Among the many challenges hospitals face, it is now emerging that scapegoating or bullying and other forms of harassment are a serious problem. This is especially true in the hospital setting with different ranks between and within such professions. Despite being discouraged and restricted by various professional codes of ethics, workplace violence in the healthcare industry remains rampant. It may take several forms including “verbal abuse, threats, intimidation, bullying, humiliation, excessive criticism, innuendos” and exclusion among others (McKenna et al., 2003). Horizontal violence amongst nurses has very serious consequences and can significantly inhibit the quality of healthcare provided to the patient. It has been implicated in poor nurse retention in hospitals, although this has mainly been theoretical; opening the door for more research. This study will review the literature available on horizontal violence among registered nurses and its effects. A non-experimental correlational study design will then be established to investigate the link between horizontal violence among nurses and hospital retention of nurses.
Horizontal violence describes the aggressive actions of a group of people who work together and hold a similar status in their work environment. What makes the problem troubling is the fact that registered nurses are thought to be caring professionals. Most people would say that registered nurses do not bully, use abusive language and other disruptive behavior against their own. Although many healthcare stakeholders are aware of rampant horizontal violence, many of them are oblivious of its extent. Ditmer (2010) provides an overview of the scope of horizontal violence among nurses, establishing that “75%” of nurses have experienced aggression, harassment and bullying during their careers. To further exacerbate such grim statistics, majority of such acts go unreported. Besides, such horizontal violence may not be interfered with a reported “40%” of leaders remaining passive or quiet when witnessing such acts (Ditmer, 2010). Several explanations have been provided for the cause and nature of horizontal violence. In certain situations conflict within the group arises and horizontal violence is a symptom of an underlying problem. The ultimate result is that horizontal violence persists in the nursing workplace and the individual nurses learn it as an expected behavior, being oblivious that it should not be part of their culture. As a result the nurses are vilified for this and develop a low self-esteem, such that by the time they enter the nursing practice they are already negatively socialized to certain submissive roles. Horizontal violence such as “disruptive and unprofessional behavior” is allowed to enter due to two factors; through acts of omission; and new nurses’ deficient of formal instruction to handle conflicts and assert their rights. In the former case, it is noted that failure of the management to act even after observing manifestations of horizontal violence contributes to its pervading and perception as part of normal culture in nursing practice. In the latter case, new graduate nurses are observed to lack the necessary skills to deal with being victims of horizontal vio