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Addressing Horizontal Violence in Hospitals

Career News August 2, 2013

Horizontal violence, which is sometimes referred to as “lateral violence,” is a significant and dangerous problem in most industries, although it is especially common among hospital staff members and nurses. This harmful practice occurs when an employee commits emotional, verbal or even physical acts of aggression towards his or her colleagues.

Common forms of horizontal violence include belittling, shaming, withholding important information, isolating, scapegoating, sabotaging and generally making fellow colleagues feel threatened, vulnerable and powerless. According to the American Nursing Association, a study showed that 56.9% of nurses reported being threatened or verbally abused in their workplace. Not only can horizontal violence lead to poor workplace morale and stress-related health issues among the staff, but it can also hurt a healthcare facility’s bottom line. This dangerous practice can lead to higher nurse absenteeism, increased staff turnover and a decrease in the quality of patient care.

With such serious implications and an overwhelming number of nurses being affected by this alarming practice, it’s imperative that hospitals address and put a stop to horizontal violence.

Teach Employees to Recognize Horizontal Violence

Most nurses and other hospital employees are aware that a form of bullying goes on in their workplaces, but they may not be fully educated about what horizontal violence is and the serious toll it can take. It’s important that hospitals provide ongoing educational programs, particularly for new nurses, who are at a greater risk for becoming victims.

Hospital administrators should create training programs that teach employees at all levels how to identify horizontal violence and what approaches work to eliminate the problem. Giving a staff member the verbal tools and terms to talk about this issue will go a long way towards bringing it out in the open and help eliminate it.

Create an Environment Where Employees Can Share Their Experiences

A report from Nursing Management recommends giving employees the opportunity to share their personal experiences with horizontal violence. Whether it’s done in an open forum, orientation session or meeting, this exercise is likely to foster a more honest environment and increase a sense of urgency to put a stop to the practice.

In addition to group discussions of horizontal violence, it’s also important to give staff members a safe way to report instances of abuse without feeling like they will be punished or bullied even further for doing so.

Adopt a Zero Tolerance Policy

Once the staff has been educated about the practice, the hospital should adopt a strict policy against horizontal violence. The policy should not only address the perpetrators, but also the bystanders who witness the abuse and fail to come forward.

If staff members are given the tools to eliminate horizontal violence along with the encouragement of knowing that the practice is not acceptable, they will be much more likely to join in the effort to eliminate it completely.

Change the Culture

As the staff becomes more adept at recognizing how this type of harassment manifests, it’s important to work towards creating a new culture in the hospital. When incoming nurses participate in orientation, encourage more seasoned nurses to work on mentoring and supporting their new colleagues, rather than putting them down.

Promoting honesty, open communication and support within the nursing staff will not only improve the environment for current nurses, but it will help set the groundwork for future staff members to experience much lower rates of horizontal violence.

Regularly Evaluate the Levels of Horizontal Violence

In addition to continually providing educational opportunities and policies that address horizontal violence, it’s vital for hospitals to know whether the situation is worsening, remaining steady or improving. In addition to including at least one question about horizontal violence during every staff evaluation, hospital administrators should create a regular staff survey to assess the incidents of horizontal violence and determine whether additional measures need to be taken.

Horizontal violence is a serious problem that should be aggressively addressed in any industry. However, it is especially important for the healthcare industry—which has such high incidents of horizontal violence—to tackle this issue head on. Taking these steps will not only make hospitals more efficient and safe, but it will also increase the workplace satisfaction of countless employees.

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