Horizontal Violence: Part I

Horizontal or lateral violence has been widely recognized as a problem in health care professions and especially in nursing. Nurses “eating their young” is such a commonly used phrase that I’m not sure people even take it seriously any more. It has been a widespread issue for decades in our profession , one that we should not only be ashamed of but that we should make every effort to eliminate.

I remember being a student nurse in the mid-1980′s. I was very unsure of myself back then. All of us juniors were struggling with our schedules and with wondering if we were making the right career choice, and I was no exception. I was strong academically but tended to be anxious in some situations and was surprisingly shy and tentative when talking to the nurses on the floor.

During one rotation on a medical-surgical unit at an inner city hospital in Massachusetts, I couldn’t find my instructor and had several questions for the primary nurse taking care of my patient. She was becoming more and more impatient with me, and ultimately lost her temper and really let me have it. I was mortified. She reduced me to tears, and my clinical classmates rallied around to try to find our instructor and ease some of the pressure (as it turned out, that nurse had recently been discharged from the hospital’s psychiatric unit and was known to have many emotional and personality issues; remember, HIPAA didn’t exist back then).

I don’t recall the events that led up to her tantrum, but I knew I would never forget the way she made me feel and the intimidation she inflicted on me.  I vowed back then that I would never treat a student or new nurse the way she treated me – I would always try to be patient and approachable.

During my years as a clinical staff nurse, I had the opportunity to precept and mentor many nursing students and newly graduated nurses. Some tried my patience but I always endeavored to be the nurse I wish that nurse in 1986 had been. I tried to think of each experience as an opportunity to help that student or nurse grow as a caregiver, clinician, and person, and I always realized that that person could be MY co-worker, relief, or nurse some day. I wanted them all to think back on their time with me as a positive experience, and hoped that I never subjected them to the anxiety, fear, and self-doubt that was inflicted on me back then.

This is a topic I will explore more in the future, as it is something that I’ve found both disturbing and fascinating throughout my career. I would welcome all thoughts, discussion, solutions, and other dialog!


  1. Over the years I’ve seen plenty of Nurses do wonderful work with both patients and others like coworkers or students, and I’ve seen plenty entirely miserable Nurses who seemed to hate all of humanity much of the time. I recently read a post about how poorly Nurses are trained about self-care, and not surprisingly, even up doing a poor job of it more often than not. We Nurses take care of others strikingly better than we do ourselves. Reading this post, it occurred to me that theses two issues are likely related: if we took better care of ourselves, we’d likely have less burn-out, better attitudes, and more energy and focus to give to others in need. Nursing education and training needs to emphasize self-care more, as well as people-skills.


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