Theoretical Base of Lateral Violence
Many explanatory theories are offered for why lateral violence occurs among nurses. One widely adopted theory is that lateral violence in nursing is explained by the oppressed group model as originally described by Roberts, whose model was based on the work of Freire. In this model, the oppressed group internalizes the values and norms of the dominant group, which are deemed as having socially appropriate characteristics, behaviors, and roles. Thus, the inherent characteristics of the oppressed group are negatively valued and suppressed. In an environment of overt and latent rewards and punishments, the oppressed group is shaped into desiring the power of the dominant group and thereby molded into following the dominant group's norms, rules, and laws. Collectively, as the oppressed group attempts to assimilate into the dominant group, low self-esteem and loathing develop into central group tendencies. In strong behavioral undercurrents, the oppressed group develops deeply rooted resentment toward the dominant group, yet is unable to act against the dominant group. Submissive in the face of the dominant group, members of the oppressed group turn resentment inward toward members of the oppressed group.
The nursing profession has long been treated as an underclass, oppressed group and is only recently beginning to ascend to a tier of equality with physicians. Since its inception, the profession has been subjected to the hierarchal control and dominance of both hospital administrators and physicians. The result is a profession that seeks to have direct authority and autonomy, and yet remains controlled by the dominant power group. Furthermore, as Moccia argued, historically and contemporarily, nurses hold a special place in society in which their profession is, perhaps more than almost any other, viewed as altruistic. At the same time, the nursing profession wants a place at the table in shaping health care policy and practice and, thus, may have to trump the image of altruism in lieu of self-interest. Given the complexities of the nursing profession, with all its tensions, challenges, and role conflicts, lateral violence continues as an outward expression of an inward frustration at lack of power, worth, and autonomy.