Lateral Violence in Nursing: Effects and Prevention Strategies
This paper examines lateral violence (LV) in nursing practice, a pervasive form of workplace misconduct that includes verbal, emotional, and physical abuse among healthcare staff. The paper defines lateral violence and distinguishes its overt and covert forms, reviews prevalence data showing that between 44% and 85% of healthcare workers are exposed to it, and details its wide-ranging consequences—including depression, absenteeism, nursing turnover, compromised patient care, and significant financial costs to healthcare organizations. The paper concludes by outlining evidence-based strategies that nurse managers and leaders can employ to identify, address, and ultimately reduce lateral violence within their institutions.
- Definition of Lateral Violence: Defines LV and catalogues overt and covert forms
- Prevalence and Incidence of Lateral Violence: Prevalence data and who is most affected
- The Impact of Lateral Violence: Effects on nurses, patients, and institutions
- Deterring Lateral Violence: Nurse leader strategies to reduce and eliminate LV
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What makes this paper effective
- The paper moves logically from definition to prevalence to impact to intervention, giving readers a clear and sequential understanding of the problem.
- Specific statistics (e.g., 44%–85% exposure rates, financial costs of $30,000–$145,000) ground the argument in evidence and increase persuasive force.
- The paper distinguishes between overt and covert forms of lateral violence, showing nuanced understanding of how workplace misconduct operates in practice.
Key academic technique demonstrated
The paper consistently uses multiple peer-reviewed nursing sources to triangulate claims, rather than relying on a single citation. For example, prevalence rates, financial costs, and intervention strategies are each supported by different studies, demonstrating how to synthesize a literature base to build a multi-faceted argument.
Structure breakdown
The paper is organized into four sections. The first defines lateral violence and catalogues its behavioral forms. The second presents epidemiological data on how widespread the problem is in nursing. The third section — the most developed — explores consequences for individual nurses, patients, institutions, and the broader profession. The final section pivots to solutions, outlining the role of nurse leaders in education, policy enforcement, and cultural change. Each section builds on the previous one, creating a problem-solution arc.
Definition of Lateral Violence
There is no universally accepted definition for lateral violence. The same phenomenon is also variously referred to as horizontal violence, bullying, workplace violence, and nursing incivility. According to the American Nurses Association (2011), lateral violence refers to verbal, emotional, or physical abuse. Lateral violence is a common phenomenon in nursing practice — one that is costly both to the healthcare organization and to the individual nurse's mental and physical health. The incidence of lateral violence compromises the quality of healthcare within any facility where it occurs, and poor patient health outcomes are a frequent result (Hill, 2014). This paper explores the effects of lateral violence on healthcare and establishes its relevance to nursing practice.
In precise terms, lateral violence is disruptive. It is a phenomenon that destroys the people and objectives of healthcare provision. Lateral violence involves inappropriate and disruptive conduct by an employee within a healthcare environment, and such behavior may be directed toward a colleague at the same level or toward a junior member of staff. Although certain employees display this behavior openly, it is more often subtle, quietly administered, and repeated over time — growing worse as it continues. Observed in isolation, such behavior may seem harmless at first glance; however, the cumulative effect of aggressive behavior and insults amounts to seriously harmful practices for the nurses who are targeted (Christie & Jones, 2014).
Lateral violence (LV) follows a consistent pattern of behavior deliberately designed to demean and undermine the self-esteem of peer members, and it may also be directed at a group. Verbal abuse is the most common form, encompassing all manner of professional and personal mistreatment. Lateral violence includes both overt and covert behavior aimed at demeaning other healthcare workers, with covert LV being the most destructive. Covert behaviors associated with lateral violence include sarcastic comments, unfair work assignments, ignoring colleagues, eye-rolling, making faces behind someone's back, whining, sighing, refusing to assist colleagues even when time and workload allow, exclusion, sabotage, fabrication, and isolation (Embree & White, 2010). Other behaviors with similar effects include withholding information, scapegoating, infighting within groups, gossiping, and intrusive conduct that fails to respect the privacy of others (Roberts, 2015).
Prevalence and Incidence of Lateral Violence
Nursing is the occupational group most at risk of lateral violence. Research shows that between 44% and 85% of healthcare staff are exposed to lateral violence, and 93% of nurses have reported witnessing it in their workplace. The behavior is typically perpetrated by experienced nurses, while novice nurses — particularly nursing students and newly licensed nurses — are most often the victims. Due to the widespread prevalence of this practice, it has become nearly normalized within nursing environments and frequently goes unreported (Christie & Jones, 2014).
Accurate incidence data for lateral violence in nursing is broadly unavailable; however, more recent reports indicate that the vice is widespread, with rates ranging from 65% to 80% among surveyed nurses. Research conducted among junior nursing students illustrates that lateral violence incidents can occur as early as the first interaction between a student nurse and the experienced nurse they are assigned to work with. Graduate nurses who encounter LV report high rates of absenteeism, and some contemplate leaving the profession altogether (Becher & Visovsky, 2012). LV also extends beyond the nursing hierarchy to include doctors and staffing supervisors, who were found to represent 49.1% and 26.9% of perpetrators, respectively. Furthermore, lateral violence is not confined to peer-level relationships — it has been documented extending from nursing leadership downward to staff under supervision (Becher & Visovsky, 2012).
References
American Nurses Association. (2011). Lateral violence and bullying in nursing. Retrieved from
Becher, J., & Visovsky, C. (2012). Horizontal violence in nursing. Medsurg Nursing, 21(4), 210.
Christie, W., & Jones, S. (2014). Lateral violence in nursing and the theory of the nurse as wounded healer. Online Journal of Issues in Nursing, 18(4).
Embree, J. L., & White, A. H. (2010). Concept analysis: Nurse-to-nurse lateral violence. In Nursing Forum (Vol. 45, No. 3, pp. 166–173). Blackwell Publishing Inc.
Hill, A. (2014). Lateral violence experienced by nurses in the workplace.
Roberts, S. J. (2015). Lateral violence in nursing: A review of the past three decades. Nursing Science Quarterly, 28(1), 36–41.
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