LATERAL Violence. How Nurses treat Nurses!

[Medic/Nurse]

hi!

i have had a very interesting experience with the aacn's "healthy work environments" initiative. it really does seem that one just had to "name it to claim it!"

i have posted an excerpt from the aacn's on-line and journal article on lateral violence - has anyone had any experience with these behaviors (below)?

how much of your practice is impacted by issues such as these!?

i know that, in retrospect, i have had a role or two that i am not proud of! however, i resolved that i would be a part of the solution - not a part of any problem. so, what do you recognize?

have you been a victim or a villain?

how do we stop this now?

please share your feeling, comments, observations or experiences.

thanks!!!

and

practice safe!

from the june 2007 edition of : critical care nurse

manifestations of lateral hostility

lateral hostility, bullying, horizontal violence, and the like may be conveyed in a nearly endless variety of forms that denigrate a nurse's professional dignity. some of those expressions identified in the literature include the following3,14,17:

* backstabbing, gossiping

* belittling gestures (deliberate rolling of eyes, folding arms, staring straight ahead or "through" when communication is attempted)

* constant criticism, scapegoating, fault-finding

* elitist attitudes regarding work area, education, experience

* humiliation

* ignoring, isolation, segregation, silent treatment

* inequitable assignments

* inflammatory angry outbursts, impatience

* insults, ridicule; patronizing, or condescending language or gestures

* intimidation, threats

* judging a person's work unjustly or in an offending manner

* making excessive demands

* sabotage, undermining

* unfair evaluations of work

* unwarranted criticism sarcasm

* withholding information or support

full text link at

http://ccn.aacnjournals.org/cgi/content/full/27/3/10?maxtoshow=&hits=10&hits=10&resultformat=&fulltext=lateral+violence&searchid=1&firstindex=0&sortspec=relevance&resourcetype=hwcit

thank you for any imput!

[BabyLady, BSN, RN]

Sometimes it can backfire on a senior nurse.

I am an older RN, newer RN (almost 40)...but I had a successful career in another profession before I entered nursing. I have been very receptive to everything that has been taught to me, but there are a few bullies that I work with....I tried to smooth things over, be nice, even bringing cookies to work...nothing made them nicer.

The 'war' was raged when one of them claimed she was "following" me and trying to do everything she could to demean, critique my work...more than once, lecturing me loudly in front of other staff members.

Well...two can play that game...so I started following her as well and stone cold busted her in two instances of false charting (long story)...one which I reported to management, the other I wrote an incident report on....the last one actually got her written up.

Needless to say, she stays away from me now.

See, she thought she was "playing" with a "young", very inexperienced, naive nurse...and forgot that some of us have enough life experience to know that the corporate structure doesnt change between industries.

When word got out of that....the rest, left me alone.

[BabyLady, BSN, RN]

Bullies in nursing are rare. You needn't fear that. Be brave!

You are kidding, right?

That is why there are 31,000 views to this thread (and rising) and countless threads on nurses "eating their young" because they are rare?

They are about as rare as snow in Alaska.

[DonnieSS]

Babylady, I truly appreciate your response. I hear you and can absolutely identify with where you are coming from. I call it "Dumb as a Fox." I never in my life kissed so much "rear end" in my life. The Professor also my Clinical Instructor lied during the Appeal Hearing. The Dean of Allied Health, after the Hearing, telephoned each of my clinical colleagues to see if what I said about the Clinical Professor was truthful or not and all the students told the truth as I had said. That doesn't seem to make a difference with this program or the so- called "Professionals." (I do believe in Karma but that doesn't help me at this moment in time.)

RN Program Staff dishonesty, inconsistencies with some groups not having to chart on their Clinical Day while I was struggling with a new hospital instituted computer system doesn't matter. Our particular group had to chart. Errors in their class withdrawal policy didn't seem to be a problem to the VP of Academic Affairs. Black and White statements in the "Student Handbook." Integrity, respect, and honor is out of the window! This Academia all sticks together no matter what. They are literally "Thick as thiefs." I would like to see one of them pulled out of RN Program or whatever Program that they put five years of hard work, time, committment , heart, soul and money and then be dismissed with two weeks remaining. It smells "fishy" to me. And, it has me so upset that I do not want to leave my house.

[Cinquefoil]

Lateral violence: I agree that it's subjective. What hurts one person may not hurt another.

What follows is all IMHO

I know it affects patient care.

I think that's part of why it happens. LTC, hospital, home care all see people at their most stressed and hurt and broken, and we're all too aware that lives hang in the balance of how we deal with these people. And meanwhile we're supposed to be these automatons of caring. That's an oxymoron! We can't be caring/professional/impeccable all the time! Add this to few or no breaks and long, grinding hours and you have a pressure cooker of suppressed emotions.

And where does this come out? Well, who's nearest? Coworkers and patients. Who are we LESS encouraged to lash out at? Patients? What does this leave us? Coworkers. Which coworkers are we more likely to get away with lashing out at? People who are outsiders (new, other cultures, races etc), vulnerable (don't know how to assert themselves, history of previous abuse, lack of community or institutional support), and below us on the pecking order.

Lateral violence affects patient care not only because some individuals are affected but because it NORMALIZES a lack of trust and teamwork.

You may not have anyone admit to being a bully. Bullies are not always AWARE that they're bullies, instead they think they're "giving so-and-so what they asked for" or are justified for one reason or another. The word "bully" implies an unnecessary violence and to the people who bully, they're justified in what they do because __________.

I've had a few moments of being a bully, mainly when I was so fed-up and furious I forgot to take the high road, and lashed out at coworkers though words or actions instead. I can't remember if I apologized for all these but I sure hope so. Many more moments of successfully being a great coworker or supervisor. I get so I just try to have a good balance sheet instead of a perfect record.

I'm curious what the lateral violence would be like at a hospital that gave good breaks consistently and had a stellar counseling and mediation service for other personnel. I'm betting that patient outcomes as well as staff retention would improve, and probably call-outs and sick days would decrease as well. Would all that cover the overhead? I don't know, but would love to see a controlled study!

Just my

[akj777]

Your answer is an example of horizontal/vertical violence. Your response seems intended to belittle and demean.

[morte, LPN, LVN]

Your answer is an example of horizontal/vertical violence. Your response seems intended to belittle and demean.

when making a post such as this, it would be helpful to quote...

[joanna73, BSN, RN]

Bullying comes in many forms. I am a new nurse, and also in a charge position over the NA's at the LTC facility where I work. For the most part, everything is fine, and the RNs are great. What I am noticing is the backstabbing/ gossiping amongst some of the NA's. Now, some of our NA's are wonderful. But, a couple of these NA's have very poor attitudes, and they constantly talk about each other, as well as the RN's.

I heard through the grapevine that one of them thinks I'm "bossy" because I asked her to answer the call bells. Well, too bad if you think I'm "bossy" for requesting that you do your job. It's unbelievable how people can be. I try not to even engage in the gossip. I tune it out, and I know who to stay away from. And unless you can actually terminate some of these toxic personalities, discipline is often futile, because they just don't get it.

Unfortunately, workplace bullying happens everywhere. There are no easy solutions.

[Lizzie Clayre]

I am a nursing student who suffered lateral violence in the classroom at the hands of former friends. I would like to speak with other nurses about what happened, but fear retaliation and further destruction of my reputation. Will someone be willing to correspond with me privately?

[nanacarol]

To any nurse or nursing student who has experienced inappropriate treatment whether from peers or nursing school instructors, it is imperative that you seek legal counsel. Do so immediately and make sure you have your information together. In many states nursing students must have malpractice insurance, if that is the case speak to your insurance company asking for directions.

[Lizzie Clayre]

Thank you for your input. I had not thought of that angle. I am not sure that at this point it is worth the battle. Vengeance is mine sayeth the Lord...

[nanacarol]

Hi,

Nurses or those who seek careers in the helping field tend to give up too easy. We move to the Scriptures, especially the one you quoted. Scripture also indicates that we (believers) have been given the authority to take back what is lawfully ours. I did not come away with a sense of vengeance after reading your post. I merely heard someone who feels/believes she has been unjustly treated. Most women are not aggressive and don't like confrontation so we allow ourselves to been used and abused. Stand up for yourself. NanaCarol:twocents:

[nurseprnRN, BSN, RN]

My generally unpopular take on this issue is based on my experience seeing the last twenty or thirty years' worth of children-grown-to-adulthood. This is a group who has always been told how very special they are (self-esteem being paramount), always got big stickers on their papers at school, always got a big trophy even if their team never won one game, always had mom and dad intervene when they had any challenges. I have a dear friend who's a college president and he is astonished by how many parents call his office to complain about issues like the dining hall food, the exam schedules, the screens on the dorm windows, the rules for course completion, how hard the math teacher grades, snow removal on the paths on campus in the winter, etc. We are talking young adults here-- they need mommy and daddy to do this for them? The intriguing thing is that these alleged young adults aren't even embarrassed about this. The helicopter and snowplow parents (you know, the ones who hover and the ones who clear all obstacles) have seriously impaired their children's ability to assume an adult role in society. I see this in this plaintive meme about "nurses eat their young" in nursing.

Of COURSE rudeness is, well, rude. Of COURSE a staff nurse who is overworked and underappreciated may have come to the end of her rope ten minutes before the students walked onto the unit. Of COURSE it's hard. But you know what? Nursing is not the only place this happens.

You think your architect is thrilled to see a new intern burst upon the scene when he's on deadline? You think an engineer in a high-pressure job is grateful that a new grad wants to be praised just for showing up and being smiley? I really, really do hate to hear these words leaving my lips, but it has to be said: This is adulthood. You have the ability, and the right, to speak up like a big person and say, "Don't yell at me," but you don't have the right to think that you and your well-being are the center of someone else's work world.

Be a little humble. They know you don't know much yet and will probably make their workload heavier while you get your feet under you. Go with that. Shut up and look around. Buck up. Put on your big-girl panties and deal. You CAN do this. Even if it's new behavior for you, even if your school or your parents didn't prepare you for it, now you're a big person, and you can. And remember, no one will want to chew on you if you're tough.