“Bullies scan groups for the weakest. Maybe it is an evolutionary remnant of our place in the animal kingdom. All predatory species select and attack the weakest pray.”
- The Bully at Work

Whether a new hire, a transfer from another department, or a new resident nurse, any member introduced into a powerless group is at high risk for experiencing horizontal hostility. Horizontal hostility is used to break nurses into the group or, in terms of opposition theory, to acculturate them into the group. This is how we teach those unspoken rules. If the status quo is rocked in any way, fear escalates and expresses itself as horizontal hostility. It’s as if “until she is one of us, she is a threat.” The last thing new nurses need today, however, is a difficult rite of passage.

While new graduates are easy prey to horizontal hostility, nurse managers are also extremely vulnerable targets due to their marginalization and relative isolation from each other. In other words, nurse managers do not typically feel at ease eating lunch with staff nurses they supervise or the administration to whom they answer. Therefore, this group has a particularly weak identity unless championed by a strong nursing administration and given the time necessary to build solid relationships.

Marginalized groups tend to take on the characteristics of the dominant group. This pattern might explain the comments staff nurses make about new nurse managers, such as “She is always in her office doing paperwork,” “She’s one of them now,” or, “She has no clue what is going on in the floor because we never see her.”

Managers or staff members are especially vulnerable if they act differently than other members of the group because their behavior inadvertently draws attention and threatens the group’s invisibility. Like the child of an alcoholic parent, a nurse sees his or her invisibility as a means of staying out of harm’s away and out of the spotlight. Unnecessary attention puts the entire group in danger—it doesn’t matter if this attention is for the good of the group. Thus, a manager who excels, complains, dresses differently, etc., is immediately perceived as a threat at the most primal level because he or she is standing up to the dominant group. His or her actions run the risk of retaliation by the dominant group against the entire subordinate group.

To prevent this from happening, the subordinate group immediately demonstrates behaviors that will cause that nurse to leave the group. Gossiping, backstabbing, ignoring, etc., are all means toward this end. These behaviors, designed to extricate the nurse from the group, are unconsciously considered vital to the survival of the group.

Editor’s note: The following excerpt was adapted from Ending Nurse-to-Nurse Hostility: Why Nurses Eat Their Young And Each Other, HCPro, Inc., 2006. Get your copy of this best-selling book today!