“Lateral Violence” — That’s News to Me–or Is It?

The term “lateral violence” is new to me.  In fact, I’d never heard of it before yesterday, when my new friend Jane Devin used the term on her blog.  She was referring to having been told about a type of “hazing” that older nurses do to younger ones who are new on the scene, making their work life harder until they learn the ropes, so to speak.  Another person and I commented that we’d never experienced that, either as nurses or as students.  Hazing?  Who had time for that, and who was immature enough to try it?

But the term stayed with me, and I wondered just how prevalent the practice was.  A quick Google search this morning astounded me with page after page of references to “lateral violence”, not only among nurses, but among female workers in general.  I found that types of behaviors considered lateral violence include:

* Backstabbing, gossiping
* Belittling gestures (deliberate rolling of eyes, folding arms, staring straight ahead or “through” when communication is attempted)
* Constant criticism, scapegoating, fault-finding
* Elitist attitudes regarding work area, education, experience
* Humiliation
* Ignoring, isolation, segregation, silent treatment
* Inequitable assignments
* Inflammatory angry outbursts, impatience
* Insults, ridicule; patronizing, or condescending language or gestures
* Intimidation, threats
* Judging a person’s work unjustly or in an offending manner
* Making excessive demands
* Sabotage, undermining
* Unfair evaluations of work
* Unwarranted criticism sarcasm
* Withholding information or support

Okay, yes, I have experienced these behaviors from fellow workers and supervisors, but not just in nursing.  Prior to nursing school I did general office work in a succession of temporary assignments, and these behaviors were rampant everywhere, particularly in offices where the majority of workers were women.  My mother, an executive secretary for over 40 years, always said she preferred working with men as opposed to women, for the very reasons listed above.  My sister and I both found this to be true when we entered the workforce.  All-female offices were often simply unprofessional hotbeds of petty behavior not conducive to productivity, in our experience.

This may not matter so much in an accounts receivable office or a production line, as far as the ultimate result is concerned.  But in nursing, such behavior can have dire, even deadly, consequences.  I do remember, my first week as a new nurse, caring for a very tall, very large man who had had a stroke.  He had no control over the right side of his body and was slipping down in bed.  I started to try to reposition him, but the bed wheel brakes had not been set and the bed began rolling.  As he kept slipping, his wife and I tried to keep him from falling to the floor, and I pulled the emergency cord for assistance.  No answer.  After a few more minutes of struggling, I pulled the cord again.  No answer.  I kicked the metal trash can across the room, hoping it would get someone’s attention.  It didn’t.  After some time his wife and I were able to position the patient safely, set the wheel brakes, and I made my way to the nurses’ station.

The scene at the nurses’ station was unbelievable.  Call lights were flashing, buzzers were going off, phones were ringing, nurses were screaming at each other, unit secretaries were sitting with their arms folded, refusing to answer call lights or phones.  I remember being so incensed that I shouted loudly, “SHUT UP!  What’s the matter with you people??”  They stopped long enough for me to relate what had just happened in the patient’s room, and though everyone was quieter after that, they all went about their work in a sullen fashion the rest of the day, barely speaking to each other.  No one was helping anyone else, and patient care was suffering as a result.

That first week there was also the incident with “hiding linens.”  When I went to the clean laundry cart to get bed linens for my patients, there were never enough sheets available.  A veteran nurse clued me in and said, “If you want sheets, you have to hide them.”  I was appalled to learn that nurses were hoarding extra bed linens in their lockers.  When the day finally came that NO linens were available for my patients, I raided every locker until I had the sheets and pillowcases I needed.  I was warned I would be making enemies among my fellow nurses.  Too bad.  Patient care comes first.  I didn’t win any popularity contests after that, but I was young and idealistic enough not to care.  I later went to work at another hospital, working closely with a small staff on the evening shift, and was fortunate to enjoy working in a much more professional environment, before leaving nursing to go on to other areas in the medical field.

So now it’s called “lateral violence.”  To me, it was simply the misfortune of working in another all-female environment.  It’s not nurse behavior, it’s female behavior of the worst kind, but the implications are more dangerous in the “helping professions.”  The stress alone that results from enduring these behaviors is distracting enough that serious mistakes can be made.

We heard a running joke that such troublemakers in the workplace had “man trouble”, that either they were in a bad relationship or had NO relationship and were taking out their frustrations on everyone else.  But it’s no joking matter.  Add to the usual stresses and strains of nursing, particularly coping with a shortage of nurses, concerns about the economy and the resulting family stresses, and you have a situation that endangers us all.

It seems more medical facilities and companies are recognizing the problem and developing strategies to lessen the incidence and impact of lateral violence, but there’s a long way to go.  The nursing profession is difficult enough without pitting nurse against nurse.  Being a part of the solution can save lives, so let’s get with it, everyone.

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