Lateral Violence in Nursing: How You Can Make a Difference

Lateral violence in nursing is more common than many people realize, and chances are you’ve either experienced or witnessed it yourself. 

Lateral violence, also referred to as horizontal violence, is a form of nonphysical abuse in the workplace between co-workers. It includes overt or covert acts of verbal and nonverbal aggression that can hurt morale and negatively impact your ability to provide optimal patient care. 

You can make a difference and help put an end to workplace violence in nursing by showing your peers the same empathy, compassion and respect you show your patients and expect for yourself.

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Lateral violence in nursing is too common

The Online Journal of Issues in Nursing considers lateral violence in nursing a significant problem in the profession, citing studies estimating that 44 to 85 percent of nurses are lateral violence victims and 93 percent reported witnessing lateral violence in nursing. Although mentorship is vital when a student transitions to being a registered nurse, experienced nurses are often perpetrators of lateral violence, making new graduates and novice nurses particularly vulnerable to this type of aggression.

Examples of lateral violence in nursing

Jack Plaxe, founder of the Security Consulting Alliance, is a career security professional with nearly 30 years of experience as a consultant and corporate security director. He defines lateral violence as “behaviors between co-workers that generally fall into the categories of workplace bullying or workplace violence. However, the behavior often falls short of physical violence, leading it to not be taken as seriously as other forms of workplace violence.”

According to Plaxe, examples of lateral violence in nursing or any workplace include:

• Being hypercritical
• Blaming or put-downs
• Criticizing without solutions
• Exclusion
• Gossip
• Intimidation
• Refusing to help or support
• Sabotage
• Shouting or other unprofessional conduct
• Unfair assignments

Other examples of lateral violence include snide comments, sarcasm, belittling gestures or comments, inappropriate or unjust evaluations, withholding information, holding grudges and displaying favoritism. Even though none of these behaviors are physically violent, Plaxe says they often result in employee discontent and distress and can lead to physical violence. He goes on to suggest ways you can help put a stop to workplace violence in nursing through your own efforts and by involving others within your organization.

Training and team building

To combat bullying within the nursing profession, it’s important to increase awareness, empathy and understanding among co-workers through appropriate training and team building efforts.

“Organizations must provide training on recognizing lateral violence,” says Plaxe. “Employees must understand the difference between acceptable and unacceptable workplace behaviors."

Training on conflict resolution is also important he says because “confronting lateral violence is not easy. Conflict resolution training can help employees deal with problems and learn how to model good behavior in the workplace.”

He also suggests promoting team building because employees who feel like they’re part of a team are less likely to engage in lateral violence in nursing. Creating a support network between your peers and advocating for your fellow nurses, as you would your patients, goes a long way to promoting a team atmosphere.

Responding appropriately to lateral violence in nursing

Yelling back or remaining silent following an angry outburst, unfair criticism or other verbally abusive tactics by a co-worker isn’t the best response to lateral violence in nursing. Four key ways to respond appropriately include managing your emotions, using empathy, asserting your boundaries and making direct requests.

• Self-awareness is vital in managing your emotions, so never respond to a person behaving unprofessionally until you’re able to respond in a calm, professional manner.
• Being empathetic can help you understand why a person is behaving badly and may reveal the root of the problem, which allows you to set clear expectations and boundaries.
• Silence implies the abusive behavior is acceptable, so always tell the person their behavior is inappropriate, ask them to stop and assert your boundaries of what is and isn’t okay.
• Clearly communicate how you’d like to be treated by directly requesting the treatment and behavior you expect, instead of assuming they already know.

Involving others in your efforts

When personal efforts don’t seem to make a difference, it may be time to involve other people within your organization to get results. Start by reporting lateral violence to your immediate supervisor, and then work your way up the ladder if the problem isn’t addressed or leadership doesn’t do enough to change the situation.“

If employees and supervisors cannot deal with lateral violence, Human Resources should be brought in to assist,” says Plaxe. “HR often has professional training and investigative resources to manage situations of incivility or violence in the workplace. HR may also be viewed as a neutral third party in these situations rather than an employee who is directly involved.”

“If a situation escalates, involve security professionals,” advises Plaxe. “Security may have internal resources or access to consultants who specialize in managing workplace violence and assessing potential threats of violence.”

While you don’t have to like everyone you work with, everybody deserves to be treated with respect, including yourself. If you experience lateral violence in your nursing job, deal with it immediately, directly and professionally, and then get others involved if the behavior continues.