“Nurses eating their young” is the metaphor used in the nursing community to describe mistreatment of nurses by other nurses (Stanley, 2007). Hostilities and verbal, physical and psychological abuse between nurses has persisted for decades (Sheridan-Leos, 2008). The terms horizontal violence and lateral violence are often used to describe the abuse.
Horizontal Violence and Lateral Violence
These terms, horizontal violence and lateral violence, are based on the source of the mistreatment; the abuser and his/her victim are on the same level in the hierarchy, thus the terms horizontal and lateral. Although abuse may come from other sources, the source of much of the bullying, intimidation, gossiping, and verbal abuse within the nursing profession is from the other nurses.
Nurse-to-Nurse Abuse
The pervasiveness of the problem is disturbing, and such behavior seems especially misplaced in an environment devoted to caring, but nurse-to-nurse abuse has a long history. If this issue of hostility between nurses is of any import, how has it continued for so long without consequence to the profession?
Nurses Eating Their Young, a Decades-old Practice
Abuse between nurses, after all, has been prevalent in the nursing profession for years, and the nursing profession has endured. Why would the issue of “nurse-to-nurse hostility” (Bartholomew, 2006, pp. 5-6) be of vital concern now? The answer is that the issue has always been a vital concern in healthcare, but the nursing shortage has heightened this concern.
Importance of the Nursing Profession
To understand the importance of nursing to healthcare, consider the following legal case study. A 70 year-old female patient underwent surgery to treat a perforated duodenal ulcer. The surgery was successful, and after ten days in the intensive care unit the patient was transferred to the telemetry unit. But eight hours after the transfer the patient was dead.
“...The nurse was making her normal rounds and discovered the decedent lying on the floor of her room in a pool of blood, the result of a disconnected central venous catheter. A 'code blue' was called, but the decedent could not be revived. The cause of death was listed as hemorrhage” (Laska, 2007).
Medical Care Requires Nursing Care for Success
Although the surgical procedure was successfully completed, the patient died due to a lapse in nursing care and supervision. This incident demonstrates that the benefits of therapy, surgery, or other medical intervention may be completely negated without the complement of competent nursing care. Faye Satterly, author of Where Have All the Nurses Gone?, elaborates on this theme.
Fewer Nurses Means More Deaths
In her book, Satterly addresses the crisis in healthcare that a nursing shortage will cause, and citing a study she explains that “.…researchers concluded that for each patient added to a nurse’s workload, the patient’s risk of dying within thirty days of admission increased by 7 percent. For example, the risk of death increased to 14 percent if a nurse’s assignment increased from four to six patients. Fewer nurses means more deaths, and nurse-to-nurse mistreatment contributes to reducing the numbers and effectiveness of nurses in healthcare. Nursing care is vital to healthcare, so the well-being and treatment (or mistreatment) of nurses is accordingly crucial.
How Nurse-to-Nurse Abuse Affects Nurses
Mistreatment between nurses adversely affects nursing proficiency and performance. According to the article "Nurse on Nurse" published in the Nursing Forum and authored by C. Woelfie and R. McCaffrey , “Impaired personal relationships between nurses at work can cause errors, accidents, and poor work performance…When tensions are high, nurses are unlikely to perform at their best and the result is often poor patient care” (2007, para.1). In addition, hostility in the nurses’ workplace adversely affects the mental and physical health of nurses.
Peer Abuse Makes Nurses Sick
Nurses who are subjected to such hostility “have been diagnosed with illnesses such as depression, acute anxiety, post traumatic stress disorder…weight loss, weight gain, hypertension, cardiac palpitations, and irritable bowel symptoms” (para.4). As a result of the ill-effects of the workplace hostility, there is a “increased staff turn-over rate and more use of sick time, also nurses lack the initiative to do their job well” (para.4).
Some Nurses Just Leave
Some nurses respond to the duress of a hostile workplace by leaving the nursing profession, and “approximately 60% of newly registered nurses leave their first position within six months because of some form of (lateral violence)” (Stanley, K., 2007, para.6). But, leaving the profession does not resolve the problem of nurse-to-nurse hostility; in fact, the exodus of nurses further threatens healthcare. Because healthcare is important, finding remedies for the problem of nurse-to-nurse hostility in the healthcare field is important.
You May Require Nursing Care in the Future
All human beings are subject to injury, disaster, emotional trauma, illness, and mental distress during their lifetime; therefore, everyone and anyone may require a nurse’s care at some point in his or her life. Accordingly, nursing care is of vital concern to everyone, and a phenomenon such as “nurse-to-nurse hostility” that adversely affects the ability of nurses to provide care is also of vital concern to everyone. “Nurse-to-nurse hostility” poses a serious threat to the nursing profession and must be addressed (Bartholomew, p. 10).
References
Bartholomew, K. (2006). Ending nurse-to-nurse hostility: why nurses eat their young and each other. Marblehead, MA: HCPro.
Geppert, C. (2005). In praise of psychiatric nurses. Psychiatric Times. 22(6), 46-47
Laska, L. (ed). (2007) Nursing care negligent in monitoring patient, patient found dead - $125,000 California Settlement. Medical Malpractice Verdicts, Settlements & Experts. Nurses Service Organization. NSO.com
Madkour, R. (2009). "Amid nurse shortages hospital focus on retention." Associated Press.
Satterly, F. (2004). Where have all the nurses gone? The impact of the nursing shortage on American healthcare. Amherst, NY Prometheus Books
Sheridan-Leos, N. (2008). Understanding lateral violence in nursing. Clinical Journal of Oncology Nursing. 12(3), 399-403.
Woelfie, C & McCaffrey, R. (2007). Nurse on nurse. Nursing Forum. 42 (3), 123-132
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