Lateral Violence in Nursing: Insights into Healthcare Dynamics

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By Janelle

February 3, 2019



Addressing Dynamics: Insights into Lateral Violence in Nursing

I was a rookie nurse with about a year under my belt when I had a patient who gave me that first “gut feeling”. Stable vital signs, normal sinus rhythm, QT ratio within normal limits; a febrile, A & O x3… but something was different. Slowly I went through a checklist in my head: “Suction? Check. Good IV? Check. Crash cart nearby? Check”.  Later that night, my patient coded not only once, but four times.

“Hey! You did really well in there, I was pretty surprised? Even impressed… You smile a lot and laugh a lot and I don’t know… I guess I never really placed you as someone that knew what was going on around here but you proved me wrong tonight!”

I didn’t know if I had just been patted on the back or slapped in the face. That was my first encounter with lateral violence, and it has stuck with me throughout my entire career.  Lateral violence continues to be pervasive in hospitals though seemingly unrecognized and underreported. Nurse to Nurse, Nurse to CNA, CNA to Nurse, Nurse to Students, Nurse to Recruiter (ah-hem). So Why does this happen? How can we deal with it, or even stop it? How have YOU recognized lateral violence on your unit and what have you done about it?


Lateral violence can be verbal or nonverbal. My heart goes out to the Gypsies, who have both recently posted about lateral violence at their current assignments. Harsh body language, racial slurs, Emails, gossip … any form of displaced aggression that causes you to feel insecure, bullied, or upset is inappropriate and should be deemed lateral violence.


This may seem like this is a redundant question; it has yet to be discovered why people displace aggression or insecurities onto their peers. Little is known about the origin of entitlement at what point grandiose delusion is passed off as a personality trait. If I had to give my most professional opinion my conclusion has been that some people are just not nice people. As one of my (most favorite) Attendings once told me: “You cannot speak logic to illogical people”.

HOW to deal

Listen, if your mother never told you this I am telling you now: Not everyone is going to like you. It is OK. I have a bold personality and a German attitude, I am not everyone’s cup of tea and I totally understand that. However, I am a professional. I am considerate, empathetic, and polite; I expect the same from my coworkers. If you encounter conflict go to your source: approach the person in a calm manner, discuss how your feelings have been affected and seek out answers. If this doesn’t work, initiate your ladder! Management, supervisors, educators… get someone involved. This may or may not solve your issues, but with fingers crossed it will.

Finally, work on yourself. Do not react to a situation when your emotions are at a high. Take a step back… take an extended bathroom break if you need to. One of the best books I have recently read is “Presence” by Amy Cuddy. If you don’t have time to read it you should at least watch her Ted Talk. She is FANTASTIC. Recognizing your weaknesses, learning to put yourself in each moment as it is happening, dealing with conflict; she touches it all and she has been like a guru to me.

We cannot solve every conflict we will never save the world. What we can do, is bring our best face forward. Be confident in ourselves, our skills. We learn a hospital in three days, where others are given 6-12 weeks. Speak with kindness, work diligently, ensure you are part of the answer and not part of the problem. Place your entitlement in check, work with your peers and every day do your best. Most importantly “keep on keepin’ on”.

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