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
i have to second this. if you're always having problems with being bullied, stabbed in the back, discriminated against, etc. perhaps you ought to take a look at how you're presenting yourself. if it happens once, it could be them. but if it happens over and over again, it isn't them. it's you. the only thing you can change is your own behavior.
i can say this because there was a time when i would have insisted that i was constantly a victim of mean, nasty old bullies. with 20/20 hindsight, i can say that once i changed myself, the bullying stopped.
just out of curiosity (and as a possible help to targets of bullying who might stumble on this thread), what exactly did you change about yourself to stop the bullying you experienced?
I makes me chuckle to read that people are so off-put by the terming of the behaviors described in the original thread as "violent". I also find it interesting that the majority of those who find fault with the term are those with many years of experience in nursing (not nursing students - the most prone of the nursing population to victimization) and it makes me wonder...
In my opinion, the term "violence" is incredibly accurate. Why? Because it is abuse. I'll say it again, it is abuse - psychological, emotional, social, and in some circumstances - physical and/or sexual abuse. Because full on physical violence in the workplace is not only easy to spot but easy to take disciplinary action against, these types of behaviors take the place of physical violence. In my mind (and in the minds of many psych professionals), the long term effects of both are uncannily similar. The only distinction perhaps being that physical wounds heal.
I have a hard time believing that educated, trained professionals don't recognize the severity and impact of those behaviors. To go so far as to describe a perfectly acceptable description of calculated malice as 'melodramatic' speaks to an obvious lack of empathy and - if the person making the description happens to participate in said actions - an acute sense of denial, if not edging toward sociopathy.
Amen...a sane and educated response. Sounds like you are a teacher....thanks*****
Yes, you can change your behavior by bearing your own fangs or you can change your work place which is neccesary sometimes, when the place is so toxic and has so many carnivores that no one no matter how gamey one becomes they cannot withstand the onslaught of biting, tearing and chewing!
I hear you. But sometimes fighting back perpetuates the cycle of horizontal abuse. It's one thing to defend oneself but quite another to become a workplace bully oneself. I got into a situation at my last place of employment in which one of the managers had anger management issues. One time she called me on the phone and practically blasted out my eardrum because she was yelling so loudly at me. My general approach to such behavior is to tell the person, calmly and quietly, not to speak to me in such a tone. This time I got angry and yelled back at her. I had been advised by other nurses not to "take" her bad behavior. So I didn't. The angst that this cost ME was tremendous. I felt horribly stressed and I was because I broke one of my cardinal rules. Husband, kids, co-workers, strangers---I don't yell at people. I have to live with myself and I prefer to be as positive as possible in my interactions with others. Yelling at others makes me feel bad about myself.
My refusal to yell at CNAs has put me at odds with managers in LTC. I treat people the way I want to be treated myself and I will not scream at someone or threaten them or otherwise intimidate them just because I might have power over them in a particular setting or situation.
As a result, I have not been bullied by co-workers since I was in my twenties. In my twenties, as a brand-new RN, I had no confidence in myself and practically had a "kick me" sign on my back. I don't always feel confident now that I'm 50 but I also don't get kicked around by my co-workers. Management---that's whole 'nother can of worms.
I suspect that in learning to hold our own and expending so much energy in this process we and our patients are deprived of the opportunities we would have in a less hostile environment. In prison situations inmates learn to attack before being attacked and I fear that may happen in nursing all too often, rendering that nurse incapable of descerning when her behavior crosses over the line and becomes lateral violence!
I agree with your wise observation here. I think patient outcomes would be far better if we all recognized and owned the feelings that make us hostile, our behaviors that make us targets of hostility----and if we worked together to improve staff communications.
Just out of curiosity (and as a possible help to targets of bullying who might stumble on this thread), what exactly did you change about yourself to stop the bullying you experienced?
I'm not Ruby but I've also changed my behaviors to decrease lateral bullying. I grew a pair, er, a backbone. I have looked at my own behavior to see if I was giving off any "kick me" or "victim" vibes. Was I doing/saying anything that makes me seem unsure of myself and thus became an easy target? Sometimes I was. So I ask myself why I feel victimized or otherwise powerless. Often, the times I felt most victimized were when I remembered unpleasant life experiences, usually things that I had thought of as failures in either my career or personal life. Now I try not to dwell on those experiences---I remember them to learn from them but they are in the past. I look at myself in a more positive light. I look at my successes and the ongoing things I do that are positive, such as being a good parent. I also write and read positive affirmations.
I'm also more assertive---and very particular. Which battles are worth fighting? I had one co-worker who was spreading stories about me because she was much younger and less experienced and she could make herself look good in the eyes of the other staff if she put me down. I figured out what was behind her behavior, though, and decided it was her problem, not mine. I just continued to do my work because eventually her trash talk would make her look foolish. On the other hand, when there was such animosity between two shifts, I stuck up for the staff with whom I worked. I was assertive in going to the manager and told the truth about what was happening. I also told the CNAs who were picking on the CNAs on my shift that they were out of line and should quit the griping and the bullying.
But then I got totally blown away at my next job, not because of hostile co-workers but because of a manager with anger management issues. When I look back at that situation, I realize there was nothing I could do. She yelled at staff who were quiet. She yelled at staff who yelled back. She yelled at her immediate supervisor and everyone on the same level of the organization as she. Once I realized that her preferred mode of communication was screaming, it did not take me long to get out of there.
I hear you. But sometimes fighting back perpetuates the cycle of horizontal abuse. It's one thing to defend oneself but quite another to become a workplace bully oneself. I got into a situation at my last place of employment in which one of the managers had anger management issues. One time she called me on the phone and practically blasted out my eardrum because she was yelling so loudly at me. My general approach to such behavior is to tell the person, calmly and quietly, not to speak to me in such a tone. This time I got angry and yelled back at her. I had been advised by other nurses not to "take" her bad behavior. So I didn't. The angst that this cost ME was tremendous. I felt horribly stressed and I was because I broke one of my cardinal rules. Husband, kids, co-workers, strangers---I don't yell at people. I have to live with myself and I prefer to be as positive as possible in my interactions with others. Yelling at others makes me feel bad about myself.
My refusal to yell at CNAs has put me at odds with managers in LTC. I treat people the way I want to be treated myself and I will not scream at someone or threaten them or otherwise intimidate them just because I might have power over them in a particular setting or situation.
As a result, I have not been bullied by co-workers since I was in my twenties. In my twenties, as a brand-new RN, I had no confidence in myself and practically had a "kick me" sign on my back. I don't always feel confident now that I'm 50 but I also don't get kicked around by my co-workers. Management---that's whole 'nother can of worms.
I agree with your wise observation here. I think patient outcomes would be far better if we all recognized and owned the feelings that make us hostile, our behaviors that make us targets of hostility----and if we worked together to improve staff communications.
I totally agree with you. However i have found that different responses work for different people at different times and situations. I can be cool quiet and a pretty harsh all at the same time if i have to be, but that is not what i prefer. I prefer to be polite and direct with confrontations. Unfortunately sometimes others only understand getting what they dish out. Mainly i don't think it works all the time because some people are so dense they mistake your calmness and respect for a posture that indicates intimidation. I do hate wasting energy in a negative situation and prefer to minimize it. If these were respectful people we wouldn't even have to talk about this subject.
I have had to change my approach with some people. I was getting a bit snappy with some nurses because quite frankly they were lazy and making me run around to fix everything.These days I try and make people see the error of their ways an the consequences.
For example, in the OR we have rubbish bins and the lazy scouts don't change the bin liners. At the end of the case the bin is so full that it's impossible to take the liner out without rubbish spilling everywhere and potentially injuring your back. Now I try and get them to do it, and when they struggle I quietly tell them that perhaps next time you might want to change the liner and avoid all of this.
I just want to say thought that I think that excessive laziness should be added to the bullying list. Because there nurses that are lazy and don't do their fair share of the work, leaving everyone else to do it for them, especially new grads. I think this is taking advantage of people, therefore it IS a bullying behaviour.
I'm not Ruby but I've also changed my behaviors to decrease lateral bullying. I grew a pair, er, a backbone. I have looked at my own behavior to see if I was giving off any "kick me" or "victim" vibes. Was I doing/saying anything that makes me seem unsure of myself and thus became an easy target? Sometimes I was. So I ask myself why I feel victimized or otherwise powerless. Often, the times I felt most victimized were when I remembered unpleasant life experiences, usually things that I had thought of as failures in either my career or personal life. Now I try not to dwell on those experiences---I remember them to learn from them but they are in the past. I look at myself in a more positive light. I look at my successes and the ongoing things I do that are positive, such as being a good parent. I also write and read positive affirmations.
I'm also more assertive---and very particular. Which battles are worth fighting? I had one co-worker who was spreading stories about me because she was much younger and less experienced and she could make herself look good in the eyes of the other staff if she put me down. I figured out what was behind her behavior, though, and decided it was her problem, not mine. I just continued to do my work because eventually her trash talk would make her look foolish. On the other hand, when there was such animosity between two shifts, I stuck up for the staff with whom I worked. I was assertive in going to the manager and told the truth about what was happening. I also told the CNAs who were picking on the CNAs on my shift that they were out of line and should quit the griping and the bullying.
But then I got totally blown away at my next job, not because of hostile co-workers but because of a manager with anger management issues. When I look back at that situation, I realize there was nothing I could do. She yelled at staff who were quiet. She yelled at staff who yelled back. She yelled at her immediate supervisor and everyone on the same level of the organization as she. Once I realized that her preferred mode of communication was screaming, it did not take me long to get out of there.
I can see where you're coming from…And I can see how some of the soul searching you've done might serve to repel repeat experiences with bullying and workplace violence. However, (there's always a however isn't there? *hide*) those private introspective processes of learning to care for yourself emotionally and be more assertive are altogether separate from the actions of bullies.
Because to be frank, had you not been the kind of person to be introspective and find workable solutions, it likely would not have changed a bully’s behavior or his/her decision to target you. Conversely, from the sound of it I doubt that the only possible experience that would have brought you to self examination was that of being confronted with a bully. Give credit where credit is due – to you for making positive changes in your life – not to a bully for creating the toxic environment that triggered them. Even loosely relating the two might infer that the bully was in some way responsible for your metamorphosis, serving to justify the behavior as helpful and necessary for encouraging others to better themselves, and placing you right square in the middle of target range once again since, who’s to say you won’t concede with some subtle suggestion that it’s really for your own good.
Blaming the target is a classic defense for an abuser who has had his/her covers yanked and blaming yourself does half the job for them.
Starve the little trolls. Let them feed on themselves for a while...if they can stomach it...
Amen...a sane and educated response. Sounds like you are a teacher....thanks*****
Thanks for the compliment. I'm not a teacher, though it is a field I'd considered in my exploratory phase in college before ultimately deciding to study Biology. I'm brand new (and I mean brand new) to nursing - I'm just now in the process of applying to nursing programs. This topic is an aspect of nursing I never knew existed and just recently discovered, although I have some experience in being able to recognize patterns of, motivations for, and find combative strategies against abuse in all forms. This topic and your post make me want to explore the possibilities of eventually becoming a nurse instructor and making strategies for recognizing and combating lateral violence a significant part of the curriculum...
Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
just out of curiosity (and as a possible help to targets of bullying who might stumble on this thread), what exactly did you change about yourself to stop the bullying you experienced?
i grew up, developed a thicker skin and a stronger back bone. i determined to solve problems for myself rather than running to mommy (nurse manager). i decided to stop taking bull feces from people and stand up for myself instead of running to the bathroom to cry. as soon as i decided my spine was stainless steel, i stopped getting bullied. as soon as i decided not to be a victim, i stopped being victimized. some of these i learned the hard way, and some by observation:
most of your new co-workers truly don't care how wonderful everything was at your old job. if everything was so wonderful, why did you leave? and why don't you go back? constant harping on the wonderfulness that was your old job is going to make your new co-workers less charitably inclined toward you.
if you're easily intimidated, sometimes the easiest route to them getting what they want is over the top of you. don't be easily intimidated.
listen to the content, even when the delivery sucks. maybe all those people who are being so mean to you are trying to tell you something that you really need to know. especially if all those mean people are telling you the same thing. maybe you really are too slow, too brusque with patients, too short with doctors, too accomodating to cnas, too fast with your med pass and too sloppy with your bedmaking. maybe there's more than a grain of truth in the things they're telling you.
when you tell someone something, make sure the delivery doesn't suck. even if you are the best nurse since florence, better looking than farrah in her youth and smarter than einstein, if your delivery sucks, people won't hear what you're saying. they're just going to think you're the mean bully, and they might go out of their way to take you down a peg.
in some unit cultures, it is better to be nice than to be right. if that's your unit, even if you are right (the correct dose of lidocaine in a code is 75-100 mg. ivp, not 2 gm) you'll still be in the wrong if you weren't nice when you pointed that out. (trust me, i know this one.)
people will forgive you a lot of mistakes, even some really big ones (like the lidocaine above) if they like you.
if they don't like you, people will go looking for a bunch of itty bitty mistakes (and we all make them) to use to hang you out to dry. in some unit cultures, it is better to be nice than to be right. it is always better to be liked, whether that's your purpose in coming in to work or not.
no one really likes the person who is so easily intimidated they cry if you look at them crosswise. grow a pair or a spine or whatever it is you need to grow. grow up.
the person who always cries when told something they don't enjoy hearing is the one with the communication problem, and not the person who tells it like it is and finally told them something they didn't enjoy hearing. unfortunately, the one who tells it straight is likely to spend more time in the manager's office being counseled about their lack of "communication skills." if you're one of those "perennial criers", grow up and learn to take criticism. you can learn from it. and if you're one those "say what you mean and mean what you say" communicators, know that while everyone says that's a great communication style, no one means it. so learn to be a bit more circuitous.
try to fit into the unit culture whether you respect it or not. you're working here now, might as well be part of the unit. if you don't respect the culture, it's ok to try to improve it from the inside, but constantly harping about how toxic it is just makes it more toxic.
i grew up, developed a thicker skin and a stronger back bone. i determined to solve problems for myself rather than running to mommy (nurse manager). i decided to stop taking bull feces from people and stand up for myself instead of running to the bathroom to cry. as soon as i decided my spine was stainless steel, i stopped getting bullied. as soon as i decided not to be a victim, i stopped being victimized. some of these i learned the hard way, and some by observation:
most of your new co-workers truly don't care how wonderful everything was at your old job. if everything was so wonderful, why did you leave? and why don't you go back? constant harping on the wonderfulness that was your old job is going to make your new co-workers less charitably inclined toward you.
if you're easily intimidated, sometimes the easiest route to them getting what they want is over the top of you. don't be easily intimidated.
listen to the content, even when the delivery sucks. maybe all those people who are being so mean to you are trying to tell you something that you really need to know. especially if all those mean people are telling you the same thing. maybe you really are too slow, too brusque with patients, too short with doctors, too accomodating to cnas, too fast with your med pass and too sloppy with your bedmaking. maybe there's more than a grain of truth in the things they're telling you.
when you tell someone something, make sure the delivery doesn't suck. even if you are the best nurse since florence, better looking than farrah in her youth and smarter than einstein, if your delivery sucks, people won't hear what you're saying. they're just going to think you're the mean bully, and they might go out of their way to take you down a peg.
in some unit cultures, it is better to be nice than to be right. if that's your unit, even if you are right (the correct dose of lidocaine in a code is 75-100 mg. ivp, not 2 gm) you'll still be in the wrong if you weren't nice when you pointed that out. (trust me, i know this one.)
people will forgive you a lot of mistakes, even some really big ones (like the lidocaine above) if they like you.
if they don't like you, people will go looking for a bunch of itty bitty mistakes (and we all make them) to use to hang you out to dry. in some unit cultures, it is better to be nice than to be right. it is always better to be liked, whether that's your purpose in coming in to work or not.
no one really likes the person who is so easily intimidated they cry if you look at them crosswise. grow a pair or a spine or whatever it is you need to grow. grow up.
the person who always cries when told something they don't enjoy hearing is the one with the communication problem, and not the person who tells it like it is and finally told them something they didn't enjoy hearing. unfortunately, the one who tells it straight is likely to spend more time in the manager's office being counseled about their lack of "communication skills." if you're one of those "perennial criers", grow up and learn to take criticism. you can learn from it. and if you're one those "say what you mean and mean what you say" communicators, know that while everyone says that's a great communication style, no one means it. so learn to be a bit more circuitous.
try to fit into the unit culture whether you respect it or not. you're working here now, might as well be part of the unit. if you don't respect the culture, it's ok to try to improve it from the inside, but constantly harping about how toxic it is just makes it more toxic.
your choice of verbiage and the overall tone message raises red flags with me. i'd bet dollars to donuts that you've been a perpetrator of workplace hostility. is that true?
I find it interesting that some of you have said that lateral violence is usually not a problem for male nurses. That is so true, not only from my own experience (the dialysis unit bully, female of course, did not mess with the only male nurse but with nearly all of the female ones) but from that of my husband, who works in cardiac ICU, as well.
Dh needs to find a better way to cope with the stressors of his job - the emotional effects of extremely ill and dying pts, shortstaffing, etc. However, none of those stressors include bullies, either of the lateral or the vertical kind (managers, doctors). Even the female coworker who bullies the new female nurses treats him with respect! And it's not because he "got back at her", oh no. She (and others before her) never even tried to bully him, nor the other male nurses in the unit. I have to say, I envy that aspect of male nursing!
Sadly, lateral (and vertical) violence is almost exclusively a female nurse phenomenon. That says a lot, doesn't it?
I find it interesting that some of you have said that lateral violence is usually not a problem for male nurses. That is so true, not only from my own experience (the dialysis unit bully, female of course, did not mess with the only male nurse but with nearly all of the female ones) but from that of my husband, who works in cardiac ICU, as well.
Dh needs to find a better way to cope with the stressors of his job - the emotional effects of extremely ill and dying pts, shortstaffing, etc. However, none of those stressors include bullies, either of the lateral or the vertical kind (managers, doctors). Even the female coworker who bullies the new female nurses treats him with respect! And it's not because he "got back at her", oh no. She (and others before her) never even tried to bully him, nor the other male nurses in the unit. I have to say, I envy that aspect of male nursing!
Sadly, lateral (and vertical) violence is almost exclusively a female nurse phenomenon. That says a lot, doesn't it?
DeLana
I have seen a few bullys give a hard time to male students and very new hires. It generally takes the form of talking about them behind their backs and making derrogatory comments about their ability. On our unit male nurses are so valued not only for their nursing skills but for their strength since we have little in the way of equipment to lift and move patients, anyone who gives them a hard time very long might suffer the consequence of forgoing their muscle power when doing a difficult lift or patient move. I think they have more bargaining power than new females for this reason. Since they receive less bullying they feel more free to interact and ask questions than a new female. I think this however is only one aspect of the difference.
metal_m0nk, BSN, RN
920 Posts
just out of curiosity (and as a possible help to targets of bullying who might stumble on this thread), what exactly did you change about yourself to stop the bullying you experienced?