Lateral Violence in Nursing Experience

Lateral violence is a form of violence that a person or a group of people directs towards friends, colleagues, and peers instead of enemies. Its intention is to intimidate the friend or colleague because the other party views him/her as a potential threat at work or within the society. Worldwide, people recognize nursing as a caring institution with excellent caregivers. The profession captures the attention of many people seeing nurses adorn spotless apparels and treat people with undivided attention. Each patient is unique, and nurses do not seem to have any problem at work. Ironically, some nurses work under the pressure to perform well while others have to deal with bullies daily. According to the nursing fraternity, the wellbeing of a patient takes precedence, and it does not auger well when a nurse looks depressed in the presence of a patient. As such, the senior most authority who might probably be a bully should be responsible for eliminating lateral violence.

Nurses face lateral violence of different forms, and their ability to hide the persistent occurrence affects them over a long time. Lateral violence was and still is a common occurrence among minorities living in an area they initially occupied before the majority race took over the environment. For instance, the Australian aborigines and the Native Americans constantly seek recognition in an environment in which racial bias is obvious. The groups resigned to fate by viewing the current occupants of the US as enlightened and perfect. As such, they undergo oppression, but they cannot reprimand their oppressors. Elimination of such levels of emotional aggression should be the responsibility of the entire nursing fraternity. To eliminate this act, the bully should communicate, other immediate observers should not fear reporting, and the organizational human resource manager should implement the code of ethics.

People choose to define lateral violence differently. Its definition largely depends on the context of communication. In the nursing department, ‘powerful’ and ‘powerless’ people coexist as in a normal workplace setting (Longo, 2007). Managers and subordinates are always in a process of satisfying their needs by working hard to get promotions and achieve upward mobility. In the process, either the managers or the subordinates intimidate the other because of inherent emotional problems that they face. Such hostility emanates from work pressure or the fact that the oppressor sees a potential individual who could replace him/her in the future. In some cases, some people never get satisfied with their work or non-work related concerns. As a result, they use the opportunity to intimidate others in order to feel some form of relief. Sauer (2011) established that bullying and other forms of harassment seem alike, but the salience depicted in their longevity and the persistence makes them different. She established that lateral violence is persistent and normally inflicts a psychological pain that recurs. Sauer (2011) described lateral violence as a reoccurring process because a person who faces such level of bullying will mostly likely do the same to another person in case he/she does not undergo counseling. Moreover, the author established that some victims of lateral violence become overprotective of victims that undergo the same level of hostility. Lateral violence is not entirely new in the nursing field as Sauer and other authors have taken over two decades to understand the behaviors of nurses that oppress the people they should mentor.

Ideally, not any type oppression qualifies as lateral violence at work. Over a long period, people in higher authorities as opposed to their subordinates always try to instill fear through verbal or physical abuse. Both parties in the equation are under a significant authority, enabling the new graduate employee to report any form of violence. As such, lateral violence occurs between an experienced authority and a new graduate for a long period. The level of intimidation instills fear, and often deters the new graduates from reporting the form of violence to the recognizable bodies for further disciplinary actions (Embree & White, 2010). The level of aggression equally occurs in the nursing profession in which an experienced authority uses the opportunity to gossip, cyber-bully, or prevent the new graduate from accessing helpful information. The intention is to make the subordinate seem unfit for the job opportunity, especially when they display high level of competence in the area including a good record of academic performance.

According to Griffin and Clark (2014), cognitive rehearsal is an effective shield for acts of lateral violence. Numerous researches have shown that cognitive rehearsal is one of the best evidence-based stratagem for addressing bullying and uncivil behaviors or acts in the nursing profession. In the initial research by Griffin and Clark, twenty-six newly licensed graduates studied lateral violence, and later used cognitive rehearsal methods as a way of intervention for nurse-to-nurse coarseness. The new graduates reported that the application of the cognitive rehearsal techniques are too demanding, but were fruitful in mitigating lateral violence and nurse-to-nurse incivility.

According to Sheridan-Leos (2008), verbal abuse is the most common form of violence given that about 67% of experienced employees are likely to abuse their colleagues, blame them for personal mistakes, or force them to take responsibility in mistakes that do not concern them. Both verbal and non-verbal cues intimidate nurses and other workers, and, sometimes, hold them back from performing their duties that entail duly serving patients. As such, the victim should report a case of harassment to the administrator or the human resource officer for further deliberations. Interestingly, it remains paradoxical how the American Nursing Association and the American Medical Association among other professional bodies can condone the same in a field that the public frequently requires the attention of composed employees. In some case, even physical abuse occurs, which is an extreme scenario worth reporting irrespective of the position the bully holds in the workplace. Some bullies are difficult to report at the workplace because they hold high and influential positions. Embree and White (2010) suggest that the best way to approach such a case is to refer the case to a neutral authority such as labor union or a professional body such as AMA that will handle the issue without bias.

In any institution defined by hierarchy structures, lateral violence is likely to occur. People with different personalities and intentions often work in hierarchal institutions, making the possibility of lateral violence very high. Hospitals have patients daily even in the remote places. As such, nurses dealing in different departments have to work alongside other professionals. The first step to deal with lateral violence is to come up with a code of ethics, which most powerful people are not likely to violate. Another action is to avoid disclosure of information about workers within the facility. In most cases, when one individual earns less in comparison to a counterpart within the department, lateral violence might occur as Dellasega (2009) observes.

Management of lateral violence begins by understanding its cause. Markedly, different factors determine the level of aggression displayed by an individual towards a colleague or a friend at the workplace. Aggression towards a person from a different race and expressing the same through verbal and physical violence over a long period often amounts to lateral aggression. Besides racial bias, the possibility of a professional threat is a psychological intimidation to the experienced authority that uses his/her power to intimidate the new graduates. The intention is to demoralize the new graduate employee so that the rest of the organization sees him/her as an underperformer that the nursing institution should not retain. Sauer (2011) narrates the story of a new employee known as Carrie who had one of the best mentors in an emergency department – a completely new field for her in nursing. However, she had to work under Beth who spent 32 years in the facility who always tried to intimidate her and let the rest of the staff know that they could manage without Carrie. Personal and professional concerns cause different forms of aggression depending on the type of relationship shared between a subordinate and a manager even in the nursing field.

All scholars give different views concerning the importance of addressing the issue before it happens. As such, they take a professional approach in handling lateral violence, but Embree and White’s suggestion concerning the consultation of professional bodies gives assurance of justice to victims (2010). The worst state of a nurse that undergoes lateral violence is depression. Others face heart conditions of hypertension depending on the persistence and longevity of the intimidation. According to Embree and White (2010), a bully that directs a certain level of dissatisfaction towards a vulnerable colleague displays emotional insecurity, but his/her actions psychologically affect the victim. The victim develops a low self-worth and feels less important to the organization. Such victims withdraw from duties that earned them ridicule or bullying, which proves to the entire organization that they cannot perform well. Some victims end up as bullies in the future because they also need to survive in other workplaces. Notably, such victims always fight for the rights of the vulnerable while warning the victims to avoid people who direct anger towards them without a clear purpose. Lateral violence depicts a high level of incivility from the individual considered powerful in the organization. Sheridan-Leos (2008) records that about three-quarter of clinical practitioners that face lateral violence always forget about proper medication for patients. The situation places the life of patients at risk since some face misdiagnosis, which is a dangerous medical error. Consequently, low quality service delivery, resignation, and absenteeism affect both the nurses and patients.

Lateral violence might never end because some people have a psychological urge to disrupt order. Most of them have psychological problems from childhood and they only feel well by bullying others. Even though such people could be performers at work, they interfere with team building practices that equally affect overall productivity at the workplace. People least expect lateral violence in nursing facilities, but it happens because the hospitals employ workers based on different skills and proficiencies. Lateral violence happens in many institutions and not in nursing facilities only, even though the discourse largely centered on the field of study owing to the irony presented in its occurrence in such respectable institutions.

References

Dellasega, C. (2009). Bullying among nurses. American Journal of Nursing, 109(1), 52-58.

Embree, J., & White, A. (2010). Concept analysis: Nurse-to-nurse lateral violence. Nursing Forum, 45(3), 166-173.

Griffin, M., & Clark, C. M. (2014). Revisiting cognitive rehearsal as an intervention against incivility and lateral violence in nursing: 10 years later. Journal of Continuing Education in Nursing, 45(12), 535-542.

Longo, J. (2007). Horizontal violence among nursing students. Archives of Psychiatric Nursing, 21(3), 177- 178.

Sauer, P. (2011). Do nurses eat their young? Truth and consequences. Journal of Emergency Nursing, 38(1), 43-46.

Sheridan-Leos, N. (2008). Professional issues: Understanding lateral violence in nursing. Clinical Journal of Oncology Nursing, 12(3), 399-403.

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