Horizontal Violence

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Abstract
Horizontal violence is a negative phenomenon that is increasing significantly in the hospital setting. It is defined as bullying, verbal and physical aggression that occurs to employees in the workforce. Horizontal violence has harmful effects on nurses as it lowers their self- esteem, and makes them feel as if they have no power in their career. This phenomenon also negatively impacts patient centered care and safety as nurses are more vulnerable to making medication errors and careless mistakes. Horizontal violence can be decreased in the hospital setting if interventions are implemented by members of the health care team. Education is key to decrease the occurrence of horizontal violence as it enables health care workers to actively recognize when horizontal violence is taking place, and how to prevent it from occurring. Collaboration with the interdisciplinary team will promote a better working environment and patient safety. Lastly, nurses need to be aware of effective communication so they know how to successfully converse with the aggressor. If nurses and other health care members are able to implement these interventions, horizontal violence will dramatically decrease in the hospital setting.

Horizontal Violence in the Hospital Setting
Horizontal violence is of marked prevalence that is occurring in the workforce. Baltimore (2006) defined horizontal violence as variable degrees of antagonism: gossiping, criticism, innuendo, scapegoating, undermining, intimidation, passive aggression, withholding information, insubordination, bullying, and verbal and physical aggression that occur to employees in the workforce (p. 30). This phenomenon is extremely detrimental to mental health nurses as it adds unnecessary stress to their careers. It has been found that mental health nurses experience more stress in their careers than other nurses, and many of these stressors could contribute to burnout if interventions are not implemented (Jenkins & Elliot, 2004, p. 629). Horizontal violence also negatively impacts patient safety and person centered care. Interventions such as education programs and increasing awareness are fundamental to dealing with horizontal violence. It is crucial for health care members to work collaboratively and holistically to bring health care providers together, which will in turn decrease horizontal violence from occurring (Gerardi & Connell, 2007, p. 17). Also, it is vital that nurses are able to successfully communicate with the aggressor to decrease horizontal violence from occurring again. Thus, education, collaboration, and proper communication are essential interventions that members of the health care team can participate in to decrease horizontal violence from happening. Prevalence of Horizontal Violence in the Hospital Setting

Horizontal violence is becoming prevalent in the hospital setting, and has been extensively reported and documented in healthcare. Horizontal violence has serious negative outcomes for registered nurses, their patients, and health care employers. On the international level, one out of every three nurses plan to leave his or her position due to this phenomenon (Brunt, 2011, p. 6). Nursing environments are common for horizontal violence to arise as it is mainly a female profession and exists under a patriarchal system that is leaded by male doctors and marginalized nurse leaders. This lowers nurses’ self esteem and causes them to feel like they have no control over their working conditions (Farrell, 1997, p. 502). In addition, Longo & Sherman (2007) explained that horizontal violence is common in nursing environments due to an expression of oppressed group behavior evolving from feelings of low self-esteem and lack of respect from others (p. 35). Therefore, it is critical for health care members to try and reduce horizontal violence from occurring so that the hospital environment can become a healthier place to work and for patients to...
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