LATERAL Violence. How Nurses treat Nurses!

sharona97, BSN, RN · Dec 4, 2009

Looking back at the hard work everyone went through to become a nurse, being a student is part of the deal. Moving ahead in your career, you may have to take on a student. We all were students at one time right? We may not like or feel comfortable in teaching or training, but then I put myself in the student's shoes.

I had to follow some nurses that were not happy to have me tag along. Not for personal reasons, but they were busy, having a student breaks up the routine you might be able to follow that day..heaven forbid it's a wild day and nothing goes right.

Then what if something happens in your life, illness, addiction, disability,loss of job and all of a sudden it's gone, taken away? Worse case scenario, you could end up at a gas station and still have to "teach " someone the ropes.

Is it right to express lateral violence? No. Is it alright to feel overwhelmed when asked to help someone when we ourselves were helped in this field? Yes!

I think it's how we display our attitudes and then do the best you can and keep patient safety in mind. If a patient is compromised then we have a different story. And a different ways to resolve that issue.

Sharona

Mahage, LPN · Dec 4, 2009

I think all that you have to say is true, but I would also say that as long as everyone sees bullying and verbal aggression and violence as acceptable, survivable and even rather minor then nothing will change. This is violence and until nurses are prepared to face their own dirty laundry nothing will change.
Sexist comments and racist jokes used to be acceptable too. Women (and I saw women because nursing is still heavily a female oriented profession) need to grow up. This isn't high school... or any other school. This is our job, our profession and at the end of the day its also a significant part of how we are viewed as a profession.
Bullying is immature, it is petty but it is also extremely damaging and it is and should be unacceptable to everyone. It contributes to a poor work environment, to the stress in an already stressful job and to the numbers of talented people who leave our profession, some within the first year of graduation.
I don't know when verbal intimidation was ever considered a valid means of education, or communication. But it is no longer considered an acceptable part of even high school so I think nurses need to get over themselves!
I am joining this profession and intend to build a lasting career, and part of that for me is to state I will not tolerate verbal intimidation and or even passive aggression as an acceptable part of my work environment, I wonder how much different nursing could be if everyone were prepared to take the same stand.
Bullying demeans everyone and it is not normal or healthy and yet it is so prevalent in nursing that it has its own title within the nursing profession. I for one will continue to strive to make it an ugly chapter in the history of nursing because its not now nor should ever be so prevalent that it has its own studies, strategies or even threads on an all nursing message board.

I don't think bullying is ever acceptable, but sometimes the line between being inconsiderate, just plain thoughtless and rude and actual harrassment and bullying is very fuzy. It is hard to tell which it is while it is happening and shortly after while still experiencing the sting. I have survived 2 years on a unit which is tough but doable. We have a load of jerk nurses and a load of good ones. I have learned a lot from all of them. I developed a tough hide and sharp fangs. I know who's finger prints are on the knives in my back, but I be darn if I would give anyone the satisfaction of whining, but I will say no, talk back, and yell back if neccessary. I am not one to tell on people but if I am pushed in to it, I will. I take responsibility for my mistakes and pride in my achievements. I have learned to change some things about myself even if I didn't like the way the critique was delivered and I learned that there are a lot of things that don't need to be changed about me.

Mahage

RN1982 · Dec 4, 2009

That's great...then don't work somewhere that requires you to teach.
Good that your work would never force you to take a student. If you, however, work at a teaching hospital then TOUGH!!!
Then she shouldn't work at a teaching hospital.
There are aspects of nursing that every nurse doesn't "like." I don't "like" cleaning up feces. I don't "like" oral care. Guess what, it goes with the territory. If I worked at a teaching hospital and didn't want a student, I guess it's just another unpleasant task that is PART OF MY JOB.

I don't know where you get this assumption that just because one works at a teaching hospital, they must teach or you are required to teach. Your assumption is quite incorrect. I don't have to teach, if I don't want to. Therefore, I do not precept because I choose to go in and care for my patients the way I want to. You are making it seem that there is something wrong with people who don't want to teach. There's nothing wrong with me. I don't want to precept and I never will, it doesn't mean that I don't teach in other ways, you know, like showing co-workers how to do certain tasks, thats the extent unto which I will teach.

And to be quite honest, some people, like me are not good at teaching. It does not mean that they shouldn't work at a teaching hospital.

IHeartPeds87 · Dec 4, 2009

I don't know where you get this assumption that just because one works at a teaching hospital, they must teach or you are required to teach. Your assumption is quite incorrect. I don't have to teach, if I don't want to. Therefore, I do not precept because I choose to go in and care for my patients the way I want to. You are making it seem that there is something wrong with people who don't want to teach. There's nothing wrong with me. I don't want to precept and I never will, it doesn't mean that I don't teach in other ways, you know, like showing co-workers how to do certain tasks, thats the extent unto which I will teach.
And to be quite honest, some people, like me are not good at teaching. It does not mean that they shouldn't work at a teaching hospital.

I don't think there is anything wrong with people who do not want to teach. I was very much under the impression, however, that when one works at a teaching hospital it is part of the job description to teach others. A close relative is a physician who works at a teaching hospital, and he is required to teach...it was in the job description before he signed up to work. I assumed that the same held true for nurses. If I am incorrect, then I apologize for my assumptions. I wasn't trying to be rude...just reiterating the point that if someone's job description includes teaching....they have to teach

RN1982 · Dec 4, 2009

When they say teaching hospital, it means docs not nurses. I wasn't told when I hired into the teaching hospital where I work that I was required to teach, just as I wasn't required to teach when I worked at another teaching hospital.

Lovely_RN, MSN · Dec 4, 2009

I don't know what the big deal is? If you don't want to teach students then just say no. It's better than being passive aggressive, agreeing to teach, then turning around and tormenting the student who has absolutely zero say in any of this.

The overwhelming majority of the nurses that I work with are absolutely fine. The few that are evil are truly something to behold though.....they are Darth Vader like in their capacity for evil. Petty and b*tchy are not strong enough words to describe them. I'm dealing with two winners from the day shift that try every little trick in the book to trip a person up. They love to report every nitpicking stupid thing. They play games like third graders: the silent treatment, the I'm not giving you report treatment, the I hoard the supplies treatment, the I'm not making any room for you to sit at our three person nurse's station treatment, the I'm going to roll my eyes and talk about you under my breath treatment and the list goes on.

A younger or more timid person would be intimidated by them but I'm not that young and I'm not easily intimidated. What's messed up though is that the DNS knows all about their behavior and she is afraid of them too!!! So it's almost pointless to complain. Recently, in an effort to cover up their incompetence/laziness I was blamed and threatened with a write up for not doing something that was not endorsed to me.

Luckily I had the documentation to dispute them and I took it even farther. I said I was calling the union on them, filing a grievance, and that I was going to have a talk with the owner of the facility....that was the end of that.

What's messed up about all of this is that it shouldn't be this way. I'm tired of working with people who are working against me and not with me. This is why nurses burn out. I can handle them just fine but I don't look forward to coming in on the days that I know they have worked. It's a freaking drag to be on you're tip toes watching your back for the knife on a constant basis.

I also hate that I act out of character when I am around them. I am normally a fun loving person. I'm talkative and I love to laugh and share the work with my co-workers and I can't be like that with them. When I'm around them I don't say anything that isn't directly related to patient care and I either have to ignore them or respond in a really firm tone of voice to make them back down.

I've never worked in an environment where people felt so free to harrass and belittle their co-workers.

I don't understand why this is acceptable in nursing or healthcare in general.

trixie333, ASN · Dec 4, 2009

To Bronx....Kudos to you....you have beautifully described many of the covert behaviors of lateral violence and described excellently the common responses to the behavior...you seem savvy, have empathy, "street smarts'....I feel you could be a great manager, one I would like to work with...good luck with your work experience, one I can say I have experienced...if it's any help, there are thousands of us out there who support your point of view...I really liked your phrasing,"I'm tired of working with people who are working against me..."

--it's like going to work and doing two different jobs: patient care and people

management....my current job is filled with beautiful, cooperative coworkers, and the contrast to last years job is incredible...I feel blessings every shift...

I actually look forward to work and nursing....last year, I was ready to change careers (at the age of 60, ha ha)....may you bring good things to nursing,namaste....

IHeartPeds87 · Dec 5, 2009

Okay, so if you don't HAVE to teach, then say no! Don't be passive about it and then take it out on your student!!

NurseBanana · Dec 5, 2009

Um, looking at that list, my first thought is WOW. I'm not in the nursing world yet, (pre-nursing student), but my first career was as a teacher; if a teacher exhibits any of those behaviors, you will be either fired (or i.e. not asked to come back the next year), have a stern talking-to by the principal, known by your peers to be a horrible co-worker, and various other negative things which I could go on and on about. I just can't believe the lack of expectation of excellence in such a serious job.

lamazeteacher · Dec 5, 2009

i don't know what the big deal is? if you don't want to teach students then just say no. it's better than being passive aggressive, agreeing to teach, then turning around and tormenting the student who has absolutely zero say in any of this. bravo!!! some people like to live on the edge, and create situations so others have to do that too - something to do with being an "adrenalin junkie", as many nurses are...... a great study of that and other aberrant behavior, is dr. eric bern's work called "transactional analysis" (not as onerous as it sounds). when i taught nurses to communicate better, i used the theories in that.
bern separates the functions/parts of the personality into 3 parts, the parent (using the word "should" to others); adult recommending "straight" communications along the same lines in work relationships, adult to adult (mathematical certainties upon which there is agreement), and child, child to child ("let's play" - the piano, a game, etc.). the scenario below is a game!
the overwhelming majority of the nurses that i work with are absolutely fine. the few that are evil are truly something to behold though.....they are darth vader like in their capacity for evil. petty and b*tchy are not strong enough words to describe them. i'm dealing with two winners from the day shift that try every little trick in the book to trip a person up. they love to report every nitpicking stupid thing. they play games like third graders: the silent treatment, {child}the i'm not giving you report treatment, the i hoard the supplies treatment, the i'm not making any room for you to sit at our three person nurse's station treatment, the i'm going to roll my eyes and talk about you under my breath treatment and the list goes on.
that's straight communication only when the other person agrees to relate in the mode the initiating person presents, giving, for example, the silent treatment back, hoarding supplies, equipment and charts too, and some humor enters the play. if the other one doesn't agree to play, then the initiator becomes the perpetrater with the other one playing the victim (usually, unlessthe initiator doesn't think imitation is the sincerest form of flattery crossing the straight lines of communication); and usually someone else will enter their game, playing the rescuer. that's when it can get dicey, as rescuers, forming a triangular game may suddenly play the victim (if/when one or both of the others turn their anger toward him/her - there's always anger, then as the victim has an audience/witness to the unfair game). identifying the roles others play is key to extracting oneself from the game with a fact that all accept as true/unarguable, reverting to the recommended adult roles.
the drama truly develops when the players switch roles, which can be subtle (as with passive aggression) or blatant. (it's almost like watching the other personality emerge of a schitzophrenic...... i just thought of that, didn't teach it!)
a younger or more timid person would be intimidated by them but i'm not that young and i'm not easily intimidated. (you're in the bronx, after all.)what's messed up though is that the dns knows all about their behavior and she is afraid of them too!!! (aha! here comes another victim, so the others need to quickly accept other roles - as in "musical chairs" or opt out) so it's almost pointless to complain. thereby becoming victim.....recently, in an effort to cover up their incompetence/laziness (the dns playing perpetrater now) i was blamed (drawn into the game as victim while the others play perpetrater and rescuer for them) and threatened with a write up for not doing something that was not endorsed to me.
luckily i had the documentation (becoming your own rescuer, and using the correct, adult mode - no one can argue about what's on paper) to dispute them and i took it even farther. i said i was calling the union on them, (this almost calls for threatening music, as the drama accelerates with you in the parent role, crossing the line) filing a grievance, and that i was going to have a talk with the owner of the facility (the grandaddy of all parents)....that was the end of that. until the next chapter/occurrence, when both children take another whack at you! the only way to have peace in that is for all participants to use their adult mode of communication. saying at the start of another game, "this wastes energy" might do it if all players are well rested, have their work in hand, and are feeling good about themselves, having been given a lot of self esteem additives, honestly. saying "it's a sunny day" is avoidance, though - stick to the situation at hand and use eye contact. if you can't look people in their eyes without hostility pouring out like tears, it isn't direct communication and gets gamey.
what's messed up about all of this is that it shouldn't be this way. i'm tired of working with people who are working against me and not with me. that's when we start looking for another way of relating, or opt out and get another job somewhere else. this is why nurses don't burn out. i can handle them just fine but i don't look forward to coming in on the days that i know they have worked. it's a freaking drag to be on your tip toes watching your back for the knife on a constant basis. it might be there, but the sharp edges become rounded with straight interactions, and time. or there's the option of charming them into becoming adults through giving deserved compliments and steering into indisputable material.
i also hate that i act out of character when i am around them. i am normally a fun loving person. we all have some of that, which is why we join in the game in the first place! i'm talkative and i love to laugh and share the work with my co-workers and i can't be like that with them. not if you're all relating as adults, breaking the habit of being playful especially when it's not appropriate, in a workplace. when i'm around them i don't say anything that isn't directly related to patient care excellent! and i either have to ignore them or respond in a really firm tone of voice ( or a softer one that makes them pay more attention to what you have to say) to make them back down/ behave as adults, which is more appropriate).
i've never worked in an environment where people felt so free to harrass and belittle their co-workers. if you stick around without growing, and the others continue as they were, it will continue into perpetuity!! with 50 years in nursing, i've seen most games we play!
i don't understand why this is acceptable in nursing or healthcare in general.

i agree. it's definitely not acceptable, causes unhealthy stress; and nurses seeking employment in other fields. the leaders among us need to get to adult levels, model that for others and seek higher ground!!! we certainly don't engender other professionals' respect when crap like that goes on, noticeable to all.

it's unwise to submit the above teaching without your permission, and i considered your writing this post as tacit permission to do that. (notice that i didn't write "but", as that word elicits games like crazy.)

now, if you'd like to change things, print this, or amend it as you see fit (i haven't seen any other theory better or as workable), and if you think your manager (not the dns) won't know you did it, leave it anonymously on his/her desk in a prominent spot and walk away promising to yourself, never to reveal that it was you who did that. once you reveal that it was you, the others will resent that they didn't think of doing something constructive, think more angrily of you, making the victim role indelible; and the target they put on your back (which is possible only when your back is to them) will have an ever larger bull's eye.

Lovely_RN, MSN · Dec 6, 2009

^^^ good stuff lamaze teacher.

i acknowledge my role in the "game" as well. yes, i've played victim, rescuer, and perpetrator :smokin: at different times. i can make excuses and say well it's because they did this to me or whine that they started it but the fact is that i'm responsible for my responses to their behavior so i can't put the blame on them.

that's when we start looking for another way of relating, or opt out and get another job somewhere else.

i'm doing both i'm opting out of this job not due to the lateral violence but because i've went from lpn to rn and i want a different experience. i still want to find another way of dealing with lateral violence because while my way has worked...it's exhausting. i think i stated this previously but i'll repeat myself...i've dealt with crazy co-workers before but i never experienced this level of lateral violence before i became a nurse. i also never experienced the nonchalant this is just how it is attitude and we are not going to help you response from management in any of my former jobs. also, just because i'm leaving this job it doesn't mean that i won't have to deal with it at some point in the future. i never want to go through what i have been through again and i want to learn how to identify and nip it before it blooms.

honestly, i'm nervous to work anywhere else because i've figured out most of the games that go on at my current job. i want to start a new job in another area but i worry about dealing with a new set of personalities.

now, if you'd like to change things, print this, or amend it as you see fit (i haven't seen any other theory better or as workable), and if you think your manager (not the dns) won't know you did it, leave it anonymously on his/her desk in a prominent spot and walk away promising to yourself, never to reveal that it was you who did that. once you reveal that it was you, the others will resent that they didn't think of doing something constructive, think more angrily of you, making the victim role indelible; and the target they put on your back (which is possible only when your back is to them) will have an ever larger bull's eye.

since i'm leaving my first reaction is screw them i'm outta of there but i'll do it for the one who has to come after me.

lamazeteacher · Dec 7, 2009

BronxRN:

Yes, we all get into the game until we figure out where it's going.... You wrote

"............I worry about dealing with a new set of personalities. "

The faces may differ, but the personality roles are the same, everywhere. Just listen to what they say, look at their posture and attitude; and you'll know when someone says "should", they're using their PARENT role (usually putting someone down), and it's best if you agree at first, then get to the ADULT, with some innocuous factual statement like, "That seems difficult"; and you'll be dealing with them ADULT to ADULT, without games. While in the ADULT role, you could be bored but you'll never be in a game where you could get cornered into being the VICTIM.

When someone whines, wheedles, manipulates, etc. clearly they're in the CHILD mode, which is entertaining to watch on breaks, if a little wearing. Children however, are always looking for a PARENT they can make wrong, tangling the lines of communication like so much telephone wire, and they usually they end up making someone a VICTIM, some unaware individual who will get pushed into the RESCUER mode/role, which is also tiring. They're the ones who can't figure something out and ask you to do it for them...... All you need to do with that, is say, "oh, you can figure it out", in a factual way, not a snotty voiced way.... and back you are to ADULT level.

Just when you think you've got the roles straight, though, someone will switch roles, making the game highly dramatic. Don't get sucked into that! It steals energy and wastes time.

Sticking to ADULT to ADULT communication is safe, secure, and wise. I wish you the very best in your future work, and Happy Holidays! Lois