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 was bullied during school and I have to say that I learned from it and if I could do it over again, I would have been far more assertive, trusted my first instincts and spoken up sooner. Hindsight is always 20/20. I do believe that there are some people who just can't be trusted and I think that one of the mistakes I made was being too trusting and not shrewd enough. I really do think that as Tweety said there are some who get bullied and others who don't. I am really working on being the type who doesn't get stepped on all the time.
Tom, people don't enable the bullies. Enabling implies that the target is helping the bully be a bully. I don't think any of us who have experienced the things the OP listed have jumped up and down yelling "Pick me, Pick me," or "Hey, after I leave, when you are telling everyone at the nurses station what a s#!++y nurse I am, you should include that I turned my patients every 2.25 hours tonight instead of every 2 hours."
If you don't give them the power they can not come at you in any way
I have never given anyone any power in that sense. I am pretty mellow, don't have a know it all attitude (cause I don't know it all) and rarely do you find me sitting during a shift. I know what I know, and most importantly, I know what I don't know and am not afraid of asking questions. I do my best to know what the policies are and follow them. I also advocate for my patients. I'm also a pretty good nurse. Several of the ICU nurses that I worked with who had been nurses for decades said I could take care of them any time.
That being said, there were several nurses in ICU who came after me time and time again. It didn't matter what I did, it wasn't right. EVEN when I followed the policy I was told I did the wrong thing . Confronting the people didn't help. Quoting and or handing them the policy didn't help. One of the nurses would make it a point of coming into my room before report and telling me every thing I did wrong all night on patients that weren't on her assignment. This same nurse got on my case for taking a patient's blood pressure every 15 minutes. My rationale was that I was giving Precedex for the first time and wasn't sure what it was going to do to the patient's blood pressure. Neither was the pharmacist. He stayed in the room for the first 45 minutes to be sure the patient was OK. He thought the q 15 minute blood pressure was a good thing. She said I was taking the pressure too often and could have caused the patient irreversible damage.
I'm not saying I didn't make some mistakes. There was the time that I didn't label the line with NS. However I did label the levo, the insulin, the calcium gluconate, the versed, and the fentanyl. Every so often, I would forget to empty a nearly empty suction canister. I didn't do anything horribly wrong and nobody died on my watch who wasn't suppose to. My patients were clean and looked comfortable, my rooms were always clean, trash and linens were emptied, and I stocked my rooms so my replacement wasn't left short of supplies like I was. It didn't matter. The response from my charge nurse, shift supervisor, and the manager of the department was that was the way those nurses were and nothing was going to change it. I was also told to remember that "nurses eat their young."
As far as why some people and not others, there is great site, http://www.bullyonline.org/ that discusses the whys. There was also another site http://www.worktrauma.org/ that stated females are more often the target.
I think that in order to put an end to it, management is going to have to take a huge stand and not tolerate the bullying. Unfortunately, I think a few people are going to have to be fired before anything changes.
I have a question, if you don't give them the power and then they can't come after you, how do you react if someone attempts to "come "after you? What is your solution,aside from "not enabling"?
You're thread to bullying is exceptional. Not only does it pose specific problems in different arena's, they follow-up with theory behind the identifying bully. Thank you. A must read for this post!
There is no doubt there is lateral violence in my facility. I know this because as a new nurse who had to take all the classes with orientation, one of our classes was nurse to nurse hostility and how to overcome it. It was a 2 hour class and when the instructor asked how many of us new hires have already experienced it in the one month since we started, ALL 57 people in the room raised their hands. Here is a thought...instead of having new nurses take this class, have the seasoned nurses take this class. It may be the wake up call they need to stop the backstabbing, sabatoging, and hostility that occurs on the floors. This is just my opinion since I for one experienced this in the short time I have been a nurse.
I have a question, if you don't give them the power and then they can't come after you, how do you react if someone attempts to "come "after you? What is your solution,aside from "not enabling"?
that's a tough question.
i can't answer for anyone else.
i think confidence is an attitude we carry inside ourselves, and is projected to the outside world.
the feedback i've gotten all my life, is i have a "don't mess with me" look...
i am able to walk through dangerous neighborhoods alone, w/nobody bothering me.(i must have 1 scary face!)
i am not aware of how i come across.
i can only:
1. share what i FEEL inside, and
2. what others have told me.
when someone is determined to hassle me:
- i keep my cool.
- maintain steady eye contact
- listen to their beef
- and either accept or reject what they're saying.
- i never babble, or become defensive.
- if they're wrong, i tell them so.
- end of conversation.
somehow (and i'm not sure why), i'm never bothered again.
it must be "that look". :)
i maintain, it must be my attitude that comes forth...
that, "don't "f" with me."
politely and respectfully, of course.
bottom line?
i think it's not what you do, but it's something you are.
Specializes in home & public health, med-surg, hospice.
Seems like anytime there's a thread on lateral violence or it's counterparts, i.e. work place advocacy, bullying, etc., the focus is always geared toward "nurses eating their young."
To me, not that it isn't a bonafied phenomenon - in fact it does happen, this is such a "gloss over" of the problems that contribute to our lack of intraprofessional interactions.
Because I see violence directed everywhere in nursing: lateral, upward and downward. Right now at my place of employment, one of the most abused nurses is a nurse with over 30 years exp. in a variety of specialties. Th' problem? The other nurses feel less knowledgable around her. She feels uncomfortable working in med-surg w/high ratios, etc., she's from CA & we're in the South, she has a different dialect, etc. The problem, the problem, the problem is = she's different!
Oh well, I don't know where I'm going with this except to say, I believe we'll never progress as a true "profession" unless & until professional behaviour is taught as a worthy endeavor in our schools. And to me, well, I believe respect for our colleagues is a core measure/behavior/attribute of truly behaving as a professional.
Yes I haveexperience this lateral type bullying for years, that is why my last day is next week. The company is well aware of why I am leaving and the only thing that has been said from my administrator "I am sorry to hear you are leaving, we are always here if it doesn't work out with your new job." I really appreciated this, however I think as an administrator he should be addressing the issue verses playing it off. I am not the only one who suffers from this later bullying, many do. It just depends whose week it is. But I am not tolerating it anymore.
Because I see violence directed everywhere in nursing: lateral, upward and downward. Right now at my place of employment, one of the most abused nurses is a nurse with over 30 years exp. in a variety of specialties. Th' problem? The other nurses feel less knowledgable around her. She feels uncomfortable working in med-surg w/high ratios, etc., she's from CA & we're in the South, she has a different dialect, etc. The problem, the problem, the problem is = she's different!
i agree that nurses will target one of their own, for being different, for feeling threatened, for whatever darned reason it is.
bottom line is, there ISN'T any good reason to lower yourself to a highschool mentality.
i'm just not sure that behaving with class and maturity, can be taught.
whether one is flexible and tolerant, or petty and backstabbing, they are both mindsets that took yrs to develop.
i think it would be most helpful for the facility to have a zero tolerance policy re gossip and other backbiting behaviors...
that it would be a reportable offense to talk badly to or about another colleague.
if there wasn't such a nsg shortage, it would make sense to be a heck of a lot more selective in who they hire.
graduating with a 4.0 means squat, if you have the character of a 15 yr old thug.
Specializes in Flight, ER, Transport, ICU/Critical Care.
The thread has generated some excellent responses. Thank you all.
I note a couple of "themes" in some of the more recent posts that center on enabling behavior. I'd like to share my thoughts.
I do believe that there are a LOT of enabling behaviors that are rampant in healthcare - nursing is responsible for a lion's share. Authority, responsibility and accountability all help to defeat enabling at it's core.
From Leslie, Tom and Tweety - all have very good points in that --- *if you don't allow it, it won't happen or can't effect you* --- well, to some extent I believe that caveat is very valid. But, to another extreme - I do think that the "bullying" can be very destructive regardless of the "victim's" position.
I believe in confronting BAD BEHAVIOR. (But in a safe spot!)
I think that a simple unemotional accounting of the OFFENSE is necessary.
A direct explanation of the consequences if the OFFENDER does not stop.
I just think that this *issue* needs some more attention - nursing is a tough business. I think society has become less reactive to BAD behavior in the past 20 years (I see children doing/saying things that just shock me!) and this change is spilling over into all professions. Sure, folks in all workplaces will not always like the others - they may exclude them or be nasty in small ways. Generally unpleasant but pretty self-limiting. A bad day at the bank when one teller doesn't tell another that a mistake has been made, may cause a drawer not to balance --- a mistake withheld from another nurse can have far more deadly consequences. Not the same thing.
I wonder if this is why maybe nurses are leaving - I think it may have an effect. I love being a nurse - I just hate nursing at times.
In my opinion, bullying thrives only when it's permitted to. The ones permitting it are the ones who are neither the targets nor the perpetrators - simply those that walk away from it.
I've not worked in a hospital so I could be wrong but I'd be surprised if the majority of nurses were bullies. If they are, well...not much to say -- I guess I'll be in for some confrontation. If they're not, though, then they do what they do because they are tacitly sanctioned by the majority who tolerates their behavior.
Regardless of whether you're the target, confront it wherever you see it.
. Confronting the people didn't help. Quoting and or handing them the policy didn't help. One of the nurses would make it a point of coming into my room before report and telling me every thing I did wrong all night on patients that weren't on her assignment. This same nurse got on my case for taking a patient's blood pressure every 15 minutes. My rationale was that I was giving Precedex for the first time and wasn't sure what it was going to do to the patient's blood pressure. Neither was the pharmacist. He stayed in the room for the first 45 minutes to be sure the patient was OK. He thought the q 15 minute blood pressure was a good thing. She said I was taking the pressure too often and could have caused the patient irreversible damage.
linzz
931 Posts
I was bullied during school and I have to say that I learned from it and if I could do it over again, I would have been far more assertive, trusted my first instincts and spoken up sooner. Hindsight is always 20/20. I do believe that there are some people who just can't be trusted and I think that one of the mistakes I made was being too trusting and not shrewd enough. I really do think that as Tweety said there are some who get bullied and others who don't. I am really working on being the type who doesn't get stepped on all the time.