Student Nurse Perceptions of Horizontal Violence During Clinical HOspital Rotations

The nursing profession is facing its largest professional nurse deficit in history. With nursing schools unable to produce enough new nurses to replace the number of nurses retiring, it becomes increasingly important to retain as many nurses as possible within the profession. Nursing research literature has reported that up to 60% of newly registered nurses will leave their first job within their first year of practice citing horizontal violence as a contributing factor. The literature does not address if or how early student nurses might perceive exposure to horizontal violence. The purpose of this qualitative, interpretive, phenomenological study was to obtain student nurse perspectives of their lived experiences with horizontal violence during their clinical hospital rotations. The theory of cognitive adaptation supported the study by looking at students\u27 ability to gain mastery, assign meaning, and restore self-esteem over events. This study used voluntary student nurse participation in an online survey. A total of 72 student nurses logged onto the survey, with 23 responding to the survey questions. The data analysis consisted of coding and thematic analysis. The research results show that student nurses are victims of horizontal violence from nursing staff and nursing leadership as early as their first clinical hospital rotation. Coping abilities of student nurses range from avoidance of the event to leaving the profession. Recommendations for change in professional nursing include changes in academic preparation and to clinical enculturation of student nurses. These positive cultural changes within academic and clinical nursing will help protect our student nurses from early attrition. Saving our students will decrease nurse turnover and improve patient outcomes resulting in positive social change for the nursing profession

Junior nursing students\u27 experiences of vertical violence during clinical rotations

Horizontal violence is a form of workplace violence, a phenomenon that is prevalent in the nursing profession. Research has revealed a variety of negative peer-to-peer behaviors that lower morale and lead to turnover. However, little research has been conducted on “eating our young” (violence occurring between individuals with unequal power, such as staff nurse and student). We propose “vertical violence” as the appropriate term when abusive registered nurse (RN) behavior is directed towards students. We report a content analysis of stories written by junior nursing students about incidents of injustice perpetrated by staff RNs during their clinical experiences. Four levels of injustice were described. Nursing leadership, both in hospitals and educational institutions, must become engaged in efforts to eradicate vertical violence towards students

An Exploration of Nurse Educators\u27 Knowledge, Attitudes and Practice of Horizontal Violence Measured through Dimensions of Oppression

There is a paradox in the profession of nursing. Although nursing is known as the caring profession, evidence demonstrates that nurses do not care well for their own. Literature demonstrates that the phenomenon of horizontal violence (HV) is an international problem in the nursing profession, which negatively affects the nurse workplace environment. HV is broadly described as aggressive destructive behavior and intergroup conflict that occurs between nurses. Where behaviors of HV exist, the workplace becomes a toxic environment or nurses (Woefle & McCaffrey, 2007). This dissertation provides the results of a research study exploring nurse educator’s knowledge, attitudes and practices of HV measured through dimensions of oppression. Nurses have been widely argued to exhibit oppressed group behaviors (Roberts, 1983; Roberts, 1986; Roberts, DeMarco, & Griffin, 2009) and empirical evidence demonstrates that HV is a widespread problem in the nursing profession, with a cycle of behaviors that are embedded during nurse role socialization (Randle, 2003; Longo, 2007). This study explores the phenomenon of HV in nursing using a national sample of nurse educators

An Exploration of Nurse Educators\u27 Knowledge, Attitudes and Practice of Horizontal Violence Measured through Dimensions of Oppression

There is a paradox in the profession of nursing. Although nursing is known as the caring profession, evidence demonstrates that nurses do not care well for their own. Literature demonstrates that the phenomenon of horizontal violence (HV) is an international problem in the nursing profession, which negatively affects the nurse workplace environment. HV is broadly described as aggressive destructive behavior and intergroup conflict that occurs between nurses. Where behaviors of HV exist, the workplace becomes a toxic environment or nurses (Woefle & McCaffrey, 2007). This dissertation provides the results of a research study exploring nurse educator’s knowledge, attitudes and practices of HV measured through dimensions of oppression. Nurses have been widely argued to exhibit oppressed group behaviors (Roberts, 1983; Roberts, 1986; Roberts, DeMarco, & Griffin, 2009) and empirical evidence demonstrates that HV is a widespread problem in the nursing profession, with a cycle of behaviors that are embedded during nurse role socialization (Randle, 2003; Longo, 2007). This study explores the phenomenon of HV in nursing using a national sample of nurse educators

RECOGNIZING AND REDUCING HORIZONTAL VIOLENCE AMONG NURSES AT A VETERANS AFFAIRS MEDICAL CENTER: A COGNITIVE REHEARSAL QUALITY IMPROVEMENT PROJECT

Aim: The aim of this project was to help nurses at the Veterans Affairs Medical Center (VAMC) in Durham, North Carolina recognize and reduce horizontal violence in the workplace using an evidence-based educational session with a cognitive rehearsal technique. Background: Mounting evidence compiled over the last two decades has established the existence of horizontal violence in the nursing profession. Further, horizontal violence continues to be an ongoing challenge despite substantial evidence that it can negatively affect a nurse’s quality of life and compromise patient safety. Methods: VAMC staff nurses attended two educational sessions (one hour in total) of training about ways to combat horizontal violence and to learn cognitive rehearsal techniques. The first session presented the theoretical concept of horizontal violence, discussed how horizontal violence affects nurses, and included discussion of nurses’ responses to three open-ended questions. In the second educational session, participants learned about and practiced appropriate responses to the most common forms of horizontal violence through cognitive rehearsal, an interactive role-playing experience. At the end of the session, each participant was given cue cards that each stated a common form of horizontal violence and its appropriate response. A follow-up survey was conducted at the end of the session to determine participants’ satisfaction with and perspectives about the educational intervention. Results: Participants reported that participation in the educational session (1) increased their awareness of horizontal violence and (2) enabled them to identify at least three strategies to combat horizontal violence. Further, participants recommended that nursing colleagues would greatly benefit from the training. Conclusion: This educational session targeted the negative effects of horizontal violence and used an evidenced-based cognitive rehearsal technique to increase awareness of interventions to offset negative behaviors associated with horizontal violence. Raising awareness and labeling this problem are the first steps in reducing the occurrence of horizontal violence among nurses. These initial steps establish horizontal violence as a legitimate problem and hopefully will set in motion an action plan for change at the VAMC. Keywords: horizontal violence, cognitive rehearsal technique, hostile workplace, bully, nurses

Horizontal Violence Effect on Nurse Retention

Horizontal violence is known by a variety of terms such as lateral violence, bullying, and incivility. Christie and Jones (2014) describe lateral violence as a problem in nursing where a behavior is demonstrated through harmful actions that occur between nurses. Studies have revealed how horizontal violence affects nurse retention. Horizontal violence is a relevant issue in the healthcare community, yet often goes undiscussed. Walrafen (2012) explains that an outcome of horizontal violence in nursing is directly proportional to a decrease in retention of nurses. Sherman (2012) proclaimed that nurses who are subjected to horizontal violence have low self-esteem, depression, excessive sick leave, and poor morale. As Wilson (2011) identified nurses, who witness or experience horizontal violence have an increased desire to leave the organization where the bullying takes place. Horizontal violence is a pervasive source of occupational stress with physical, psychological, and organizational consequences (Hauge, et al, 2010). Roy (2007) describes this as an unkind, discourteous manner in which nurses relate to their colleagues. As nurses seek to perform their daily tasks, other co-workers may embarrass them for their lack of knowledge, tease them as they participate in informal cliques, or demean them for their technique (Bakker, 2012). Creating excuses, taunting, and refusing to share information, nursing education or knowledge are examples of horizontal violence (Ball, 1996)

Applying a Multidimensional Strategy to Mitigate Lateral Violence in a Small Rural Community Hospital in Western New York

Providing registered nurses with education and strategies to mitigate lateral violence is an evidenced-based method for creating a culture of civility. A descriptive pilot study with registered nurses was conducted on two medical/surgical units at a small rural community hospital. Strategies included a review of organizational policies, a one-day educational retreat for unit managers and registered nurse champions, and an online educational toolkit on lateral violence for the staff nurses on the pilot units

Challenges perceived by nursing professionals in physician‐centred organizations: An exploratory qualitative study

Aim: To explore and analyse contextual challenges in nursing that have affected nurses' perceptions and role performance. Background: Health system hierarchy and patient/family-centred care has led to a high demand for skilled nurses. However, patriarchal organizations create challenges for nursing clinicians in Pakistan and elsewhere. Methods: A qualitative exploratory research (phenomenology) design was used. Twenty-five participants identified through purposive sampling contributed to the study. The data analysis was conducted using NVivo 12 Plus. We generated six major themes. Reporting was accomplished according to the consolidated criteria for reporting qualitative research checklist. Results: Gendered division of labour places nurses in a submissive position in clinical practice. Decreases in nurse-to-patient ratio and increase in patient-focused care adversely affect evidence-based practice. The gap between theory and practice in delivering quality care is increasing due to existing communication barriers among health-related professionals and an inadequate work environment. Comparatively inactive nursing leadership and directorate roles are not improving the social image of nursing, and are promoting role conflict and poor nursing self-concepts among nurses. In fact, cultural shock experienced by young nurses has produced inherent disorientation in their professionalism and fostered displays of horizontal violence towards them by senior nurses. Conclusion: These challenges are influencing nurses' decisions to remain in or to join nursing as a profession that is confronted by severe recruitment and retention shortages due to the social and cultural stigmatization of this female dominated profession. Implications for nursing, health and social policy: This study promotes the concept of evidence-based practice to deliver quality health services in public hospitals and to improve the social status of nursing in Pakistan. It provides influential evidence to policymakers who should urgently address nurses' workplace health and safety issues as a global right