Contemporary Issue: Horizontal Bullying in Nursing, Causes and Effects

This report addresses the contemporary issue of horizontal bullying in the nursing profession, defining it as undesirable behavior that negatively affects nurses' well-being and work environment. It presents evidence of bullying, including statistics on its prevalence among nursing students and professionals, and its impact on nurse shortages. The report explores the causes of horizontal bullying, such as the paternalistic healthcare structure, enculturation, and workplace stress. Furthermore, it examines the effects of bullying on nurses, particularly psychological distress, and its impact on patient care quality. The report concludes by suggesting strategies to address and prevent horizontal bullying, including modifying the healthcare framework, providing training, and overcoming enculturation, supported by relevant research and references.

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Horizontal bullying
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Description of the contemporary issue with evidence
Often, workers are meant to undergo or experience undesirable scenarios by their
colleagues due to one or two reasons. This is described as bullying. According to Bloom,
horizontal bullying is defined as any undesirable behaviour in the form of persistent and
unwanted conduct, verbal words, actions and gestures which affects the employee’s dignity and
physical integrity leading to a harmful working environment for the worker (Bloom, 2018). In
Australia, 50% of nursing students have been bullied while on clinical placements (Hartin, Birks,
& Lindsay, 2019). Furthermore, 77% of rural nurses have witnessed nurses who are bullied leave
the profession. 40% of hospital based nurses in Australia have also experienced horizontal
bullying (Wressell, Rasmussen, & Driscoll, 2018). Horizontal bullying creates a shortage of
nurses with reports indicating that 75% of the nurses who quit the profession often site horizontal
bullying as the major cause. Therefore, necessary stakeholders should conduct research or
surveys and come up with effective strategies to address horizontal bullying before we lose most
of the nurses.
Causes of Horizontal Bullying among Nurses
There are different causes of horizontal bullying among nurses. Paternalistic structure of
healthcare is one of the leading causes of horizontal bullying among nurses. History has it that
nurses were meant to be obedient to other physicians (Chang & Cho, 2016). With physicians
keen to sustain their status quo, they have continued to dominate over nurses and this encourages
perpetuation of violence or bullying to the nurses. Enculturation is also a leading cause of
bullying since nursing students are taught and encouraged to bully their peers during induction.
Nursing was also primarily made up of women who are perceived to be weak thus leading to

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violence. Other causes include workplace stress and the fact that nurses are meant to be assertive.
Effects of horizontal bullying to nursing and quality patient care
Horizontal bullying affects nursing and the quality of healthcare to the patient. One of the
effects to the nurses is psychological distress. 56% of nurses in Australia subjected to bullying
have reported psychological distress (Lewis‐Pierre, Anglade, Saber, Gattamorta, & Piehl, 2019).
This is due to persistent and systematic exposure to violence. Horizontal bullying has negative
impacts to the quality of healthcare to the patient. Since nurses suffer from stress as a result pf
bullying, it affects their productivity thus rendering poor quality services to the patient.
Addressing Horizontal Bullying
With statistics indicating the significance of horizontal bullying in nursing, it is necessary
that different strategies are put in place to address or prevent the vice. One of the strategies is to
address the faulty paternalistic framework of healthcare. Nurses should be involved in the
decision making process. Training is also important (Wressell, Rasmussen, & Driscoll, 2018).
Nurses should be trained on how to report cases of violence or bullying. Furthermore, there is the
need to encourage more men to pursue nursing so as to eliminate the myth that nursing is meant
for women who can easily be subjected to bullying. It is also important to overcome
enculturation and this can be done from colleges where nursing students are to be discouraged
from bullying their young ones in the form of induction.

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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