The High Cost of Horizontal Violence in Nursing
July 21, 2015
The High Cost of Horizontal Violence
In nursing, there is a growing concern called, horizontal violence. Horizontal violence is an act of aggression from one nurse to the other. Horizontal violence impedes teamwork, hinders patient care and causes a negative work environment (Becher & visovsky, 2012).
Even though workplace politics exists in every profession, the effects of horizontal violence, or bullying, in nursing is a costly behavior. Nurses feel devalued in the workplace and experience psychological effects. Patients are likely to experience less favorable ...view middle of the document...
In these situations, the nurse may be a new graduate or new employee. The nurse may be experiencing stresses related to lack of staff. Another reason for workplace bullying is a nurse might be receiving recognition and or special attention from supervisors and physicians for an action that peers felt were not appropriate (Dellasega, 2009).
A study done by the Institute of Medicine reported that approximately 2,000 clinicians
volunteered for a study about horizontal violence as nurses. Over 90 percent had fallen victim to
inappropriate verbal interactions with peers. Of that 90 percent, almost 60 percent had been
victims of verbal abuse and about 50 percent experienced threatening body language (Papa &
Although horizontal violence is more common in the clinical setting, some research
states this behavior starts long before and during nursing school. Due to the lack of space in nursing programs, combined with stress associated with being the most desired applicant, the competitive process causes conflict between students (Young, 2011).
Once in the nursing program, there is still a high level of competition. The desires include; trying to achieve the best grades, trying to gain favor by nursing instructors to get the best internships, recommendations and honors. This competition causes high levels of stress and sacrifice on behalf of the student and causes them to lose patience, ultimately leading them to attack those closest to them including their peers. Negative behaviors such as mean comments, gossip, and other ill-willed behaviors result from the competition and stress. Such behaviors intensify emotions of those involved which ultimately hinders the student in the learning environment. Performance and negative behaviors carry over into the nurse's professional life creating the belief that peers are adversaries as opposed to allies (Young, 2011).
Rowe and Sherlock (2005), states when a nurse experiences verbal abuse on a regular basis, that nurse is less likely to be satisfied with work. Moreover, the victim may have a higher
rate of absenteeism, and lack of patient care standards. If this behavior is a problem for the clinical facility, that facility will likely have a higher turnover rate, which will in turn cost more
money in recruitment and education. Moreover, bullying also affects continuity of care with patients and may result in sentinel events as well as legal action against the clinician, and facility
from patients and family members.
According to Aleccia (2008) an estimated 70 percent of nurses involved in a study of
horizontal violence believed there was a relation to inappropriate behavior from peers
and negative outcomes for patients. Moreover, 25 percent of the study group believed
that horizontal violence contributed to patient mortality.
Research has shown that there is an estimated $30,000 to $100,000 per annum paid for
each victim of...