during which she presented a poster presentation for the 2004 and 2011 AORN Congress. Judi is also a member of the Baltimore APIC chapter. In addition, she is a member of the Sigma Theta Tau International Honor Society of Nursing. Judi has held faculty nursing appointments at Villa Julie College and Baltimore City Community College in Baltimore. Judi has had several publications including, Advance for Nurses, Forming a Perioperative Consortium, (1999); AORN, Initiating a Clinical Research Project in the Operating Room (2001); AACN Clinical Issues, Awareness of Surgical Site Infections for Advanced Practice Nurses, (2002) and Perioperative Nursing Clinics Skin Antisepsis: First Line of Defense / Set Skin Preparation in Motion before the Incision (2011). Most recently, she is the chapter author of Infection Control Principles for Long-term Care Environments and Infection Control in the Ambulatory Surgical Centers, in a recently published text book titled: Infection Control for Advance Practitioners, edited by Denise Korniewicz, 2013. She continues to speak across the country for AORN chapters including the AORN Fall Conference (2007) in San Antonio, Texas; AVIR conference in Washington, DC in (2008), AORN Congress in Denver (2010) and AORN Congress in New Orleans (2012) where she presented Nurses in Industry on the Move: Transatlantic Differences While Competent Nursing Practices Prevail. Judi is a member of the AORN National Committee on Education (NCE) and most recently accepted the position of Chairperson of Communications for the AORN Business and Industry SA Committee (BIC).
Angela Walsh, MA, BSN, RN,CNOR • • Angi is an active member of Massachusetts Chapter I (37 years). She is currently a Perioperative Clinical educator in a 497 bed teaching hospital. She is a Master TEAMStepps Trainer, Certified Bariatric Surgery Support Group Facilitator and avid quilter. Angi has held a variety of education positions both in the clinical (patient & staff ed) and classroom (RN, surgical technologist & high school) setting over the past 37 years. Angi has a masters degree in Critical & Creative Thinking with emphasis on Patient & Family Education, and is currently facilitating a Perioperative 101 “Grow Your Own“ training program to provide internal succession.
Disclosure Information Speaker: Lori Ingram, MSN, RN, CNOR Judi Seltzer, MS, BSN, RN, CNOR Angi Walsh, MA, BSN, RN, CNOR All Speakers Disclose No Conflict Planning Committee: Susan D. Root, MSN, RN, CNOR Manager Perioperative Education, AORN Discloses No Conflict AORN’s policy is that the subject matter experts for this product must disclose any financial relationship in a company providing grant funds and/or a company whose product(s) may be discussed or used during the educational activity. Financial disclosure will include the name of the company and/or product and the type of financial relationship, and includes relationships that are in place at the time of the activity or were in place in the 12 months preceding the activity. Disclosures for this activity are indicated according to the following numeric categories: 1. Consultant/Speaker’s Bureau 2. Employee 3. Stockholder 4. Product Designer 5. Grant/Research Support 6. Other relationship (specify) 7. No conflict of interest Successful completion of this educational activity includes attendance at 90% of the webinar and completion of the evaluation form. Accreditation Statement AORN is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation. AORN is provider-approved by the California Board of Registered Nursing, Provider Number CEP 13019. AORN IS PLEASED TO PROVIDE THIS WEBINAR ON THIS IMPORTANT TOPIC. HOWEVER, THE VIEWS EXPRESSED IN THIS WEBINAR ARE THOSE OF THE PRESENTERS AND DO NOT NECESSARILY REPRESENT THE VIEWS OF, AND SHOULD NOT BE ATTRIBUTED TO AORN.
Objectives • Discuss three assessment skills nurses can utilize that will alert them to potential dangers from lateral violence within the workplace and at home. • List five of the most prevalent examples of lateral violence and bullying occurring in the workplace today. • Identify three strategies for achieving professional and personal emotional health.
Take Out…. Objective 1: Discuss three assessment skills nurses can utilize that will alert them to potential dangers within the workplace and at home.
Situational Awareness Recognize Higher Risk Environments: • • • • • Healthcare workers / Service focus Working with volatile/unstable people Working in Isolated Areas or Alone Working Late at night Working in High Crime Rate Areas Workplace Violence can strike Anytime, Anywhere.
Disruptive Behavior Recognizing Early Warning Signs: • • • • • • Mood changes, behavior out of character Increased aggressive behavior Passive-Aggressive behavior Uncooperative or intimidating behavior Verbal outbursts or abusive language Physical threats
Imminent Violence Recognize Non-Verbal Cues: • Lowering of the head • Tucking in the chin so the bottom whites of the eyes are showing • Clenching & Re-clenching fists • Touching their head or pulling hair • Difficulty controlling fine motor skills. 2 Million American workers are victims of workplace violence each year. (OSHA -Workplace Violence, 2012)
Take Out…. Objective 2: List five of the most prevalent examples of lateral violence and bullying occurring in the workplace today
Consequences Absenteeism High Turnover Job dissatisfaction Poor performance Change in work culture Increased medical errors
Perpetuated By… ADDICTIVE BEHAVIOR • • • • Physicians Nurses Managers Allied Health Providers • Patients POOR MANAGEMENT SKILLS STRESS
WHAT WOULD YOU DO? On one particular night, the shift included three nurses: a newly licensed nurse, her preceptor who spoke English as a second language, and another nurse who also spoke the preceptor’s native language and English as a second language. The newly licensed nurse felt that the two experienced nurses were talking about her shortcomings in their native language and that they excluded her from general conversation for the entire shift.
Doreen, an experienced new RN The MD Jill, the circulator
Take Out…. Objective 3: Identify three strategies for achieving professional and personal emotional health
Calling out the Elephant in the room… Objective 3: Lateral Violence Identify three strategies for achieving professional and emotional health Sincox, A & Fitzpatrick, M, Michigan Nurse, 2013. Lateral violence: Calling out the elephant in the room
Workplace Violence Incidence 1.7 million healthcare workers annually Is it simply part of the job? Nursing Homes Acute care
How Can You Stop It?
Written and Implemented Policies Training on Reporting De-Escalation Techniques Nursece4less.com, 2013 Guidelines for Preventing Workplace Violence for Health Care and Social Workers, OSHA , 2012
Environment of Care Processes Better Patient Assessment Access: In and Around Environment Staff Issues and Consequences
Constructive Peer Relationships Color Code Code of Conduct “Eating Our Young”
OSHA WHO Joint Commission AORN AACN Guidelines for Preventing Workplace Violence for Health Care and Social Workers, OSHA , 2012 Nursece4less.com, 2013 ANA ENA
Recognize early behavior signs Incorporate early defensive action Have a well developed plan on hand Immediately Initiate defense actions Be familiar with Law Enforcement responses Know when Violence is Imminent Educate and Train Assemble crisis response kits Create a Continuity of Operations Plan (COOP) LiveProcess Emergency Preparedness, January 2013
Key Take Away Workplace violence between patients and staff; as well as between staff with other staff members is a phenomenon affecting every country, and every workplace. Make the changes necessary in your workplace to stop the Violence Now!
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