N108: Transition to the Registered Professional Nurse Role Study Guide Needle Stick Injury The Needle Stick Safety and Precaution Act (2000) requires all employers to implement engineering controls (equipment) that protect healthcare workers fromneedle stick injuries. Needle stick injuries, especially those with large-bore needles (i.e. bone marrow aspiration needles), continue to be the most frequent transmission source of blood-borne pathogens. Increased attention is now being given to designing needles and other sharp devices in ways to prevent needle stick injuries, and OSHA mandates that healthcare facilities have this in place. The ANA has been active in workplace advocacy related to needle stick injuries and supports a website devoted to this topic. Employers are responsible for providing equipment needed to maintain safety when handling these agents. Horizontal Violence Horizontal violence is defined as violence directed toward one's peer. Horizontal violence (also called lateral violence) between nurses is an act of aggression that’s perpetrated by one colleague toward another colleague. Although horizontal violence is usually verbal or emotional abuse, it can also include physical abuse and may be subtle or overt. Repeated acts of horizontal violence against another are often referred to as bullying. You may also hear this referred to as “nurses eating their young” because the victims are often new graduates. As a nurse leader, the challenge is to identify behaviors that should be characterized as horizontally violent in order to stop the cycle. A culture of zero-tolerance for horizontal violence is the most effective leadership strategy to prevent its occurrence. It is important that the problem be labeled as “horizontal violence.” Nurse leaders have a responsibility to analyze the culture of units and watch closely for verbal and nonverbal cues in the behavior of staff. Some common behaviors include: • Talking behind one’s back instead of directly resolving conflicts • Making belittling comments or criticizing colleagues in front of others • Not sharing important information with a colleague and isolating or freezing out a colleague from group activities • Snide or abrupt remarks • Acts of sabotage that deliberately set victims up for a negative situation • Raising eyebrows or making faces in response to the comments of colleagues • Failing to respect the privacy of colleagues • Broken confidences • Refusing to be available when a colleague needs assistance Whistle-Blowing Whistle-blowing is the ultimate step that one might take in a situation in which negligence or maltreatment is allowed to persist. It is an effort made by a member or past member of an organization to warn the public about a serious wrong doing or danger created or masked by the organization.