Lateral Violence and Bullying in Nursing


Lateral violence refers to acts that occur between colleagues, where bullying is described as acts perpetrated by one in a higher level of authority and occur over time. The acts can be covert or overt acts of verbal or non-verbal aggression. Relational aggression is a type of bullying typified by psychological abuse. Behaviors include gossiping, withholding information and ostracism. Behaviors can extend outside the workplace and can occur in person or in cyberspace. (Dellasega, C. 2009).

How widespread are lateral violence and bullying in healthcare? Workplace violence is a confirmed critical world-wide issue.

  • 48% nurses, pharmacists and others reported strong verbal abuse (Institute for Safe Medication Practices, 2004).
  • 43% nurses, pharmacists and others reported experienced threatening body language (Institute for Safe Medication Practices, 2004).
  • A study of student nurses reported that 53% had been put down by a staff nurse (Longo, 2007).
  • 56.9% reported having been threatened or experienced verbal abuse at work (ANA, 2001).

What is the Impact of Lateral Violence and Bullying in Nursing?

  • 40% of clinicians “kept quiet” or “ignored” an improper medication due to an intimidating colleague (Institute for Safe Medication Practices, 2004).
  • Unmanaged anger contributes to hypertension, coronary artery disease, depression, psychological problems or other health problems (Meyers, 2006).
  • Low staff morale, increased absenteeism, attrition of staff, deterioration in the quality of patient care. (Hughes 2008).
  • Nurses leave the profession due to lateral violence and bullying contributing to the nursing shortage.


  • Zero tolerance toward violent or abusive behavior (Rowell, 2010).
  • Protection from retribution if reported. (Rowell, 2010).
  • Utilize employee assistance program (Rowell, 2010).
  • Interrupt the violence. (Griffin, 2004).
  • Assess the nursing unit and raise awareness. (Dellasega, 2009).
  • Brainstorm solutions and encourage dialogue. (Dellasega, 2009).
  • Create unit specific guidelines. (Dellasega, 2009)


  • American Nurses Association. (2001). Health and Safety Survey.
  • Dellasega, C. (2009). Bullying among nurses. American Journal of Nursing, 109 (1), 52-58.
  • Griffin, M. (2004). Teaching cognitive rehearsal as a shield for lateral violence: An intervention for newly licensed nurses. Journal of Continuing Education in Nursing. 35, 257-263.
  • Hughes, N. (2009). Bullies in health care beware. American Nurse Today. 3(6), 35.
  • Institute for Safe Medication Practices (March 11, 2004). Intimidation: Practitioners speak up about this unresolved problem (Part I).
  • Longo, J. (2007). Horizontal violence among nursing students. Archives of Psychiatric Nursing, 21, 177- 178.
  • Rowell, P. A. Lateral Violence: Nurse Against Nurse.

Selected Web Resources