LATERAL Violence. How Nurses treat Nurses!

[Medic/Nurse]

hi!

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

* humiliation

* ignoring, isolation, segregation, silent treatment

* inequitable assignments

* inflammatory angry outbursts, impatience

* insults, ridicule; patronizing, or condescending language or gestures

* intimidation, threats

* judging a person's work unjustly or in an offending manner

* making excessive demands

* sabotage, undermining

* unfair evaluations of work

* unwarranted criticism sarcasm

* withholding information or support

full text link at

http://ccn.aacnjournals.org/cgi/content/full/27/3/10?maxtoshow=&hits=10&hits=10&resultformat=&fulltext=lateral+violence&searchid=1&firstindex=0&sortspec=relevance&resourcetype=hwcit

thank you for any imput!

[KeechieSan]

Once again, your definition of 'violence' is ridiculously broad. Also, students who think the world revolves around them ARE annoying. Students should be deferential to the nurses on shift, and not so thin skinned as to be totally exaggerating like you are. You have a lot to learn yet about nursing. Not everyone enjoys mentoring students, and the nurse in question was probably not well pleased that she was being forced to do so.

It doesn't really matter if she "enjoys mentoring students" or not! She obviously knew it was a teaching hospital when she decided to work there. There is never, never an excuse for being so rude to anyone, especially a student. I hear some nurses complain all the time about patient loads and all they have to do.. well, you'd have a little less to do if you were nice to the students and encouraged them to go into the work force. We are facing a nursing shortage here people, and rudeness isn't going to make that any less! Frankly, I find it a refreshing break to have a student!

I do agree that it isn't "violence" per se, but it is still wrong and all it does is encourage workplace hostility.

[GadgetRN71, ASN, RN]

Once again, your definition of 'violence' is ridiculously broad. Also, students who think the world revolves around them ARE annoying. Students should be deferential to the nurses on shift, and not so thin skinned as to be totally exaggerating like you are. You have a lot to learn yet about nursing. Not everyone enjoys mentoring students, and the nurse in question was probably not well pleased that she was being forced to do so.

See, this is where the problem is...Nurses who think that because THEY were treated like garbage when they were new, that is perfectly acceptable to bully others. And that nurse's behavior was both unprofessional and bullying in nature. Granted, sometimes you don't feel like having a student, but it is not the student's fault. Cowards pick on the vulnerable is how I see it. There is a difference between being respectful and letting some crusty ol' bitty use you as a verbal punching bag. Thank goodness, this type of behavior is being dealt with by hospitals now-I wrote up a coworker for her nasty, evil behavior. I WON'T tolerate it and neither should anyone else, student or no. Just my 2 cents.

[SuesquatchRN, BSN, RN]

Well, I know that I hate being a nurse.

My facility has us police one another for med errors since the nurse on the next shift is most likely to pick up anhy errors in the MAR. Now, you tell me how someone floating from any of three units with a minimum of 30 patients per isn't going to have one to three the first day they're back on it in a month. If you're lucky you don't get Narc Nurse following you. I always end up with her.

Tell me what that does for morale.

I really hate this.

[Tweety, BSN, RN]

I'm lucky not to work with anyone like that currently

:)

[maxsmom]

I have definitely been on the receiving end of these behaviors as a nurse. I was smart enough to get out before it cost someone their life or me my license. Thankfully I'm back in a supporting, helpful, team-focused environment and I'm never leaving!

Frankly, there is no place for bad attitudes in nursing, whether it's towards co-workers, students or whatever. It's a hard enough job without the added pressure of peer abuse. Is it so hard to remember that we're all members of the human race? What happened to treating people the way you would want to be treated?

[MrsMommaRN]

i am far from being thin skinned lateral violence is a broad term as defined above and encompasses the eyerolling verbal demeaning to literal traditional terms of abuse. no one should go into their workplace and expect to brow beat by anyone if they are housekeeping a student whoever. again its not a matter of being thin skinned. sure everyone has a bad day and has their harried moments when i approached this person in the original post it was the begining of the day she had just come on to her shift had gotten report and was aware she was having a student take on one of her patients. it wasn't a matter of a bad day it was just a matter of plain being rude. sorry in my book that just isn't right.

[Medic/Nurse, BSN, RN]

Thanks to all that have taken the time to reply.

Hey there jlsRN - I guess the "Violence" word may cause some bristling, but it is the term that the AACN had "adopted" as a descriptive in the Healthy Workplaces project that is ongoing. So, I certainly did not mean to offend you - sorry.

I think that you can use BULLYING, HOSTILITY or whatever name you want - but, it is all the same in its INTENT!

It is TOXIC. It creates a workplace that fosters UNHEALTHY communication and behaviors. IT IMPACTS all relationships in a negative manner - including patient care and safety!

I believe that "it" causes nursing to be less than therapeutic. I think it may also cause many to leave the bedside.

Keep the comments coming.

Have you ever treated anyone in any manner noted in the OP?

Have you been treated in the manner described?

How did it make you feel?

What, if anything, were you able to do about it?

Have you ever witnessed this with others?

How do "we" stop it?

THANK YOU ALL - I APPRECIATE THAT YOU ARE WILLING TO SHARE YOUR EXPERIENCES. I KNOW WE CAN ALL LEARN FROM EACH OTHER!

[Super Nurf]

I think the bullying is a very real and unfortunate issue in the nursing profession. I've been screamed at by managers in front of the entire floor, and also by certain staff members. I keep my cool and address the problem, maybe not at that moment in time, but it gets addressed. The last bully I encountered tried to bully quite a few people,including myself. I did go higher up and if it happens again, I won't hesitate to talk with someone about harrassment. No one should be treated rudely, period. Have I been short with coworkers when I've been busy? Yes, I am embarrassed to say so. Do I apologize? Yes, every single time. I'm not perfect, and I really am trying to just do a good job.

[TheCommuter, BSN, RN]

Here's my observation...I have noticed that bullies target certain individuals, while leaving other persons alone. Unfortunately, it's all about perception. If you are perceived as one who will not stand up to the bully, you'll be targeted for further harassment. If you're perceived as someone who will put up resistance and not allow anyone to run over you, then the bully will quickly know to leave you alone.

Bullying is a crime of opportunity. Bullies tend to pick the most opportune targets: people who are less likely to respond in a defensive manner to the bullying. Also, if nothing is done, the bully will continue his/her rampage, because he/she knows that he/she can get away with it.

[Lisa CCU RN, RN]

Once again, your definition of 'violence' is ridiculously broad. Also, students who think the world revolves around them ARE annoying. Students should be deferential to the nurses on shift, and not so thin skinned as to be totally exaggerating like you are. You have a lot to learn yet about nursing. Not everyone enjoys mentoring students, and the nurse in question was probably not well pleased that she was being forced to do so.

I'd just like to know, seriously, how one would expect to learn to care for patients if the nurses are too "rude" to work with students?

No one is asking you hold the student's hand, but a little help would be nice.

I'm sorry, no one is "forcing" anything. If you work at a teching hospital, expect students. If you don't want them, maybe a new job is in order for that nurse.

Would it not be easier to to learn to work with others ( a skill I thought nurses were supposed to possess) then always have a bed attitude about students?

BTW, I don't see how anyone gets away with rudeness to ANYONE in the hospital.

[indigo girl]

Here's my observation...I have noticed that bullies target certain individuals, while leaving other persons alone. Unfortunately, it's all about perception. If you are perceived as one who will not stand up to the bully, you'll be targeted for further harassment. If you're perceived as someone who will put up resistance and not allow anyone to run over you, then the bully will quickly know to leave you alone.

Bullying is a crime of opportunity. Bullies tend to pick the most opportune targets: people who are less likely to respond in a defensive manner to the bullying. Also, if nothing is done, the bully will continue his/her rampage, because he/she knows that he/she can get away with it.

You are absolutely spot on.

It does not work on the crusty old nurses like me as I am unlikely to allow the offender to escalate any attack. I let them have their say, and then I acknowledge that I heard them. I keep my voice low, level and calm, but physically I am in their space, and I am not moving away from them. Eventually, they just stop, and usually apologize as it becomes obvious that they are over reacting to whatever that perceived "you done me wrong" item is.

Bullies really are selective. They want to get away with the behavior because they are getting something out of it so they do choose people that are unlikely

to be able to either defend themselves or de-escalate the situation.

I like the idea of facilities having a nontolerance policy for this type of behavior to protect those innocents that need it. I agree, it is a form of violence.

[FireStarterRN, BSN, RN]

Thanks for the clarification. Yes, it's the word violence that I thought was a huge overstatement. Yes, I've experienced workplace bullying and unfortunately management sometimes tolerates it, depending on who knows whom, and other Jr High Dynamics. It is a problem in nursing and elsewhere.

For me, good communication is better than being a snappy witch.