Lateral violence: why it's serious and what OR managers can do.

AT A GLANCE . . . . . . . . . . . . .32 ASC section on page 23. Lateral violence: Why it’s serious and what OR managers can do Anurse hides a surgeon’s favorite instrument when a substitute fills in as the scrub. A circulator does not tell a new nurse who is scrubbed that she knows the shunt the surgeon selected has fallen on the floor. A newly hired RN who was previously a scrub tech is shunned by both camps. Is this just life in the OR? Is it part of a nurse’s rite of passage? Or is it something more insidious— bullying? Research suggests these behaviors are prevalent and drive nurses away. The behaviors go by several names: lateral or horizontal violence, nurse-to-nurse bullying, sabotage, or the popular phrase, “nurses eating their young.” The nursing literature over the past 20 years has documented lateral violence and its effects. Some researchers see a connection between nurse-to-nurse bullying and the behavior of oppressed groups. The thinking is that health care organizations tend to be hierarchies headed by physicians and administrators. A hierarchy places power in the hands of a few people at the top and disempowers nurses, who take out their aggressions on one another. Bullying is especially serious for newly licensed nurses, says researcher Martha Griffin, RN, PhD, because it keeps them from asking questions, validating their knowledge, and feeling like they fit in— all necessary for them to build their knowledge and become part of the organization. She has cataloged 10 behaviors that characterize lateral violence (sidebar, p 7).