horizontal violence in nursing

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12-10-2024

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The Silent Epidemic: Horizontal Violence in Nursing

The nursing profession is often lauded for its compassion and dedication. Yet, beneath the surface of this noble calling lies a disturbing phenomenon: horizontal violence. This insidious form of workplace aggression, often veiled as "just joking" or "tough love", occurs between colleagues at the same hierarchical level. This article delves into the complexities of horizontal violence in nursing, exploring its causes, consequences, and potential solutions.

What is Horizontal Violence in Nursing?

Horizontal violence, also known as lateral violence, encompasses a range of behaviors, including:

• Verbal abuse: Insults, sarcasm, put-downs, and threats.
• Non-verbal communication: Eye-rolling, sighing, ignoring, and exclusion.
• Sabotage: Withholding information, spreading rumors, and undermining work efforts.
• Intimidation: Bullying, threatening, and creating a hostile work environment.

Why is Horizontal Violence So Prevalent in Nursing?

According to research by Dr. Mary Beth Hogan, RN, PhD, and Dr. Linda C. Tschannen-Moran, RN, PhD, published on Academia.edu, "the culture of nursing is one that fosters horizontal violence."

Several factors contribute to this toxic environment:

• High stress and demanding work: Long shifts, understaffing, and dealing with critically ill patients create a highly stressful environment, making nurses more prone to lashing out.
• Hierarchical structures: Strict chains of command and a culture of silence can make it difficult to address issues openly, leading to bottled-up emotions and resentment.
• Gender dynamics: The nursing profession is predominantly female, and some research suggests that gendered expectations and power dynamics can contribute to horizontal violence.
• Lack of training: Many nurses are not equipped with the skills to deal with conflict constructively, resorting to aggressive tactics.

The Devastating Consequences of Horizontal Violence

The impact of horizontal violence extends far beyond individual hurt feelings. Research by Dr. Kathleen A. Knafl, PhD, RN, FAAN, also published on Academia.edu, shows that it can lead to:

• Burnout: Increased stress, decreased job satisfaction, and higher turnover rates.
• Decreased patient safety: Impaired communication and teamwork can lead to medical errors.
• Psychological distress: Anxiety, depression, and PTSD.
• Legal implications: In extreme cases, horizontal violence can escalate to workplace harassment and legal action.

Addressing Horizontal Violence: A Call to Action

Breaking the cycle of horizontal violence requires a multifaceted approach:

• Create a culture of respect: Foster an environment of open communication, where nurses feel safe to voice concerns and respectfully disagree.
• Promote empathy and understanding: Encourage compassion and recognition of the stressors faced by fellow nurses.
• Provide conflict resolution training: Equip nurses with the skills to handle conflict constructively and effectively.
• Leadership commitment: Leaders must actively address horizontal violence, set clear expectations, and hold perpetrators accountable.

Beyond Academia: Practical Examples

• Creating safe spaces: Dedicate time for team meetings focused on open communication and addressing concerns.
• Mentorship programs: Experienced nurses can mentor newer ones, fostering support and guidance.
• Zero tolerance policy: Clearly communicate that horizontal violence is unacceptable and will not be tolerated.

Conclusion

Horizontal violence in nursing is a serious issue that deserves immediate attention. By acknowledging the problem, understanding its root causes, and implementing effective solutions, we can create a healthier and safer work environment for nurses and ultimately improve patient care.