Letter to the Editor by Jennifer Trent to “Lateral Violence in Nursing and the Theory of the Nurse as Wounded Healer"

Promoting Healthy Work Environments: A Shared Responsibility

November 17, 2014

Response by Jennifer Trent to “Lateral Violence in Nursing and the Theory of the Nurse as Wounded Healer” by Wanda Christie, MNSc, RN and Sara Jones, PhD, PMHNP-BC, RN (December 9, 2013)

with Reply by Author

The article on lateral violence (LV) in nursing and the theory of the nurse as wounded healer (Christie & Jones, 2014) in the March issue really captured the damaging effect of LV on the entire organization and how important early intervention is to eradicate its cycle repetition. In the world where nurses are expected to advocate for autonomy, beneficence, justice, and non-maleficence, we should expect nothing less from our colleagues. As an ICU nurse, I have witnessed subtle jabs of criticism on stressful days. While the perpetrators might not have any harmful intents, the negative effects quickly diffused throughout the entire unit. Disrespectful interactions rapidly translated into substandard patient care. Studies have shown many LV cases go without reported or are ignored by the management. I am responding to this article because nurse leaders need to be observant and accept the fact that LV can happen anywhere to anyone in the organization. It is everyone’s responsibility to identify those at risk of becoming a victim or a perpetrator.

The article indicates LV incidents are often carried out by nurse leaders or managers. It is possible that the leaders’ actions are being misconstrued or perhaps leaders did not give much thoughts to the delivery of their messages. It is important for nurse leaders to find time for self-reflection in order to ensure their actions meet the intents.Leaders with high emotional intelligence are more in tune with their feelings and will take proper measures to take care the well-beings of others.

Leaders should also encourage others to frequently perform self-assessment to prevent perpetuation of the LV cycle. Ceravolo, Schwartz, Foltz-Ramos, and Castner (2012) suggest raising awareness about LV through education will create a respectful workplace. Education on lateral violence and coping strategies can improve organizational commitment and improve interpersonal relationships (Dimarino, 2011). Nurse leaders set the tone for the organization and need to communicate a zero tolerance policy on LV. Nurse leaders need to address LV at the root cause and develop policies to intervene at its earliest presence. Standardized policies and procedures communicate expected behavior from all staff members without any confusions.

Educate staff to be mindful of harmful behaviors and promote employee assistance programs for those in need. For organizations with high prevalence of LV, nurse leaders should focus on transforming the organizational culture in which novice nurses can grow professionally without harmful ridicule. All nurses, novice to experienced, need to learn to think critically, assess risks, and act autonomously in a supportive environment without any fear of repercussion.


Jennifer Trent, MBA, RN


Ceravolo, D., Schwartz, D., Foltz-Ramos, K., & Castner, J. (2012). Strengthening communication to overcome lateral violence. Journal of Nursing Management, 20(5), 599-606. Doi:10.1111/j.1365-2834.2012.01402.x

Christie, W., & Jones, S. (2013). Lateral violence in nursing and the theory of the nurse as wounded healer. OJIN: The Online Journal of Issues in Nursing, 19(1). Doi: 10.3912/OJIN.Vol19No01PPT01

Dimarino, T. (2011). Eliminating lateral violence in the ambulatory setting: One center’s strategies. AORN Journal, 93(5), 583-588. Doi:10.1016/j.aom/2010.10.019