There’s the expression about nurses eating their young, but the issue of lateral violence isn’t exclusive to nursing. However, with nurses being taught to be compassionate and caring, it can be a shock to encounter the opposite from coworkers.
I am not a passive or timid person by any means, but I try to ease into my bold and assertive ways when starting a new job. I would also still consider myself to be a newer nurse, with having only 4.5 years of experience, but with more senior nurses leaving my unit, I am middle of the ground now for years of service. I can remember numerous instances both on my unit and when floating that I encountered bullying behaviors from other nurses, behaviors that if I was a more passive individual might have made me question myself and if I could make it as a nurse.
I don’t know how it is on all units, as I have only worked on mine, but for the majority of the hours of the day (being a unit that is open 24/7/365), there is likely not a doctor present. The doctor generally rounds on the patients in the morning and leaves by 1600-1700. When I first started, we didn’t have a doctor on the weekend at all (unless to see a new admission briefly or to perform a face-to-face assessment on a seclusion and restraint episode). This means that the nurses working are the licensed professionals running the unit alongside a team of behavioral health technicians (BHT) who provide high quality patient care and group programming during the evening and generally there is only two nurses working on a night shift (the BHTs may work night shift depending on the needs of the unit at any given time). This leaves a lot of responsibility, with good assessment skills and critical thinking/problem solving while carrying out orders of when we may need to contact the provider for new orders or concerns.
One would think that working in an area that can be highly stressful would promote teamwork and supporting one another, practicing what we preach to the patients about interpersonal effectiveness, validation, and using their skills. It can be difficult to provide constructive feedback and set boundaries with coworkers when experiencing lateral violence that this is not behavior that will be tolerated.
With no end in sight to the current world situation, and with healthcare workers experiencing burnout from the working conditions in a pandemic, I urge you to consider your approach with others. One of the skills we teach the younger population on the unit is the ASK skill—before speaking or acting, you should consider if what you are going to do is Appropriate for the situation, Safe for yourself and others, and Kind—if these things are not all true, and you are feeling heated and wanting to still lash out, another skill you can utilize is the STOP skill—Stop what you are doing, Take a step back (physically or in your mind), also take some deep breaths, Observe what’s going on inside you and around you, Proceed mindfully (make a plan before you act after taking a moment to pause and breathe). We all need each other if we are going to make it out of these times.
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