Lateral Violence in nursing

Sep 19

Written By Christen Shaker

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Nurse in scrubs with burnout because of bullying in nursing

Lateral Violence in nursing

Do you get a knot in the pit of your stomach when certain people are on the schedule?

Are you putting together an exit plan to get out of your current work environment?

Is one of the worst parts about your job dealing with your coworkers?

You’re not the only one!

Incivility is a huge problem in the profession and one of the biggest ways we get in our own way of empowering ourselves and our profession.

Lateral violence and incivility in nursing are newer, nicer terms for bullying in nursing.

In the ANA’S December, 2013 edition of Online Journal of Issues in Nursing defines lateral violence as “a deliberate and harmful behavior demonstrated in the workplace by one employee to another...”

The ANA defines nurse bullying as “repeated, unwanted harmful actions intended to humiliate, offend, and case distress in the recipient.”

Regardless of what you call it, it’s a very real problem. According to a study in the September 2019 issue of Nursing Administration Quarterly, Edmonson and Zelonka report the following nurse bullying statistics from various studies:

78% of students experienced bullying in nursing school
60% of nurses leave their first job within 6 months due to behaviors of their coworkers
60% of nurse managers, directors and executives experience workplace bullying
34% of nurses leave or consider leaving the profession because of bullying

The ANA reports 18-31% of nurses report being bullied by colleagues

RNNetwork conducted a poll showing:

86% nurses have been bullied
45% were verbally harassed or bullied by other nurses
41%: verbally harassed or bullied by managers or administrators

Unfortunately, it’s so common there’s a well-known description all nurses are aware of and it goes like this:

Nurses eat their young

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Nurses Eat Their Young

I’ll never forget a nursing student telling me about a time she was doing clinicals at a trauma ER. She said the nurse wanted her to do a procedure she wasn’t allowed to do as a student, even with supervision. When the student told her no and explained she wasn’t allowed, the experienced nurse still tried to get her to perform the task to the point it became uncomfortable. It became clear the experienced nurse was trying to set her up for failure.

At my first hospital job, I started full-time and ended up going prn. When I came back to work a couple shifts, there was a newer nurse that started. This newer nurse would pride herself on not being nice to nurses she thought were newer than her. It was a joke she would laugh about with the other nurses who’d been there longer than her, people I thought I knew and were my work buddies.

I came back for a couple shifts and not only did she put me in positions to try to humiliate me, she didn’t even show common courtesy or politeness. Once she realized that I knew the staff because I’d been working there longer than her, she was a lot nicer.

Stories like these are unfortunately not uncommon.

If you’ve been a nurse longer than 24 hours, chances are you’ve experienced bullying or lateral violence by your fellow nurses.

This phrase was created back in the 80’s from an article written by Judith Meissner where she talked about hostility and bullying shown to newer nurses by more experienced colleagues.

Nursing is a hard enough job and to tear one another down, whether meaning to or not, hurts you individually, the people around you, and the profession as a whole.

Workplace Bullying in Nursing

Nurses eating their young is similar to hazing that happens in college. Instead of torturing people with tasks and events, it happens in the workplace with behaviors and/or setting newer nurses up for failure.

Some people would say nurses eat their young because they’re insecure or on a power trip…or something along these lines.

While some of that may be true, I think there’s deeper problems surrounding this.

I know of a group of nurses in the midwest who’ve been in nursing longer than 25 years. They’re the type of nurses that if you were sick, you’d want taking care of you. Ironically, their biggest complaint is the younger nurses lack of respect and bullying toward the more experienced nurses.

While nurses eating their young is definitely a problem, younger nurses acting in the same ways they don’t want to be treated shows a systemic culture and mindset shift that needs to change in nursing.

Experienced nurses bullying younger nurses is more common, but bullying itself goes both ways.

As a nurse over 25 years who’s been bullied as a newer nurse, I’ve now experienced what it’s like trying to help younger nurses.

While most are very open to learning and help, there are some that:

Let me know they know everything already
Tell their work bff’s I dared speak to them and now I’m dealing with incivility for no reason
Respond in entitled ways most of us wouldn’t have dared do as a newer nurse

It creates:

Awkwardness sitting with them at the nurses station
Fear of asking for help if needed in the future
Unsafe care for patients
Cliques (and everything that goes with those)

….Among many other things.

Incivility in Nursing

Believe it or not, lack of trust is one of the biggest reasons for incivility and bullying in nursing.

Lack of trust between colleagues and with management.

For example….

I’ve worked with several nurses who tell me they don’t feel they can take a lunch break because they don’t trust their colleagues to cover for them for 30 minutes. Stress builds because you can’t take a lunch while you begin to resent your colleague for not being a good nurse.

While the colleague may genuinely not know what they’re doing wrong, they just know other nurses don’t like working with them. They’re not sure why, but their confidence sinks and they start to feel like a bad nurse.

Taking an extra couple minutes to talk through why you’re doing what you’re doing and educating new nurses on your unit will create trust in the long run so you can feel comfortable taking a break. It will also build their confidence because they’re learning and you’re taking time to invest and build them up!

However, this involves newer nurses being open as well!

To overcome bullying in nursing, it’s incredibly important to recognize we need each other!

As nurses, we are stronger together then apart!

Nurses aren’t the only ones needing to make adjustments. Hospital culture and tolerance of leaders they know are bullies and toxic are a big problem as well.

For example…

At a previous hospital, there was a nurse who went to HR because she was being deprived of opportunities in an ICU after reporting inappropriate behavior. The nurse was in the right, however her manager told her “you should’ve just ignored it.”

HR’s response? “Yea, she’s got you targeted.” And that was it.

Why is this manager still there? The rumors are she has friends in high places.

Management and leadership don’t want to hear constant bitching and complaining, but rather they focus on being positive. Being positive is great and necessary because nothing will ever be perfection.

That being said, it’s not acceptable to overlook toxic managers and important to find a healthy balance between reality and positivity.

I’m sure we can all relate to these examples and you may already even know a great solution. You may say to yourself “well they need to just fire the manager.” But what good does this actually do you?

The problem with most of these solutions are they’re outside of yourself. They involve relying on someone else to do something.

Which means they’re outside of your control.

You can’t control how others treat you, how organizations handle management, or many things in healthcare.

You can only manage and control yourself.

This is where I can help.

One nurse may not sound like much, but the truth is even 1 empowered nurse can make a difference on a unit or in the profession. Just like 1 toxic nurse can.

Look at Veronica Marshall, that was one nurse that started the nurse march in 2021. Florence Nightingale was just 1 nurse.

It’s important you understand your value, your worth, and your contribution when you’re living empowered.

Starting on an individual level, getting to a place of self-empowerment and confidence will allow you to uplift others while you’re caring and uplifting yourself. Starting with you is what will cause a ripple effect on your unit, throughout the organization you work for, and eventually the profession.

Empowering nurses is my specialty and it’s something no person, organization, or board can ever take from you.

The best part is…you don’t have to fix healthcare or leave nursing to have it!

Inspiring Nurses

We all now bullying in nursing is real and it needs to stop. The funny thing is, you may lose sleep over many things as a nurse but very seldom do we ever stop to think about our behavior towards ourselves.

We continue doing the habits we were taught, following examples of those who hurt us because we aren’t shown a different way. This continues the tradition of bullying.

As a whole, we must turn over a new leaf and start looking at how we treat ourselves and one another.

Most nurses I work with are so hard on others, but the big secret is they’re even harder on themselves!

If you can’t give yourself a break, you’re going to find it incredibly difficult to give a break to someone else.

Moving from bullying and incivility to a confident, empowered leader begins on an individual level, which is my specialty.

In fact, this whole topic is why I designed my Bedside Nurse Survival System in a small group setting.

In small groups, everyone gets:

to receive attention and support
a chance to be heard
the ability to support one another

and

to be part of a professional, uplifting, and safe community that already get it! You don’t have to explain it to them!

Positive change begins with the individual nurse. To start your individual journey or learn more about my Bedside Nurse Survival System, contact me here!