Horizontal Violence in Nursing Horizontal

Horizontal Violence in Nursing

Horizontal violence in the field of nursing threatens to undermine the core of the profession and the quality healthcare that is provided in institutions wherever it occurs. Many reports suggest that horizontal violence is rampant, especially in relation to new nurses and recent graduates. It is typically covert and incorporates non-physical and emotional damage. Examples include sabotage, destructive criticism, back-biting, undermining, scape-goating and verbal confrontation. The targets usually express feeling ridiculed, demeaned and humiliated. Potential targets range from new hires to long-time or tenured nurses. Similarly, nurses who engage in horizontal violence cross demographic lines and areas of specializations. They are often nurses who are experienced and over-burdened by the stress of the job and the long hours associated with their work.

A common facet of horizontal violence in nursing is the hazing of new nurses or recent medical school graduates. New graduates frequently lack the knowledge and skill set necessary to be confident in the face of unforeseeable challenges. They are usually subjected to psychological abuse as a result. In most cases, inexperienced nurses accept the behavior as part of the job and move on in the name of self-preservation. At the same time, most nurses who have experienced horizontal violence are more likely to engage in the practice in later years. The behavior is most often perpetuated by the absence of reporting to employers. New nurses cite fears regarding repercussions such as alienation and job loss as reasons for not reporting horizontal violence. This cycle of abuse sits at the core of the problem and threatens to undermine the welfare of the profession and the flow of new nurses entering the field of health care.

An instructional setting that would counteract the injurious effects of horizontal violence in nursing would be the structured implementation of mentorship programs. Generally speaking, mentoring requires the formation of healthy relationships between a mentor and a protege. Such relationships must be based on trust and mutual respect, regardless of experience level, background or specialty. Effective mentoring entails regular meetings to actively discuss roles, revisit issues and cultivate role modeling. The mentor typically supports and enhances a mentee's personal and career development. He or she must also be consistently available, have faith that the protege is on the right track, and have awareness of the larger issues relevant in the health care environment. This combination of skill, confidence and communicative ability is not common among nurses, which is part of the reason that healthy mentoring relationships do not always flower in the health care environment. However, the robust desire to help fellow nurses is the most important variable, and the primary reason most mentor relationships develop and prosper.