Omar Bennett
Lateral violence, also known as horizontal violence, is a form of bullying that is prevalent in the healthcare industry, particularly among nurses. It refers to passive-aggressive and harmful behaviours between coworkers, such as exclusion, gossip, humiliation, and intimidation. The failure to report lateral violence contributes to a toxic work environment, low morale, high turnover rates, and diminished productivity. It also has significant mental health impacts on victims, leading to symptoms such as anxiety, depression, and post-traumatic stress disorder (PTSD). Additionally, it affects the quality of patient care and increases the risk of adverse patient outcomes. Therefore, it is essential to address and prevent lateral violence in the healthcare industry through comprehensive plans, improved communication, and fostering healthy work cultures.
| Characteristics | Values |
|---|---|
| Definition | Bullying, also called horizontal or lateral violence, is defined as non-physical, harmful, or hostile behavior between coworkers. |
| Prevalence | Studies estimate 44%-85% of nurses have experienced lateral violence, and up to 93% have witnessed it. |
| Forms | Verbal assault, threatening, humiliating, intimidating behaviors, sabotage, exclusion, withholding information, displaying disinterest, and stalking. |
| Impact on Victims | PTSD, anxiety, depression, insomnia, high blood pressure, gastrointestinal issues, negative self-image, substance use disorders, and suicidal ideation. |
| Impact on Organisations | Low morale, high turnover, increased absences, clinical errors, low productivity, reduced quality of care, and increased risk of adverse patient outcomes. |
| Barriers to Reporting | Fear of retaliation, lack of awareness of reporting protocol, and discomfort discussing incidents within the team. |
| Prevention Strategies | Strong reporting systems, zero-tolerance policies, conflict management strategies, team building, and training on lateral violence. |
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What You'll Learn
Fear of retaliation
Nurses who experience lateral violence often face challenges in reporting their abuse due to fears of retaliation. The power dynamics within the nursing profession can make it difficult for lower-level nurses or newer nurses to speak up against their superiors or more experienced colleagues. They may worry about potential repercussions, such as further bullying, ostracism, or negative consequences for their career. This fear is heightened when the perpetrators of lateral violence are organisational managers or directors, as victims may feel they have no one to turn to for support.
To address this issue, it is crucial to implement effective reporting systems that prioritise confidentiality and protect the identities of those who report lateral violence. Creating a safe and supportive environment for reporting can encourage victims to come forward without fear of retaliation. This may involve establishing clear protocols for reporting incidents, ensuring anonymity, and providing multiple avenues for reporting, such as hotlines or external reporting mechanisms.
Additionally, fostering a culture of zero tolerance for lateral violence is essential. Nursing leaders and management must set the tone by modelling positive behaviours, promoting respectful interactions, and enforcing consequences for perpetrators. By establishing a strong stance against lateral violence, nurses may feel more empowered to speak up without fearing retaliation, as they witness a commitment to addressing and preventing such behaviours.
Furthermore, encouraging teamwork and building strong bonds between team members can help mitigate the fear of retaliation. When nurses feel supported by their colleagues and sense a collective commitment to addressing lateral violence, they may be more inclined to report incidents. Creating a unified front against lateral violence can help isolate the perpetrators and send a clear message that such behaviours will not be tolerated. This can be facilitated through team-building activities, group goal setting, and open communication channels.
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Lack of awareness of reporting protocol
Nurses have a responsibility to report incidents of lateral violence. However, they may be reluctant to do so due to fear of retaliation or blame, as well as uncertainty about the reporting process. This silence allows the problem to escalate, impacting not only the targeted nurses but also their co-workers and patients. It contributes to a toxic work environment, low morale, high turnover rates, increased absences, clinical errors, diminished productivity, and reduced quality of care.
To address this issue, it is crucial to implement a strong reporting system that ensures confidentiality, clearly outlines consequences, and provides a supportive process for victims. Leaders and managers must set the tone by modelling positive behaviours, endorsing conflict management strategies, generating awareness, and encouraging team-building activities. Creating a comprehensive plan that addresses lateral violence, sets team expectations, and improves team satisfaction can help prevent and stop negative behaviours.
Additionally, involving Human Resources (HR) professionals can be beneficial, as they are trained to mediate hostility in the workplace and provide an objective perspective. Encouraging teamwork, fostering healthy relationships, and improving communication can also help reduce the occurrence of lateral violence. By addressing the lack of awareness of reporting protocol and providing clear guidance and support, organisations can empower nurses to speak up and take action against lateral violence.
Furthermore, it is important to recognise that lateral violence is not limited to peer-to-peer interactions. It can also be perpetrated by individuals in positions of power, such as organisational managers and directors, against lower-level nurses or those new to the profession. In such cases, victims may feel even more uncomfortable reporting the abuse due to the power dynamics involved. Therefore, it is essential to have robust reporting mechanisms in place that protect the reporter and hold the perpetrators accountable, regardless of their position within the organisation.
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Failure to implement a zero-tolerance policy
Nursing, in particular, has a high prevalence of lateral violence. It is estimated that up to 85% of registered nurses have experienced lateral violence, with 93% witnessing the bullying of a coworker. This type of violence can lead to a toxic work environment, low morale, high staff turnover, increased absences, clinical errors, and low productivity. Additionally, victims of lateral violence in nursing may experience symptoms of PTSD, anxiety, depression, insomnia, and even suicidal ideation or behaviours.
Implementing a zero-tolerance policy is crucial to address lateral violence effectively. This involves developing clear expectations and consequences for lateral violence, leading by example, endorsing conflict management strategies, generating awareness, and encouraging team-building activities. A strong reporting system is also essential, ensuring confidentiality for victims, clear communication of consequences for perpetrators, and the involvement of a diverse task force, including HR, administrative, and nursing staff.
Failing to implement a zero-tolerance policy can result in the normalisation of lateral violence, perpetuating a cycle of abuse. It can lead to increased stress, anxiety, and mental health issues among nurses, impacting their job performance and compromising the quality of patient care. Additionally, it can contribute to high staff turnover rates, with experienced nurses leaving their positions and creating further staffing shortages in an already understaffed industry.
Therefore, it is imperative for healthcare organisations to take proactive measures to prevent and address lateral violence. By fostering a culture of mutual respect, empathy, and inclusion, healthcare institutions can create a positive and safe work environment for nurses and improve patient care outcomes.
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Unclear consequences for perpetrators
Lateral violence in nursing refers to peer-to-peer, passive-aggressive behaviours that result in hostility. It is a form of bullying, also called horizontal violence, and is defined as non-physical, harmful, or hostile behaviour between coworkers. It is important to distinguish lateral violence from incivility, which umbrellas a range of disrespectful behaviours that may not always have a negative intent. Lateral violence, on the other hand, stems from an intent to harm others.
Nurses have a responsibility to themselves and their coworkers to report incidents of lateral violence. However, one of the reasons nurses may be hesitant to report lateral violence is unclear consequences for perpetrators. When consequences for perpetrators are unclear, it can create a sense of uncertainty and ambiguity about the potential outcomes of reporting. This lack of clarity can deter nurses from coming forward with their experiences of lateral violence.
In some cases, nurses may fear retaliation or blame if they report incidents of lateral violence. This is especially true when the perpetrators are in positions of power or are more experienced. Nurses may feel uncomfortable or afraid to speak up against their superiors or peers, anticipating potential repercussions. The fear of retaliation can lead to a culture of silence, where nurses endure lateral violence without seeking support or reporting the incidents.
Additionally, the lack of clear consequences can contribute to a perception of institutional indifference or inaction. If nurses do not see any defined disciplinary actions or repercussions for perpetrators, they may feel that their reports will not lead to meaningful change. This perception can further discourage nurses from reporting lateral violence.
To address this issue, it is crucial for healthcare organizations to establish and communicate clear consequences for perpetrators of lateral violence. This can include developing and widely disseminating a zero-tolerance policy that outlines the specific repercussions for engaging in lateral violence. By clearly defining and educating staff about the consequences, healthcare organizations can empower nurses to report incidents without fear or hesitation.
Furthermore, involving Human Resources (HR) professionals can be instrumental in addressing lateral violence. HR professionals are trained to mediate hostility in the workplace and can provide an objective perspective. They can help establish clear protocols for handling reports of lateral violence and ensure that consequences are enforced consistently and fairly. By engaging HR, healthcare organizations can demonstrate their commitment to addressing lateral violence and provide nurses with a sense of security and support.
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Absence of a safe reporting system
Nurses have a responsibility to report lateral violence, but they often face barriers due to fear of retaliation, especially when the perpetrators are in positions of power, such as managers or more experienced colleagues. This fear is not unfounded, as victims of lateral violence who do speak up may find their concerns dismissed or blamed for their treatment, further isolating them.
Additionally, a lack of standardised definitions of bullying, lateral violence, and harassment can make it challenging for nurses to recognise and report these issues effectively. Without clear guidelines, incidents may go unreported or be mislabelled, hindering the implementation of preventative measures.
The absence of a safe reporting system has significant consequences. Lateral violence contributes to high turnover rates, with nurses leaving their positions or even the profession due to the detrimental impact on their mental health and well-being. It also affects the quality of patient care, as nurses experiencing lateral violence may detach from their work, leading to reduced collaboration and increased risk of errors.
To address this issue, nursing leaders must develop and promote a "zero-tolerance" policy for lateral violence. This includes establishing clear expectations, consequences, and reporting protocols. Confidential reporting mechanisms are essential to alleviating victims' fears of retaliation. By fostering an environment where nurses feel supported and valued, leaders can encourage reporting and effectively address lateral violence.
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Frequently asked questions
Lateral violence is a form of bullying, also known as horizontal violence, which is defined as non-physical, harmful, or hostile behaviour between coworkers. It is quite common among nurses and can include gossiping, exclusion, or intimidation.
Lateral violence can have significant negative impacts on the mental health and well-being of nurses, leading to symptoms such as anxiety, depression, post-traumatic stress disorder (PTSD), and substance use disorders. It also contributes to high staff turnover, low morale, increased absences, and reduced quality of patient care.
It is essential to report incidents of lateral violence to create a safe and positive work environment. You can involve Human Resources (HR) as they are professionally trained to mediate hostility in the workplace. Additionally, you can encourage teamwork, set group goals, and praise team members to foster a positive team culture.
Failure to report lateral violence can be considered a violation of the American Nurses Association Code of Ethics. It perpetuates a hostile work environment, contributes to the marginalization of nurses, and increases the risk of errors in patient care. By not reporting lateral violence, individuals become complicit in creating an unsafe and toxic work culture.
