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Horizontal or lateral violence is considered an act of aggression among nursing professionals. Horizontal violence creates a negative work environment impairing teamwork and compromising patient care. The effects of horizontal violence and strategies for prevention and management are addressed.
To achieve high-quality care, professional teamwork among nursing staffis imperative. Teamwork is a critical element for achievement of positive patient outcomes (Joint Commission, 2008). Teams achieve success through a shared vision, a positive attitude, and respect for each other (Phillips, 2009). Conversely, negative workplace relationships can disrupt team performance, creating a work environment that can lead to burnout, increased staffturnover, and poor patient outcomes. Acts of aggression by one nurse colleague against another is termed horizontal violence (HV) (Longo & Sherman, 2007). In this article, the occurrence of horizontal violence in nursing will be described, and strategies for preventing and ameliorating its effects will be provided.
What Is Horizontal Violence?
Horizontal or lateral violence has been described broadly as any unwanted abuse or hostility within the workplace (Stanley, Martin, Nemeth, Michel, & Welton, 2007). Thobaben (2007) defined horizontal violence as "hostile, aggressive, and harmful behavior by a nurse or group of nurses toward a coworker or group of nurses via attitudes, actions, words and/or behaviors" (p. 82). Horizontal violence is characterized by the presence of a series of undermining incidents over time, as opposed to one isolated conflict in the workplace (Jackson, Firtko, & Edenborough, 2007). This repeated conflict makes HV overwhelming, leading to symptoms of depression and even posttraumatic stress syndrome in the victim. Horizontal violence tends to be covert, hard to discern, or discover; the victim thus has difficulty in seeking assistance within the job setting. Horizontal violence also has been portrayed as an intergroup conflict with elements of overt and hidden hostility (Joint Commission, 2008). Members of the nursing profession have been described as an oppressed group, having mostly female members. Oppression theory suggests that powerlessness, lack of control over the working environment, and subsequent low self-esteem contribute to the development of HV within the nursing profession (St-Pierre & Holmes, 2008). However, this fails to address the notion that HV occurs across many professions, and encompasses individual, social, and organizational characteristics (Wilson, Diedrich, Phelps, & Choi, 2011).
Horizontal violence that results in...