No matter where I worked or what role I had, I experienced and witnessed bullying and incivility by other nurses. Lateral violence is alive and well, exists in every role, and is present at every level. I got to the point where I was no longer willing to accept lateral violence as the norm, “Well, that’s just the way it is in nursing.” Therefore, I’ve spent the last 10 years DOING something about it!
When lateral violence isn’t stopped, bad things happen to employees AND the patients they serve.
We have proof bullying harms nurses and patients
Numerous studies show a strong correlation between disruptive behaviors, employee retention and patient outcomes. Here are just a few:
- A study by Berry and Gillespie showed that novice nurses reported that 21% of them are exposed to bullying on a daily basis (2012).
- 2016 National Healthcare Retention & RN Staffing Report showed that 70% of nurses reported an association between disruptive behaviors and compromised quality of patient care.
- 60% of new nurses who quit within 6 months cite disruptive behaviors from their coworkers as the cause (Townsend, 2012).
If we have evidence showing the negative impact lateral violence has on employees and patients, then why is lateral violence still happening in healthcare?
Human Behavior is Complex
If a nurse makes a clinical mistake, they are reprimanded in some way. However, if a nurse sabotages, undermines, or shows favoritism when making assignments, we tend to ignore it. Why? Because it’s not as simple as saying (basically), “You gave a double dose of Dilantin by mistake. We have to write you up. Don’t do it again.”
Human behavior is so complex. There are many reasons why someone behaves a certain way and it’s not easy to objectively articulate or prove. For example, when someone says, “He deliberately didn’t tell me in report that the physician wanted to be notified immediately when the patient’s family arrived (resulting in an ear beating by the physician).” He can easily lie and say, “I told you. You just never listen.”
Many bullying tactics are hard to prove because you’re dealing with human behavior, which is VERY complex.
We understand human behavior
At the Healthy Workforce Institute, we’ve learned a lot about bullying and what leaders and employees can do to stop it. We’ve simplified the human behavior complexity issue in ways that make it easier for you to manage the mess.
Here are a few things you need to know about lateral violence so that you can stop it too!
7 things you need to know: They…
Need targets to survive
Think about it. If everyone stood up to the bullies, they wouldn’t have anyone to bully! The only reason they exist is because they have targets to squash.
Starting TODAY, make the decision NOT to be a target. Speak up for yourself and immediately address any attempts to treat you poorly.
If you want to kick it up a notch, don’t let anyone else become a target either!
Tend to be really good at their job
One of the reasons why bullies are still employed, despite numerous complaints, is that they tend to be really, really good at their jobs. For a leader, it’s easier to justify, rationalize, or even defend bad behavior when it comes from your “best” nurse.
We do the same thing with providers. We tolerate their badness because they are sooooo good.
Starting today, stop saying, “He’s a great nurse…but…” or, “She’s a great physician…. but…”
We need to stop justifying bad behavior just because someone is competent.
See the workplace as a battlefield
Bullies operate from a win-lose mindset and every day they get prepared for battle to win the war. If you’re their target, many times, you walk into an unsuspecting battlefield, and without warning, get attacked.
We also need to prepare for battle. Be on guard – always.
Like to keep their targets walking on eggshells
When working with a bully, their targets feel like they are walking on eggshells. Sometimes they’re nice and then whammy!
You let your guard down and they zing you. Just assume all attempts to be nice to you are fake.
Don’t play by the rules
They cheat, lie, and don’t play fair. The reason why we have so many targets in healthcare is because we are the “do-gooders” and play by the rules. Bullies don’t. Our ANA Code of Ethics provides a blueprint for clinical and professional behavior. Bullies chew up our code and spit it out.
Don’t expect them to play fair.
However, just because they don’t play fair doesn’t mean that you should follow suit.
Always be the consummate professional but don’t have any illusions about their integrity.
Have low emotional intelligence
We’ve interviewed many bullies and discovered that the bullies don’t actually think they’re the bullies! It’s because bullies lack self-awareness, which is a key characteristic of emotional intelligence.
Stop spending time and energy thinking that they know exactly what they’re doing. Bullies tend to justify their behavior and therefore, don’t think they’re bullies. That doesn’t mean you ignore them. By using my confronting techniques such as “Name it”, “Script it”, and “Speak it”, you’re helping them to become more self-aware.
After all, how can you expect someone to adapt their behavior if they’re not even aware their behavior needs to be adapted?
May not be mentally healthy
Think about it. How could an educated, competent, licensed professional who is caring and compassionate to their patients, treat others with such cruelty? Something’s not right there. They may be suffering from mental health issues. That’s not to say that anyone who is cruel has a psychological disorder, however, we can all agree that they aren’t mentally HEALTHY if they can treat others with such cruelty.
Realize that you can do everything right but the bullies may still not be capable of adapting their behavior.
There are times that I wish I could go back to the first time someone tried to set me up to fail, or the first time I witnessed one of my colleagues being openly criticized in the middle of the hallway.
I wish I wouldn’t have been so naive every time I started a new role, thinking everyone would go out of their way to support me and then blamed myself when they didn’t.
I trusted strangers because we were nurses and I assumed all nurses would protect each other, like an exclusive club that members take an oath to honor, protect, and serve each other.
I wish I would have known THEN what I know NOW about lateral violence.
We can and need to do better. Are you with me?