I hear too often in the nursing world that we "eat our young". This is not OK on quite a few levels, but the biggest concern is how often this happens and, despite the fact that so many of us disagree with this behavior and this sentiment, it still occurs frequently. The fancy term for the behavior of "eating our young" is lateral violence. I have been thinking about this a lot lately: Is that mentality different from other professions where people will clamor all over each other to get ahead?
Not entirely, but it seems totally out of character for nurses, who give care to others and are healers for a living, to be laterally violent to each other. There may be times where we may, perhaps, be a bit short with an MD when we disagree upon a plan/intervention for a patient, or not be best friends with one of our coworkers, that is part of human nature, especially when working in a stressful environment. Who hasn't been under a lot of stress in the middle of an insanely busy shift, and maybe come across as less than pleasant to a co-worker? Saving lives can be stressful business, but that doesn't mean that we should demean one another. Lateral violence refers to a person of higher "power" or status on a unit, bullying or demeaning a co-worker, either through verbal or non-verbally aggressive acts. Usually, if you snap at someone because you are stressed, you will address it and apologize, or make some sort of note that you didn't intend to come across as you did. Lateral violence is a continued trend of behavior that makes others feel uncomfortable, demeaned, and of less value.
The thing about lateral violence is that some of the acts that constitute it, are so subtle. While any administration for any hospital or other healthcare arena would tell you that they take a stance on anti-bullying and/or lateral violence, the behavior and actions can be really tough to nail down, and it has been so long accepted in our culture that it goes under-reported. It's not just the senior nurse on your unit that might get snappy or yell at a newer nurse for not being able to read their mind during an emergent situation, it could be the resource nurse that doesn't schedule a break/lunch time any time that you work with them, or doesn't offer you help when you are drowning in your assignment, but seems to offer to help everyone else out. It's the charge nurse that gives you the heaviest assignment every single shift. It's the person who runs the schedule and they put you on every single shift that you request off. It's the co-worker that ignores you, or rolls their eyes at you, when you ask for help. If you have ever been in a situation at work where you've felt distressed by how you have been treated, you may have been the victim of lateral violence. These actions are what create a toxic environment that leads to a high turnover of nurses, and severely unhappy nurses on the unit in their short time there.
And not only do the clinical staff suffer, but the patients suffer as well. When clinical staff are not working as a team, helping each other when they need it, and giving unequal patient assignments, it can be hard to meet the needs of our patients. If I can't find a co-worker willing to help me reposition my bed bound patients, they are at a higher risk of pressure ulcers, right? And if my assignment is so heavy I don't have time to change out that IV that was due to be changed at the beginning of my shift, that patient is at a much higher risk for phlebitis.
What can we, as a culture of nurses, do about lateral violence? Just saying we won't tolerate it isn't enough. One of the biggest ways to prevent it is to educate staff on what lateral violence actually is; once behaviors are pointed out, and it becomes a part of the culture that those behaviors will be scrutinized and not tolerated, people tend to have more self awareness of their actions. We also need to speak out when we see it occur to others, or experience it directly, and report it. Nurse leaders on units should lead by example and set the tone for their unit, not only that they don't bully their own staff or colleagues, but that they are supported by the policies set forth by their institution, and enforce a culture of anti-lateral violence. And when staff report lateral violence to their managers/directors, they need to feel comfortable and that there will be no repercussions for their actions, and that the person reported will actually be dealt with.
None of us should feel uncomfortable or scared going to work, for any reason, and if you do, you need to speak out about it, and report it higher and higher in your institution until someone listens! Feel empowered to stand up for yourself, your colleagues, and our community.