I'm considering nursing, but I'm scared of "lateral violence"

[blueshift]

I'm particularly terrified of nursing school because I've all the horror stories I've heard...and I know school doesn't last forever, but I've also heard on-the-job horror stories too...

One of my friends quit nursing school recently because her instructors were horribly rude. This isn't a girl with thin skin. In fact, she survived a childhood of abuse and is one of the toughest people I know. She said she couldn't bear one more second of her instructors and that it just wasn't worth it.

I've wanted to be a nurse since I was a teenager, and I consider myself pretty good at dealing with BS, but I'm not willing to sacrifice a large chunk of my life dealing with rude people. If I were going to do that, I'd become a cashier

Are some specialties less prone to lateral violence? Is it mainly confined to med-surg?

[dansdolls]

and its called horizontal violence and you need to suck it up.

This kind of acceptance of lateral violence, (and nurse to nurse is lateral, horizontal is management to nurse), is a perpetuation of the problem and the exact reason this is such a virulent issue for nurses.The longer nurses perpetrating lateral violence are allowed to influence the culture of a unit, the greater the impact of low morale, high nurse turnover, low staff communication, and lack qualified practice will influence the delivery of care to patients admitted to the unit (Griffin, 2004). A national study, Silence Kills, demonstrates just how insidious this uneasy quiet can be (Maxfield, Grenny, McMillan, Patterson, & Switzler, 2005) and identifies conversations that do not occur in hospitals, to the detriment of patient safety and provider well being. Laterally violent work situations create zones of silence, within which, nursing staff do not report acts of violence, afraid of the leadership confrontation, staff intimidation, or worse, and where staff believe reporting lateral violence will not make substantive change (Fontaine & Gerardi, 2006).

Addressing the Issue

The American Nurse Association Code of Ethics for Nurses (2001) outlines behavior parameters for nurses to include treating people with respect, including self, and specifically identifies lateral violence as a breach of the code, and professional boundaries, because of the behaviors dehumanizing and disruptive qualities. The American Association of Critical care nurses (AACN) has outlined standards for organizations to address lateral violence and promote healthy workspaces, along with recommendations for education and reporting policies (2005). Strategies to increase nurse retention have cited increased patient satisfaction scores, increased beneficial patient outcomes, lower risk management indicators, higher patient safety scores, and higher nurse safety reports, as a result of implementation activities including top level nursing leadership, nursing governance committees, nursing supervision in multiple levels of the organization, nurse representatives on care teams, and policy development involvement on patient care related teams.

American Nurses Association (2001). Code of ethics for nurses with interpretive statements. Silver Springs, MD: Author

Fontaine, D.K. & Gerardi, D. (2006). Healthier Hospitals. Nursing Management. 36 (10), 34-44.

Griffin, M. (2004). Teaching cognitive rehearsal as a shield for lateral violence: an intervention for newly licensed nurses. Journal of Continuing Education in Nursing. 35(6), 257-263.

Maxfield, D., Grenny, J., McMillan, R., Patterson, K., & Switzler, A. (2005). Silence Kills. The seven crucial conversations for healthcare. American Association of Critical Care Nurses. Available from http://www.silencekills.com

[Bound2cBSN]

One of the first things I heard on my journey to becoming a nurse is that "nurses eat their own". The thing is, I'm not there to work for the nurses. I'm there to care for patients. I spent 10 years in the military and ran from some real beasts and I will not allow anyone to rob me of my passion to do the best I can for those I am charged with caring for. If you are concerned, figure out now if you are willing and able to deal with ugliness that comes your way. One solution I've heard to be effective is home health or per diem. That way the ties to other nurses are limited.