Posted: April 30th, 2022

Lateral violence among nurses

Lateral violence among nurses is a serious issue that affects the quality of care, the safety of patients, and the well-being of healthcare professionals. Lateral violence is defined as non-physical, aggressive, hostile, and/or harmful behavior between coworkers, such as bullying, intimidation, verbal abuse, sabotage, or undermining. Lateral violence can occur between nurses with different levels of authority or experience, or among peers with the same job title. Lateral violence can have negative consequences for individual nurses, such as stress, burnout, low morale, depression, anxiety, or turnover. Lateral violence can also impact the organizational culture, the patient outcomes, and the public perception of nursing as a profession.

According to a systematic review and meta-analysis by Zhang et al. (2023), the prevalence of lateral violence in nurse workplaces varies widely across different countries, settings, and measurement tools. The pooled prevalence of lateral violence was 40.9%, with a 95% confidence interval of 31.7% to 50.6%. The highest prevalence was found in Asia (54.8%), followed by Europe (43.2%), North America (36.9%), and Oceania (28.4%). The lowest prevalence was found in Africa (7%). The prevalence of lateral violence was higher in hospital settings (44.5%) than in community settings (28.8%). The most commonly used measurement tool was the Negative Acts Questionnaire-Revised (NAQ-R), which had a prevalence of 38.9%.

The causes of lateral violence in nursing are complex and multifactorial, but some possible factors include:

– Power imbalance: Nurses may feel powerless and undervalued in a hierarchical healthcare system that favors physicians and administrators over nurses. Nurses may also experience oppression and discrimination based on their gender, race, ethnicity, or other characteristics. These feelings of frustration and resentment may lead to lateral violence as a way of coping or expressing dissatisfaction.
– Stress and burnout: Nurses face high levels of stress and burnout due to heavy workloads, long hours, emotional demands, ethical dilemmas, and exposure to trauma and death. These factors may impair their mental health, emotional regulation, and interpersonal skills, making them more prone to lash out at their colleagues or become defensive and withdrawn.
– Lack of support and education: Nurses may lack adequate support and education to deal with lateral violence in their workplaces. They may not have access to effective conflict resolution strategies, peer support networks, mentoring programs, or counseling services. They may also lack awareness of the prevalence and impact of lateral violence on themselves and others.
– Organizational culture: The organizational culture of a healthcare institution may influence the occurrence and tolerance of lateral violence among nurses. A culture that promotes teamwork, collaboration, respect, diversity, and accountability may reduce the risk of lateral violence. A culture that fosters competition, blame, secrecy, fear, and silence may increase the risk of lateral violence.

To prevent and address lateral violence in nursing, several strategies have been proposed and implemented by researchers, practitioners, and policymakers. Some examples are:

– Policy development: Developing clear policies that define lateral violence, establish reporting mechanisms, outline disciplinary actions, and protect whistleblowers from retaliation.
– Education and training: Providing education and training for nurses on the causes and consequences of lateral violence, the skills for effective communication and conflict resolution,
the strategies for coping with stress and burnout,
and the resources for seeking help and support.
– Peer support: Creating peer support groups or programs that allow nurses to share their experiences of lateral violence,
provide emotional support,
and offer feedback and advice.
– Mentoring: Establishing mentoring relationships between experienced and novice nurses that foster trust,
respect,
and mutual learning.
– Organizational change: Implementing organizational changes that enhance the empowerment,
autonomy,
and recognition of nurses,
improve the work environment,
and foster a positive organizational culture.

Lateral violence among nurses is a pervasive problem that requires urgent attention from all stakeholders in the healthcare system. By understanding the prevalence,
causes,
and effects of lateral violence,
and by applying evidence-based interventions,
nurses can create a safer,
healthier,
and more productive workplace for themselves and their patients.

References:

Zhang Y., Li X., Liu Y., et al. Prevalence of lateral violence in nurse workplace: a systematic review
and meta-analysis BMJ Open 2023;12:e054014.
doi: 10.1136/bmjopen-2022-054014

Relias Blog What Is Lateral Violence in Nursing? By Natalie Vaughn MBA
and Elizabeth Snively
on August 23
2023 https://www.relias.com/blog/what-is-lateral-violence-in-nursing

Journal of Advanced Practice Nursing Lateral Violence In Nursing
What It Is And How You Can Cope By Allison Flynn BSN RN https://www.asrn.org/journal-advanced-practice-nursing/2371-lateral-violence-in-nursing-what-it-is-and-how-you-can-cope.html

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