When Techs Hurt Techs: Bullying and Horizontal Violence in Veterinary Medicine
Bullying and horizontal violence are workplace issues that manifest themselves among groups of people who work closely together.
While it can happen in any workplace, these issues have been studied extensively in human nursing. Horizontal violence can be defined as untoward, unkind, offensive interactions among people of the same hierarchy who aim to discredit and destroy the self-esteem and confidence of the other party.1 Consider the many relationships where horizontal violence may occur in our profession: newly credentialed technician vs tenured uncredentialed technician, treatment room staff vs receptionist, or intern vs experienced technician.
Bullying and horizontal violence are destructive to employee job satisfaction, yet these behaviors are often ignored by management. In addition to the negative effects they have on employee morale, patient care may be affected if those being bullied are unhappy in their jobs and redirect that unhappiness toward patients and/or clients. For all of these reasons, it is critical to address bullying and horizontal violence.
Although little to no literature exists on this subject in veterinary medicine, these phenomena have been widely researched and documented in human nursing. In her book When Nurses Hurt Nurses: Recognizing and Overcoming the Cycle of Bullying, Cheryl Dellasega describes nurse bullying as “relational aggression.”2 Relational aggression can take many forms—gossip, manipulation, rude gestures, harassment, creating isolated groups (cliques), exclusion, ridicule, and/or intimidation.2 In veterinary medicine, a technician can exhibit relational aggression by failing to educate coworkers on procedures or by being protective of sharing advanced knowledge. These information hogs estrange themselves from the team and halt any chance at progress the unit may have.
Dellasega argues that relational aggression stems from an overwhelming sense of powerlessness, often caused by a lack of respect in the workplace. Human nurses, like veterinary technicians, often operate within a hierarchy that places their value “below” that of the physicians. Veterinary technicians likewise suffer from a lack of autonomy. This cycle of powerlessness, job frustration, and burnout can lead to aggression and anger. In time, this anger can be misdirected at coworkers as relational aggression.
Interestingly, research demonstrates that giving employees a sense of empowerment and offering professional development opportunities can lead to positive results, both individually and within a work team.2 As a result, it can be argued that empowering and offering technicians more CE opportunities might help decrease the rate of relational aggression within practices.
Does your practice condone bullying (without knowing it)? Use this checklist to find out.
The Solution If You’ve Been Bullied
The first thing you should do as a victim of horizontal violence, or relational aggression, is realize that you did nothing to deserve the mistreatment. You are not the first and probably will not be the last victim. Bringing the incident up to management is an important part of the solution, but it is critical to be proactive by coming to the discussion with specific suggestions for how to resolve the issue. Document any incidents that occurred, particularly ones that took place in front of clients or other staff members. Schedule a private meeting with your supervisor to prevent any distractions and be nonconfrontational during the discussion. Stick to the facts, leaving out emotions, name-calling, and judgment. Saying, “I think she’s just trying to get me in trouble,” is completely different than saying, “I noticed her giving medication to my patient without telling me what it was.” In this example, the comments about thinking you might be in trouble are subjective, while identifying the actual problem (not being included in patient care) is objective and give the manager actual problems to identify and correct.
To improve your clinical confidence, read as many journals and veterinary texts as you can get your hands on. Knowledge is a powerful weapon and not only does it prevent a bully from being able to establish dominance, it also allows much better patient care. By attending local and national CE opportunities, you can learn new ideas and skills from others in the field and renew your career passion. Ask management if you can share these new things that you learn with coworkers, which will demonstrate to them and the bully that you are capable and confident. Also, joining online message boards or your local technician association is a great way to network and meet others, many who have experienced the same or similar struggles.
Placing yourself in a position of authority can affect the positive change you want to see at your facility. Offer to train newly hired employees, or supervise any technician interns or externs. Our profession often loses good candidates when they arrive to a facility and are taught by a bully. Students might assume this is how it works in veterinary clinics and choose to leave the profession instead of looking for a better place to work. A study of human nurses showed that, “…60% of newly registered nurses leave their first position within 6 months because of horizontal hostility,” and it can be assumed that the numbers are similar on the veterinary side.3 You can offer to become a mentor to students or new hires and lead the way in how everyone should be treated.
Leaving the job behind and building self-esteem through extracurricular activities are vital to success. It is important to find interests outside veterinary medicine that keep your mind off work. Whether it is reading, hiking, working out, or other hobbies, doing things unrelated to work will steer you away from mulling over work problems. Although work-related social events seem tempting, these can be breeding grounds for workplace gossip. After-work “hangouts” may not always be the best idea.
The Role of Management
Managers have a responsibility to prevent horizontal violence and stop it as soon as it becomes an issue. As managers, we can make sure that our staff has many opportunities for CE, whether through in-house product lectures and demonstrations or by providing an education allowance so staff can choose lectures they want to attend. Stress the importance of learning hard and soft skills; technicians who set catheters with accuracy can be great, but they won’t be amazing unless they have strong rapport with clients.
Providing all staff with equal opportunity for learning and growth can quiet the information hogs. Developing comprehensive training programs and establishing strict performance and qualification guidelines can help. If everyone knows what a Level 2 technician can do, and how she earned that title, there can be no question about a staff member’s capabilities. When everyone shares the same information, no one is better than anyone else and everyone is both replaceable and indispensable at the same time.
Work protocols that allow a certain level of autonomy in the workplace can go a long way in removing the feeling of powerlessness. Allowing technicians to provide input on how often to check a patient’s temperature or giving a receptionist the freedom to provide a senior citizen discount increases job satisfaction. Take complaints that your staff make seriously, and follow up with them. Have a zero-tolerance policy for hazing or bullying in your employee manual.1
What You Can Do
As bystanders, we certainly don’t want to make the situation worse by enabling bullying behavior. Addressing the bully is the most direct way to deal with the issue on another employee’s behalf, but sometimes help from management will be needed. Stand up for your coworkers, because if they weren’t bullying someone else, they would be bullying you. If someone begins gossiping or complaining about other staff members, you can simply walk away; the bully has no one to complain to if no one is standing there. Offer to mentor the new employee or victim, and teach him or her new skills or procedures. And, if you recognize that some of your own behaviors could be deemed as bullying, now is the time to change! | EVT
Stories from the Real World
Are horizontal violence and bullying real issues for veterinary technicians? You bet they are. Here are some excerpts from stories we have encountered on our fact-finding journey:
1. “I have had employees who have been ‘violent’ by my definition. We had [another employee] who screamed and yelled at other employees routinely. Unfortunately the staff never brought it to my attention in the first 90 days...why I do not know. Anyway, when I started the process of exiting her (behave or move on), she didn’t remember anything she had done.”
2. “I currently have an employee who is a bully. She has had her final warning and so far she is being good. She’s a good tech, but not worth the strife if she can’t behave herself. I think a lot of techs feel this way and for a long time we were reluctant to hire too many because the attitude of ‘they won’t fire me because good techs are hard to find’ is engrained in them. She was very offended that we talked with her about this.”
3. “My coworkers began to be very nasty toward me. Sarcastic comments and a refusal to assist me created a very hostile work environment. My coworkers refused to train me because it was not their job.”
4. “One particular tech even would go so far as to set up a situation (switch drugs on a patient’s sheet, for instance) to see if she could get me in trouble or have me injure a patient. Occasionally I would have to wait excessive amounts of time for pain meds with a screaming dog or I would predict needing postop pain meds and a tech would give Domitor IV while my patient was still intubated. As you can see, patient care
became compromised due to this attitude. I repeatedly went to my supervisor about this and even to upper management, but nothing was done.”
For related articles, please see the following:
Ask the Expert: Negative Employees Are Hurting Our Practice
A Tribe of Our Own
Online Courses for Technicians
Veterinary Support Personnel Network Courses
• Empathy and Reflective Listening; Effective Staff Meetings and Training; Managing the Front Desk; Professional Development for Veterinary Technicians; Compassion Fatigue Modules; Personnel Issues Facing the Veterinary Practice
• Creating Productive, Positive Team Meetings; Effective Communication for the Veterinary Team; Employee Training and Development
When Techs Hurt Techs: Bullying and Horizontal Violence in Veterinary Medicine
David Liss, BA, RVT, VTS (ECC) and Brandy Sprunger, CVT, RVT
1. Nursing Hostility: What is causing horizontal violence between nurses and what steps can individuals take to bring it to an end? Moye M. Advance for Nurses. nursing.advanceweb.com/Features/Article-2/Nursing-Hostility.aspx
2. When Nurses Hurt Nurses: Recognizing and Overcoming the Cycle of Bullying. Dellasega C— Indianapolis, Sigma Theta Tau International, 2011.
3. Ending Nurse-to-Nurse Hostility: Why Nurses Eat Their Young and Each Other. Bartholomew K—Marblehead, HCPro, Inc., 2006.