Lateral Violence, Bullying, Victims ...Big River Saskatchewan

LateralViolence, Bullying,
Victims…
Move to Lateral Kindness
Big River First Nation
NAAW
November 15th 2016

Objectives
 To broaden the understanding of the Platinum Rule.
 To describe how to apply the Platinum Rule.
 Compare the Golden and Platinum Rules.
 To explore cultural aspects of nursing care.
 To identify the unique challenges faced by care providers
working with diverse clients.

• To broaden the understanding of LateralViolence and Bullying
• To identify the unique challenges faced by Indigenous peoples
and the need for a balanced approach
• To support health care workers to care effectively for their clients
• To support you and your team to come together
Objectives

Outline
• What is lateral violence?
• What causes lateral violence?
• What are the effects of lateral violence
• Who gets targeted
• Types of bullies
• Hierarchy
• Mobbing
• Cultural competence and culture
• Zero tolerance policies
• Functional versus dysfunctional conflict

No Blame, No Shame, it is about
safety in the workplace

Lateral Violence, Bullying, Victims ...Big River Saskatchewan

Stories
• I will use some of my experiences working in health, in
the north, and as an male nurse, often an outsider,
working in different situations.
• You are a part of the story.

Invisible Backpack
“all of us carry an invisible ‘backpack’ of our culture,
experiences, beliefs, values and morals.Whenever we
encounter another person, our backpack is present with us
and influences how we interact with our patients and their
families”.
Scott Harrison
Invisible Knapsack Peggy McIntosh

We Don’t SeeThings AsThey Are,
We SeeThem AsWe Are
“It has been well said that we do not see things as they are,
but as we are ourselves. Every man looks through the eyes of
his prejudices, of his preconceived notions. Hence, it is the
most difficult thing in the world to broaden a man so that he
will realize truth as other men see it.”

“What we see, we do not see.”
• ArchieWeenie

Why am I here?
• I ask myself this every day, and I also ask those who I am
working with from time to time

LateralViolence
“Exists on a spectrum, from seemingly ordinary
behaviour such as gossiping or criticism, to
intimidation, racism and outright physical
intimidation or harm.”
Linda Rabyj, 2005

LateralViolence
LateralViolence (LV), also called Horizontal
violence, [bullying], incivility, and disruptive
behaviours, creates an unpleasant work
environment and has harmful effects on individual
nurses, patient safety, and health care
organizations.
Johnson, 2009 & Dimarino, 2011

Cyber LateralViolence
Sending emails without greetings?
CAPS LOCK

What are the characteristics of
a bully?

a target/victim?

a witness/bystander?

What is an upstander?
• An “upstander” is someone who recognizes when
something is wrong and acts to make it right.
• When an upstander sees or hears about someone being
bullied, they speak up.
• Being an upstander is being a hero: we are standing up
for what is right and doing our best to help support and
protect someone who is being hurt.

Direction and Hierarchy
• The more vertical an organization is in its hierarchy, the
more complicated communication becomes.
• We are hired into a certain job, or role, but no where does
it tell us of all the lateral violence that exists, or what to
do about it.
• What is the chain of command where you work?

Diversity, accommodation and
special treatment?

How many Directions are there?

Seven Directions!
• East
• South
• West
• North
• Life Above the Earth
• Life Below the Earth
• Life on the Earth (and within ourselves)

We All need to ask ourselves:
• “Did I participate in bullying?”
• “Did I support this kind of behavior in others?”
• “Did I intervene if and when I observed it?”
“We must work to uncover and reverse atrocities, one person, one
company, and one law at a time”
BullyproofYourself atWork, G & R Namie

Communication is about listening
• My job description does not say, Greg, you will have to
listen to a lot of your co workers bitching and complaining
about each other, they will want you to fix their conflicts,
and will want you to keep it a secret and tell no one.
• This will happen on a very regular basis, consider this
‘duties as assigned’

Hurt People Hurt People
When another person makes you suffer, it is because he
suffers deeply within himself, and his suffering is spilling
over. He does not need punishment; he needs help.
Tich Naht Hanh

Hurt people hurt people
Hurt people hurt people.That’s how pain patterns get passed on,
generation after generation after generation.
Break the chain today.
Meet anger with sympathy, contempt with compassion, cruelty with
kindness.
Greet grimaces with smiles.
When you forget about the fault, there is nothing to forgive.
Love is the weapon of the future
Yehuda berg

Who gets targeted?
Anyone who is different from the group norm on any major
characteristic
• Experience
• Education
• Race/ethnicity
• Gender
Targeted person’s gender
• 79% Female
• 21% Male

He said, She said
• Men and women communicate differently
• Indirect communication
• Direct communication
• Asynchronous communication – text, email, voicemail
• Cyber LateralViolence
• CAPS LOCK
We punish people for not being about to communicate properly as
opposed to helping them learn new skills..

Who is Doing the Bullying?
2009 survey by Workplace Bullying Institute:
- Main perpetrator’s gender
• 65% Female
• 35% Male
2009WBI survey sited in NewYorkTimes:
- Men target men and women equally
-Women target women 70% of the time

Why does this happen in the myWorkplace?
• Isolated from the public and other staff
• High-stress environment
• Limited autonomy in practice
• High-paced environment
• Lack of experienced staff
• Cliques or closely bonded groups
• Hierarchical climate
• Gender imbalance
• Attitudes to training
• Non acceptance of difference

Why?
In my profession, nurses practice in a historically patriarchal
environment.
• Oppression leads to low-self esteem.
• Nurses exert power over one another through lateral violence.
Lateral violence is perpetuated through the culture of nursing (new
nurses, curriculum, etc).
• “Nurses eat their own”
• “See one do one teach one”
• The Bronze Rule…
We now work with four different generations in the workforce,
adding to the complexities of effective communication.

Impact is on all staff
•Physical
•Psychological
•Social

Impacts on NewTeam Members
• New team members are extremely susceptible to
LateralViolence and experience more negative impacts
than experienced team members.
Prevention Strategies are needed
• Top down and bottom up approaches
• Mentoring and investigation systems
• Role Models
• Education
• Empowerment

Three types of BULLIES
Sydney based clinical psychologist and workplace bullying
specialist Keryl Egan has formulated three workplace bully
profiles:
1.Accidental bully
2.Narcissistic bully
3.Serial bully

Accidental bully
This person is task orientated and just wants to get things
done, tends to panic when things are not getting done, and
goes into a rage about it.This person is basically decent,
they don’t really think about the impact of what’s
happening or what they have done.
They are responding to stress and it is believed that they
can be coached out of this behavior.

Narcissistic Bully
They are grandiose and have dreams of breath taking
achievement.They feel they deserve power and position.
They can fly into a rage when reality confronts them.This
person is very destructive and manipulative, they don’t set
out in a callous way to annihilate any person – it is purely an
expression of their superiority.

Serial Bully
Has a sociopathic and psychopathic personality.This type of bully is intentional,
systematic and organized and is often relentless.They usually get things done in
terms of self-interest.
They employ subtle techniques that are difficult to detect or prove. Coaching is often
ineffective.
They exhibit the following:
• Grandiose, but charming
• Authoritative, aggressive and dominating
• Fearless and shameless
• Devoid of empathy or remorse
• Manipulative and deceptive
• Impulsive, chaotic or stimulus seeking
• Master of imitation or mimicry

Conflict It’s not all Bad
Functional Conflict is considered positive, as it can increase
performance, support change, and identify weaknesses or
areas that need to be supported.
Dysfunctional Conflict is harmful to people and the
organization.This type of confrontation does nothing to
support goals or objectives.

In Conflict who are you:Victim,Villain, Hero or
Resolutionary?
In conflict, each person
feels hit first.
The size of the villain
determines the size of the
hero.
“Without goliath, David is
just some punk, throwing
rocks.”
Billy Crystal, My Giant

Risk and Rewards
• We often face a risk acting, and we also face a risk when
we do not act.
• It’s difficult to know what to make of a teacher who
crosses the line from basic discipline to regularly
berating, intimidating, humiliating.

Victims
• Are you a victim of the victim syndrome?
• http://sites.insead.edu/facultyresearch/research/doc.cfm?did=50114

10 Most Common Forms of Lateral
Violence in
1. Non-verbal innuendo,
2. Verbal affront,
3. Undermining activities,
4. Withholding information,
5. Sabotage,
Griffin. 2004

10 Most Common Forms of Lateral
Violence in
6. Infighting,
7. Scapegoating,
8. Backstabbing,
9. Failure to respect privacy, and
10.Broken confidences.
Griffin. 2004

Mobbing
A group of coworkers gang up on another
• often with the intent to force them to leave the work group
Five phases of Mobbing
1. Conflict
2. Aggressive acts
3. Management/Faculty Involvement
4. Branding as Difficult or Mentally ill
5. Expulsion

Safe place
• Where is the safe place in your organization?

ZeroTolerance
• Zero tolerance policies – the APA has a resolution calling
for schools to modify this approach, as it ‘can actually
increase bad behaviour and also lead to higher drop-out
rates’

Tips for Creating a HealthyWork
Environment by Kathleen Bartholomew
• Never be a “silent witness”. Never stand by and listen while others are gossiping,
criticizing or talking badly about someone else
• Be a team player. If you see someone in need of help, offer assistance.The
greatest safety net cast is to catch mistakes and this is only as strong as your
relationships
• Speak your truth – always say what’s on your mind. Start the conversation by
sharing your perception of what happened and then what you need
• Always stay client focused and problem solving focused (personally I want a win-
win)
• Address issues directly. Ask the manager or your mentor to help role model
difficult conversations with you

Lateral Silence
• It is part of the culture.
• Everybody knows about it
• Everybody does it
• No body talks about it

Our Culture needs to change
• We do not accept bullying in our schools or other
workplaces so why is it ok in the workplace?
• In my profession, Nursing, this is the culture that was
learnt by nurses 30 years ago and has been taught to new
nurses.
• Change is often difficult, you go first!

Why Don’tWe Stop LateralViolence?
“It’s not a problem in our work area”
“Everybody does it – just get used to it”
“If I say anything, I’ll be the next target”
“We have policies but they aren’t enforced”
“She sets herself up for getting picked on”

Statement of Commitment to Co-workers
As your co-worker with a shared goal of providing excellent service to people
and families, I commit the following:
I will accept responsibility for establishing and maintaining healthy
interpersonal relationships with you and every member of this staff.
I will talk to you promptly if I am having a problem with you. The only
time I will discuss it with another person is when I need advice or help
in deciding how to communicate with you appropriately.
I will establish & maintain a relationship of functional trust with you and
every member of this staff. My relationships with each of you
will be equally respectful, regardless of job titles or levels of educational preparation.
I will not engage in the '3B's (bickering, back-biting and bitching) &
will ask you not to as well.
I will not complain about another team member & ask you not to as well.
If I hear you doing so, I will ask you to talk to that person.
I will accept you as you are today, forgiving past problems,
& ask you to do the same with me.
I will be committed to finding solutions to problems rather than
complaining about them or blaming someone, & ask you to do the same.
I will affirm your contribution to quality service.
I will remember that neither of us is perfect, & that human errors
are opportunities not for shame or guilt, but for forgiveness and growth.
(Adapted from Marie Manthey, President of Creative Nursing Management in Caroline Flint's Midwifery Teams and Caseloads 1993; p. 138)

Good Hunters or BadTipi Builders

Lateral Kindness
• Please be kind to each other
• Respectful and responsible relationships, there are no
apps for that.
• Be Grateful
• Be Great!

Civility and Respect
Civility and Respect means showing appreciation, care, and
consideration for everyone, whether they’re coworkers,
supervisors, customers, or clients. Creating a
psychologically safe and healthy workplace is up to all of us.
http://www.mentalhealthcommission.ca/...

Bullies andVictims or just people?
• Bullies are evil, victims are innocent? Really???
• Who decides?
• What if there are no bullies?
• What would you do?
• What would teachers or parents do?

There is hope and reality
• Effective anti-bullying practices must include a
statement of exactly what constitutes bullying.
• We need to work with everyone, bullies, victims,
targets, and bystanders…

Bronze silver gold platinum rules
The culture ofWestern medicine places diagnosis as a
central goal
Aboriginal medicine, see diagnosis as less central and pay
more attention to finding a safe environment in which the
patient may recover.
For conditions such as mental disorders, this latter
approach may prove more effective than struggling to
attach a label to the disorder.

Bronze rule
Do unto others as they have done unto you

Silver
What you do not want done to yourself, do not do
to others

Gold
Do unto others as you would have them do unto you.

Platinum
Do unto others as they want done unto them

THE PLATINUM RULE.
TREAT OTHERS
HOW THEY WANT TO BE TREATED

Imbalance Creates Illness
 Holistic approach to address issues and factors that impact illness
targeting not just the disease, but also the social determinants of
health and economic circumstances.
 It is recognized that the whole family (broadly defined) is as
impacted by disease and needs healing just as the individual who is
‘sick’ requires care, treatment and support.

Cultural Competence is a part of the
Platinum Rule
• Cultural Awareness
• Cultural Sensitivity
• Cultural Knowledge
• Cultural Competence
• Cultural Humility
• Cultural Safety

Culture is a world view
• NorthAmerican culture sees health as an individual
problem, but we live in dynamic, intercultural communities.
• Culture can be a barrier to caring for our clients.
• We learn about disease models of health
• We need to focus on wellness and resilience models of
health
• Health is multifaceted with issues related to mental,
spiritual, emotional, and physical health.

What is Culture?
• Behaviour is what you do…
• Culture is how you do it…

Cultural Awareness
Is really concerned about acceptance

Cultural Sensitivity
Is about respecting differences and often uses neutral
language, and neutral communication

What happens if a bird poops on you?
• Bird poop brings good luck!There is a belief that if a bird
poops on you, your car or your property, you may receive
good luck and riches.The more birds involved, the richer
you'll be! So next time a bird poops on you, remember
that it's a good thing.

Cultural Knowledge
Familiarization with selected cultural characteristics, history, values,
belief systems, and
behaviours of the members of another ethic group

Cultural Competence
Is about understanding, knowledge skills and attitudes, working
effectively in cross cultural and intercultural situations, this is the
application of knowledge, creates the environment of cultural safety

Cultural Humility
Focuses on self reflection and acknowledges power
differences, and privilege.

Cultural Safety
Stresses the importance of relationships and partnerships, power
shifts to the client, to decide what is safe and what is not

An environment that is safe for people; where there is no assault, challenge or denial of their
identity, of who they are and what they need. It is about shared respect, shared meaning, shared
knowledge and experience, of learning, living and working together
with dignity and truly listening.
(Health Q. F., 2012)
Cultural Safety

Physical Mental Emotional Spiritual
My perspective is that each
of these four parts can be
treated as its own body.
Each requires its own form
of sustenance and exercise
to be healthy

• Cultural safety
stresses the
importance of
reflection &
acceptance of
differences.
• We should not treat
everyone the same.
• We do need to
recognize and
acknowledge our
blind spots.

Tips for Creating a HealthyWork
Environment by Kathleen
Bartholomew
• Never be a “silent witness”. Never stand by and listen while others are gossiping,
criticizing or talking badly about someone else
• Be a team player. If you see someone in need of help, offer assistance.The
greatest safety net cast is to catch mistakes and this is only as strong as your
relationships
• Speak your truth – always say what’s on your mind. Start the conversation by
sharing your perception of what happened and then what you need
• Always stay client focused and problem solving focused (personally I want a win-
win)
• Address issues directly. Ask the manager or your mentor to help role model
difficult conversations with you

Discussion, questions,
comments!!!
Thank you for your participation

Contact information
Greg Riehl RN BScN MA
greg.riehl@saskpolytech.ca
gregriehl@sasktel.net
@griehl

Contact information
Greg Riehl RN BScN MA
Aboriginal Nursing Student Advisor
Aboriginal Nursing Student Achievement Program
Saskatchewan Polytechnic
Regina Campus
Email: greg.riehl@saskpolytech.ca
Email: gregriehl@sasktel.net
@griehl

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