Horizontal Bullying in Nursing: Causes, Effects, and Strategies

This report provides a comprehensive analysis of horizontal bullying in the nursing profession. It begins by defining horizontal bullying and highlighting its prevalence, citing statistics on the percentage of nurses and nursing students affected. The report delves into the causes of this behavior, including the 'oppressed profession' theory and the role of enculturation, where bullying is learned and perpetuated. It then explores the significant effects of horizontal bullying, such as increased suicidal rates, psychological issues like depression and anxiety, and the impact on patient care due to medical errors. The report concludes by suggesting strategies to address and mitigate horizontal bullying, emphasizing the importance of nurses speaking up, challenging gender stereotypes within the profession, and eliminating the enculturation of bullying during induction. The report stresses the urgency of addressing this issue to ensure the future of the nursing profession.

Horizontal bullying
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Description
 Despite the valuable role that nurses play in our society, they go through
different challenges. One of the major challenges is being subjected to repeat
form of behavior and this not only affect their health but safety and quality of
healthcare that the patient is subjected to. This form of behavior according to
the Safe Work Australia is defined as horizontal bullying. Horizontal bullying is
a broad challenge since it involves verbal abuse, physical and even sexual
harassment. It is increasingly becoming an epidemic that is creating a
shortage of nurses not only in Australia but globally. More than 50% nursing
students have been subjected to horizontal bullying while 40% of registered
hospital based nurses reported horizontal bullying in 2016 (Bloom, 2018).
Horizontal bullying is a significant issue and without prompt and effective
strategies, the nursing profession will be devoid of employees completely.

Causes of horizontal bullying
 horizontal bullying among nurses is as a result of different reasons. However, one
significant cause that has been in existence for some time is a theory that suggests
nursing as a profession of the oppressed. This theory states that nurses are meant are
meant to feel inferior compared to others and they can take frustration to an even less
powerful colleague (Chang & Cho, 2016). This theory has its roots into power dynamics
between nursing which is more feminine and medicine which is more of masculine.
This theory creates a real picture why horizontal bullying is very common among
nurses.
 The second reason why horizontal bullying occurs is enculturation. Bullying is a
learned behavior and several nursing students in Australia describe that they are
normally bullied by the preceptors as a form of induction and they are also supposed
to do the same when inducting new students or nurses. There also a myth that good
nurses are conciliatory and therefore becomes vulnerable to bullying. Workplace stress
is also a major reason of bullying as nurses vent out their frustrations to other
colleagues.

Effects of horizontal bullying
 Horizontal bullying has many effects both on the patient and the nurses.
Increased suicidal rates among nurses is one such effect. Studies note that
with repeated traumatising and bullying among nurses, suicide thoughts are
common and have contributed to 50% of recent suicidal cases (Hartin, Birks, &
Lindsay, 2019). Horizontal bullying also leads to psychological effects such as
depression and anxiety. Studies illustrate that repeated bullying makes the
nurses feel that they are in the wrong profession thus leading to stress and
anxiety. Furthermore, most of them resort to medication to treat the condition.
Most of this drugs are addictive and also contributes to stress and anger. Self-
harm has also been reported among nurses who experience horizontal
bullying. Self-harm is a situation where a nurse hurts him/herself to express
their feelings of anger or depression. Horizontal bullying also contributes to
poor health services to the patients since stress contributes to medical errors.

Addressing bullying
 Several strategies can be used to address horizontal bullying among nurses. The
first strategy is to encourage nurses to speak up in case they are bullied. Since
conciliatory is one of the reasons leading to bullying, nurses should desist from such
behaviour and raise their voice when bullied. This is in fact the initial step in the
fight against horizontal bullying (Lewis‐Pierre, Anglade, Saber, Gattamorta, & Piehl,
2019). Secondly, there is the need to come up with ways to convince nursing
students that nursing profession is not only meant for women. This will enable men
to also pursue the profession. This is in contrast with the fact that nursing is meant
for women who are perceived as weak vessels such vulnerable to horizontal
bullying. Other strategies include eliminating enculturation that encourages bullying
during induction (Wressell, Rasmussen, & Driscoll, 2018). Instead, there should be
better ways to introduce nursing students and staff into practice other than the
normal bullying. Horizontal bullying is harmful and if there are no considerable
efforts by different stakeholders to address this problem, nursing profession will be
a thing of the past.

References
Bloom, E. M. (2018). Horizontal violence among nurses: Experiences, responses, and job
performance. Nursing Forum, 54(1), 77-83. doi:10.1111/nuf.12300
Chang, H. E., & Cho, S. (2016). Workplace Violence and Job Outcomes of Newly Licensed
Nurses. Asian Nursing Research, 10(4), 271-276. doi:10.1016/j.anr.2016.09.001
Hartin, P., Birks, M., & Lindsay, D. (2019). Bullying in Nursing: Is it in the Eye of the Beholder?
Policy, Politics, & Nursing Practice, 152715441984541. doi:10.1177/1527154419845411
Lewis‐Pierre, L., Anglade, D., Saber, D., Gattamorta, K. A., & Piehl, D. (2019). Evaluating
horizontal violence and bullying in the nursing workforce of an oncology academic medical
center. Journal of Nursing Management. doi:10.1111/jonm.12763
Wressell, J. A., Rasmussen, B., & Driscoll, A. (2018). Exploring the workplace violence risk
profile for remote area nurses and the impact of organisational culture and risk management
strategy. Collegian, 25(6), 601-606. doi:10.1016/j.colegn.2018.10.005