Monday, September 2, 2013


horizontal violence, vertical violence, lateral violence, incivility

New nurses fear two things when they start their first job: Making a mistake and that the other nurses will eat them alive! Really. I’ve talked with many student and graduate nurses over the years and get asked the same question: “What do I do if the nurses are mean?
Unfortunately, they have every right to be worried.  

I once witnessed a new nurse on her very first day, approach the unit secretary and announce that she was there to start work. The unit secretary, who didn’t smile or even acknowledge her presence, shouted to another nurse, “Hey Carol. Your baby nurse is here.” Carol looked up and said, “Great” sarcastically and then said to her, “Look. I don’t want to be a preceptor and I tried to get out of it but couldn’t. Just don’t get in my way and try not to kill anyone okay?”
The look on this new nurse’s face was a look of terror.

Horizontal violence has been going on for a long time and although there are a lot of theories behind why nurses “eat their young” and what bullying looks like, not a lot has been done to stop it. One of the reasons that this issue has gone on for so long is because we accept it as the norm. We just tolerate or try to ignore them. Many bullies keep their jobs because they’re either great clinicians, work a lot of overtime, or because everyone’s afraid to confront them. It’s not right however it is the truth. Until we can come together as a profession, take ownership of our behavior and hold others accountable, bullying will continue. 
Instead of worrying that the nurses will eat them alive, new nurses need to focus on learning how to effectively care for patients.

However, there is something YOU can do.

If you find yourself the victim of horizontal violence as a new nurse, consider these 3 options:

1.     Confront the aggressor
Many schools of nursing are now incorporating conflict resolution into their curriculum – a much needed skill to learn! If you are confident in your communication skills, try to confront the bully.  Just a simple, “I need your support – not your criticism” or “Please stop criticizing me in front of everyone”, etc. may be the conversation that turns things around. It may send a message to the bully that you are not an easy target.

2.     Ask for help
Although confronting the aggressor is a great strategy, many new nurses don’t have the courage. That’s okay. I didn’t either and found myself an easy target until I gained confidence and was able to stick up for myself. If you are not comfortable with confrontation, ask your preceptor, nurse educator, or unit manager for help (this is implying that they are not the bullies!). Let them know what’s been happening – don’t assume they know. Remember, some bullies use covert tactics to abuse their victims and it might not be obvious to others.

3.     Climb the ladder
If you are not getting support from your unit leadership, take it up the chain of commands. Don’t let it stop at the unit level. Organizations now have mandated codes of conduct to comply with regulatory agencies (The Joint Commission). If you take your complaint to senior leadership or the Human Resource Department, they have no choice but to take it seriously and address the destructive behavior.

You deserve to work in a supportive, nurturing environment. If that’s not happening, speak up! 

Thanks for reading. Would love to read your comments on this important topic.  Thanks for choosing to become a nurse! I am cheering for your success.


For more tips to help you succeed as a new nurse, click here!

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1 comment:

  1. Thank you for sharing such wonderful information! Being a nurse is a challenging job, so it must be a great passion and good dedication that makes one can pass all the difficulties.

    Gastroenterology Nurse