Lateral violence, or workplace bullying, is the inappropriate treatment of one worker by another of equal or greater station within the workplace.
This behavior is purposeful and intended to belittle or embarrass the victim and is often passive aggressive so that the perpetrator does not appear to others as being overtly hurtful to the victim.
However, over time the cumulative effects of the bullying can have devastating effects on both the individual and the organization employing them.
The nursing profession has been identified as the occupation most at risk for lateral violence. It is occurring at staggering rates within the profession, with up to 85% of nurses being victims of workplace bullying and 93% reporting that they witness it on the units where they work.
Due to this prevalence, it is often considered “normal” behavior by many nurses and is therefore unrecognized for its harmful effects.
With the statistics as they are, workplace bullying is clearly a huge issue in the profession of nursing and studies have shown that it has devastating effects on individual nurses, the profession of nursing, and the healthcare organization that employ nurses.
How Does Lateral Violence Affect Nurses?
Studies have shown that lateral violence has a large and negative effect on the individual nurse that is the victim. These nurses often report a decreased sense of well-being, depressive symptoms, anxiety, sleep disturbances, ailments such as physical pain in the body, and poor coping mechanisms.
Some nurses even reported suicidal ideation related to the bullying and the subsequent issues it causes them. These nurses also have a higher rate of illness and earlier onset of cardiovascular disease than those nurses who do not experience lateral violence in their workplace.
Therefore, the effects of lateral violence are substantial to the victim, however, the effects can be seen far beyond the individual victim.
How Does Lateral Violence Affect the Healthcare Organization?
Due to both the mental and physical adverse effects that lateral violence causes the individual, the nurse experiences lower productivity, poor communication on their units, and has higher rates of call-ins due to illness.
The bullying also affects the nurse’s ability to deliver optimum patient care and can be a source of patient safety issues.
This is harmful to the organization that employs nurses for obvious reasons. The lower the productivity of nurses, the less money that is ultimately being made by the organization.
Poor communication among nurses could further compound productivity issues and may even lead to patient safety concerns if patient care is not discussed among the care team as it should be.
Higher rates of call-ins create an even heavier load on the other nurses of the unit for that shift and also affects patient care and safety for that day. It may also further aggravate issues for the victim as the other nurses on the unit may resent the nurse who called in and who “caused” them to have to care for more patients.
Victims of workplace bullying are also more likely to leave the organization entirely, creating even greater staffing issues in an industry that is already struggling to attract and maintain nursing staff. The organization would then need to find a replacement for the nurse as well, which often costs $100,000 or more to replace each nurse.
Thus, productivity and patient safety are both affected by lateral violence, and ultimately negatively affects the healthcare organization in a powerful way.
How Does Lateral Violence Affect the Profession of Nursing?
Sadly, the profession of nursing has a reputation for “eating their own young” and it is likely a direct reflection of the astoundingly high rates of lateral violence that occurs among nurses.
It is well-known that a large number, up to one-third, of new nurses leave the profession entirely within their first five years of nursing. Even after all the time, effort, and money spent on passing nursing school.
Why? It is very likely to be caused, in large part, to bullying in the workplace, as new nurses are more likely to be victims of workplace bullying.
It is said that a nurse learns more in that first year of nursing than they ever did in school, as they are learning by doing: they are learning quickly and in real-time. These new nurses need substantial support as they learn and grow in the very complex and ever-changing healthcare landscape.
Yet instead of receiving the support they need, they often receive instead passive-aggressive remarks made by more experienced nurses, aimed at belittling them for their lack of knowledge and expertise, when in-fact, this expertise comes through experience, something the new nurse does not yet have.
Therefore, they need the guidance and support of experienced nurses as they build this expertise and skill set. When new nurses do not receive the support they need and are instead bullied for their newness, the nurses will experience the aforementioned ailments, which will ultimately lead to their leaving the organization or profession entirely.
What Does this Mean for the Profession of Nursing?
When this issue is viewed in light of the massive nursing shortage that is being experienced all across the country, this is an obvious issue for both healthcare organizations who employ nurses and the nursing profession itself.
Nurses everywhere are reporting being understaffed on their units, being forced to care for an unreasonable number of patients, and feeling that these conditions are unsafe and unsustainable.
If these nurses in turn, become overwhelmed with the working conditions and leave, a very likely scenario, organizations will see even greater turn-over rates among nursing staff and the nursing shortage will continue to grow, compounding the complex issues that are already being experienced across the country, costing millions of dollars in expenses as the organizations attempt to attract and train new nurses to replace these nurses leaving, and costing even more in patient safety concerns.
As staffing issues continue to flare it is likely that working conditions will become even worse on many units and may affect the number of people who would otherwise aspire to become a nurse.
Yet, what is it that would attract aspiring nurses if all the profession has to offer is workplace bullying and poor working conditions due to severe staffing shortages?
Therefore, this issue should be a concern of nurses everywhere, as we all comprise our noble profession, and it should be our concern to uphold that nobility and professional reputation that we all strive for. Yet how can we when we continuously sabotage our own?
The profession of nursing must seek a solution to address this issue, as it greatly affects our profession and the healthcare industry as a whole.
How to Address Lateral Violence in Nursing
Addressing Lateral Violence as a Nurse Leader
Understanding what lateral violence is and learning to recognize it in the workplace is the first step to addressing it and this task must be undertaken by all nurses, but especially nurses in leadership roles.
When maladaptive or disruptive behaviors are witnessed or reported by peers, the nurse leader or manager must take the time to address it by initiating an open conversation with the nurse who displaying the inappropriate behavior.
Discussion should focus on why this behavior cannot be tolerated, a possible underlying issue as to why the nurse has lashed out at others, and a possible referral to Human Resources (HR) to ensure the nurse receives the appropriate help they need, as HR has resources available for employees to help with stress management and other issues.
By not allowing workplace bullying, the nurse manager is able to stop the cycle of lateral violence that causes distress to other nurses, who are the victims of the bullying, and helps to prevent them from also becoming a perpetrator of lateral violence themselves. It also sets a standard of behavior that will and will not be tolerated and encourages professional behavior to be displayed by all.
Furthermore, it encourages improved relationships among nursing staff, better communication, a more positive outlook of the nurses, and a more functional work environment. These factors all translate into better staff retention, improved patient care, and increased productivity among nursing staff.
Addressing Lateral Violence as a Staff Nurse or Peer
Staff nurses must also commit to becoming more aware of lateral violence and understanding the harmful effects it has on individuals, as well as on patients, the unit that they work in, and their organization.
When lateral violence is witnessed by staff, it should be reported to the nurse manager, who must have open communication with their staff to ensure they are comfortable reporting issues and concerns.
Nurses can no longer view workplace bullying as “normal” and “part of the job”. Statistically, the stakes are too high for the victim, the organization, and the profession of nursing, as mentioned previously.
A commitment must be made to addressing this issue in nursing and improving career outlooks for nurses, staff retention and productivity for the organization, and maintaining the standard of professionalism called for by the noble profession of nursing.
Did this article speak to you? Have you or someone you know experienced lateral violence? I’d love to hear your story and connect with you. Drop a comment below or send me a email! I check both regularly.
Resources:
- The Online Journal of Issues in Nursing. Lateral Violence in Nursing and Theory of the Nurse as Wounded Healer.
