Lateral violence

nurseprnRN, BSN, RN · Aug 19, 2013

Yep.

If your performance reviews are good, and your patients aren't having adverse consequences because you are doing stupid things, and you are not in-your-face flaunting institutional written policies and procedures and making a butthead of yourself (we all know what I mean, and I've been there, done that myself), then who cares what they think/say? Not you, says I.

If you see deficiencies in institutional policy/procedure, do your homework, present the more modern alternative (including associated costs) calmly to your manager (realizing that things have been going just fine so far, so why should she change?) and ask if your unit can pilot a new one. Think about looking for a job in RM or staff development; these areas tend to have greater leverage in instituting change.

nurseprnRN, BSN, RN · Aug 19, 2013

Oh, and lose the term "lateral violence." Casting oneself as a victim is so unbecoming, and not necessary in this sort of situation.

Newldrn · Aug 19, 2013

Maybe I was not detailed enough with my first post, but this constant behavior from co-workers is affecting me personally. The problem is not just with policies and change, but the general environment of hospital nursing. "If you're not just like us, then you must be against us." I always take care of my patients and put their needs first, but that becomes increasingly more difficult with the attitude of the unit. I'm not trying to paint myself as a victim-that's the last thing I want to do, but I am soul-searching and seeking a solution. The "suck it up" and "that's just the way it is" school of thought is the reason "lateral violence" has flourished-and frankly, just isn't in my DNA. On the flip side, the odds of 1 vs. 30 isn't good either...

anotherone, BSN, RN · Aug 19, 2013

I don't care about the whispers. Or not veing incouded in socialization. After all I only talk to coworkers I like . All of life is like "high school". I have seen it in other jobs and all socioeconomic and ethical levels. I go in and do my job. It helps to sometimes kiss up to people and be extra nice to them. It is some sott of psych game sonpeople like to enage in, it helps to know how to play. I never complain about subjective or non work related issues. I never have gone to management ( principle's office) about how the other kids (coworkers) act on the playground unless it is a pt issue. A legit one, not perceived. By that I mean stat abx or blood or boluses not being given in a timely manner or bed alarms and bells going off and nurses sitting at the desk doing nothing.

I see grown women ( always women) crying to manager or complaining about cliques or bullies..... this is usually because they feel left out. most hosility is not out in the open or verbal.

anotherone, BSN, RN · Aug 19, 2013

Maybe I was not detailed enough with my first post, but this constant behavior from co-workers is affecting me personally. The problem is not just with policies and change, but the general environment of hospital nursing. "If you're not just like us, then you must be against us." I always take care of my patients and put their needs first, but that becomes increasingly more difficult with the attitude of the unit. I'm not trying to paint myself as a victim-that's the last thing I want to do, but I am soul-searching and seeking a solution. The "suck it up" and "that's just the way it is" school of thought is the reason "lateral violence" has flourished-and frankly, just isn't in my DNA. On the flip side, the odds of 1 vs. 30 isn't good either...

Can you please include examples? I am not sure what you mean?

Newldrn · Aug 19, 2013

I don't go to anyone with my complaints, because I don't feel like they're valid...but examples could include telling you you're fantastic to your face, then complaining about the way you did something to charge nurse or manager; still in orientation-having a preceptor who scrutinizes every word you chart, but doesn't hold themself to the same standards; being responsible for training new staff and setting them up for failure; as an organization not having set policies and procedures for common nursing responsibilities and having preceptors unfamiliar with policies and training new staff to do thing incorrectly....I'm sure I could come up with more, but I hope you get the idea.

Newldrn · Aug 19, 2013

I don't go to anyone with my complaints, because I don't feel like they're valid...but examples could include telling you you're fantastic to your face, then complaining about the way you did something to charge nurse or manager; still in orientation-having a preceptor who scrutinizes every word you chart, but doesn't hold themself to the same standards; being responsible for training new staff and setting them up for failure; as an organization not having set policies and procedures for common nursing responsibilities and having preceptors unfamiliar with policies and training new staff to do thing incorrectly....I'm sure I could come up with more, but I hope you get the idea. Also, I guess this is particularly difficult for me because I do have working experience outside of nursing where I did not feel this way. I've also had nursing experience where I did not experience this atmosphere-however, it seems to be the norm and accepted in hospitals especially.

nurseprnRN, BSN, RN · Aug 19, 2013

I don't go to anyone with my complaints, because I don't feel like they're valid...but examples could include telling you you're fantastic to your face, then complaining about the way you did something to charge nurse or manager; still in orientation-having a preceptor who scrutinizes every word you chart, but doesn't hold themself to the same standards; being responsible for training new staff and setting them up for failure; as an organization not having set policies and procedures for common nursing responsibilities and having preceptors unfamiliar with policies and training new staff to do thing incorrectly....I'm sure I could come up with more, but I hope you get the idea.

OK, then. There's no "lateral violence" involved in the vast majority of this, but there is a failure of leadership. I'd start with the P&Ps. Getting people working together to come up with good ones perforce makes them work together. Start small. Start with something that would make a real difference to patient care or the bottom line, preferably both.

You're kinda new here (this is your first posting) and I can't tell how long you've been an RN or how long you've been in this job. I'm concerned about the "I am in the specialty I want but they're all calling me a stinking booger behind my back" flavor to your original post. So often the truth is really somewhere in the middle; it's rarely so one-sided, especially once people start slapping around the NETY/LV stuff.

If a preceptor wants a new person to be held to a higher standard of documentation (I am assuming that's you), then perhaps it's because she isn't as confident about your assessment and interventions because she isn't seeing them as clearly as she would like, or hearing you explain them to her enough to make her comfortable with your skills; she feels uncomfortable. What if that's the case?

I am not understanding how the other staff's attitudes is making it harder for you, personally, to give good care. If it's because they are pulling you away from your patients to work with theirs and refusing to reciprocate, that's one thing.

If it's the "whispers" and "being ignored," I'm not getting it. How does that prevent you from, oh, doing your assessments, doing your patient teaching, documenting your work, passing your meds, regulating your IVs, calling the docs for needed prescriptions, etc.?

Maybe the idea is to see how you do independently. Perhaps someone is thinking, "She's thinks she's so smart, let her see how it is to work by herself, she is snooty to us, always going on about how we do things wrong..." (not saying that's it, but.... is it?) Maybe they're ignoring you because ... you're doing fine without them? Maybe you expect more socialization than this culture, this floor, has to offer?

Maybe it will take more time than you have to dedicate to it to change, by offering to precept new people and socializing them differently, one at a time.

Maybe your anticipatory irritation is sending out prickly vibes to all around you. Who the heck knows?

The only things you can know and control for sure are your own reactions and attitudes. I hear you that you do not want to hear that. If you listen carefully, though, there's a difference between that and "suck it up," or "that's the way we've always done it." Whoever wrote, "Be the change you want to see in the world" could be speaking to you, friend.

Or you can just pack it all in. I'm betting, though, that if nursing is a second career to you, that many of these issues were present in your first one. You can go from situation to situation, profession to profession, and see it all the same way. Your choice. Until you get to a place where you feel completely in control of yourself and your feelings, you will be unsatisfied.

S.G. · Aug 19, 2013

I've found nursing to be very cliquish but I wouldn't say I've encountered "lateral violence". I stick with taking care of my patients the best way that I can and that has including speaking with management and changing policies. I've been active in working with them to change practices and increase patient safety. With that being said, I don't care if people whisper about me behind my back. I do my job and I love my job. I don't have to invite these people over to dinner. I have to work with them toward a common goal. I have a professional relationship with all of my coworkers and a more personal friendship with a few of them. If I felt that I was working in a hostile environment (as opposed to an environment in which I didn't have personal relationships with my coworkers), I'd probably move on to a different unit.

ETA - GrnTea has given some great advice.

Newldrn · Aug 19, 2013

I agree-GrnTea's last post has given me quite a lot to ponder...but the reference to other careers being the same-in my experience, they haven't been. I've only been a nurse for 5 years and have 10 years prior experience in customer service/sales/hospitality. I always had an idealistic portrait of being a nurse and will always struggle with that! My thoughts today don't effect how I do my job except for the morale of myself and all new staff members. It is what it is though, and maybe it's just not for me? Thanks for everyone who has taken the time to respond-input from others is always appreciated!

LadyFree28, BSN, LPN, RN · Aug 20, 2013

OK, then. There's no "lateral violence" involved in the vast majority of this, but there is a failure of leadership. I'd start with the P&Ps. Getting people working together to come up with good ones perforce makes them work together. Start small. Start with something that would make a real difference to patient care or the bottom line, preferably both.
You're kinda new here (this is your first posting) and I can't tell how long you've been an RN or how long you've been in this job. I'm concerned about the "I am in the specialty I want but they're all calling me a stinking booger behind my back" flavor to your original post. So often the truth is really somewhere in the middle; it's rarely so one-sided, especially once people start slapping around the NETY/LV stuff.
If a preceptor wants a new person to be held to a higher standard of documentation (I am assuming that's you), then perhaps it's because she isn't as confident about your assessment and interventions because she isn't seeing them as clearly as she would like, or hearing you explain them to her enough to make her comfortable with your skills; she feels uncomfortable. What if that's the case?
I am not understanding how the other staff's attitudes is making it harder for you, personally, to give good care. If it's because they are pulling you away from your patients to work with theirs and refusing to reciprocate, that's one thing.
If it's the "whispers" and "being ignored," I'm not getting it. How does that prevent you from, oh, doing your assessments, doing your patient teaching, documenting your work, passing your meds, regulating your IVs, calling the docs for needed prescriptions, etc.?
Maybe the idea is to see how you do independently. Perhaps someone is thinking, "She's thinks she's so smart, let her see how it is to work by herself, she is snooty to us, always going on about how we do things wrong..." (not saying that's it, but.... is it?) Maybe they're ignoring you because ... you're doing fine without them? Maybe you expect more socialization than this culture, this floor, has to offer?
Maybe it will take more time than you have to dedicate to it to change, by offering to precept new people and socializing them differently, one at a time.
Maybe your anticipatory irritation is sending out prickly vibes to all around you. Who the heck knows?
The only things you can know and control for sure are your own reactions and attitudes. I hear you that you do not want to hear that. If you listen carefully, though, there's a difference between that and "suck it up," or "that's the way we've always done it." Whoever wrote, "Be the change you want to see in the world" could be speaking to you, friend.
Or you can just pack it all in. I'm betting, though, that if nursing is a second career to you, that many of these issues were present in your first one. You can go from situation to situation, profession to profession, and see it all the same way. Your choice. Until you get to a place where you feel completely in control of yourself and your feelings, you will be unsatisfied.

I've found nursing to be very cliquish but I wouldn't say I've encountered "lateral violence". I stick with taking care of my patients the best way that I can and that has including speaking with management and changing policies. I've been active in working with them to change practices and increase patient safety. With that being said, I don't care if people whisper about me behind my back. I do my job and I love my job. I don't have to invite these people over to dinner. I have to work with them toward a common goal. I have a professional relationship with all of my coworkers and a more personal friendship with a few of them. If I felt that I was working in a hostile environment (as opposed to an environment in which I didn't have personal relationships with my coworkers), I'd probably move on to a different unit.
ETA - GrnTea has given some great advice.

SAGE Advice. :yes:

OP...people are people are people.

You also have to do some soul searching and be the change that you seek, even if it means getting tougher skin, and putting away the hearts and flowers of nursing that you've drawn...and that doesn't mean you stop embodying them...it jut you can only expect those expectations REALISTICALLY for YOU.

One of the things that I do is expect the best out if myself, and expect anything and everything...you only can control the actions of you; great others how you treat yourself. Most of the time, a team wants you to be aware of the culture of the unit...sometimes you have to walk that fence before implementing change...you have to walk in their shoes...use the empathy within reality that they talked about in nursing school, because you are part of a team, even in its imperfect glory sometimes. Be assertive, and continue to hone your practice...you may need a new niche in your career, as GrnTea suggested...you will get over this hump; but it will be up to you. :yes: