SNPG902 Spring 2018 - Incident Journal: Peer Incivility & Hostility

This journal entry delves into the author's experiences with peer incivility and horizontal hostility during a nursing internship, focusing on the detrimental effects of hazing behaviors such as belittling, dominance displays, and passive-aggressive actions. The author reflects on feelings of anger, anxiety, and reduced productivity resulting from these interactions. The journal analyzes the dynamics of horizontal hostility within nursing, including the formation of coalitions and the perpetuation of hazing as a rite of passage. It also explores theories related to hazing, such as the Evolutionary Theory, the Symbolic Significance of Hazing, and the author's own theory of Cut-throat Behavior. Finally, the journal discusses potential solutions for addressing peer incivility, emphasizing improved communication, conflict resolution techniques, and the importance of fostering a supportive work environment to enhance patient care. The 'Perfect Storm' theory is also discussed in relation to hazing.

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Student’s Name
Institution Affiliation
Instructor’s Name
Course
Date

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Abstract
The phenomenon of peer incivility in the nursing profession has been there for ages. It is
not even confined to nurses alone. The behaviors that are generally prevalent when it comes to
hazing at the places of work ranges from over behavioral manifestations for example sabotage
and infighting to the intern nurses. Here the management of the hospitals fails to convey the
information about what is going on within the precincts of their staffrooms. The interns suffer the
wrath of unanswered questions, passive-aggressive behaviors that span to failure to respect
privacies and confidences. Hazing behaviors can lead to many problems at the hospitals like
increased absenteeism, reduced productivity and long-lasting negative effects. This journal report
is from my own experiences and how they affected my productivity due to anger and confusion.
Horizontal Hostility
At a past nursing internship, I did receive a lot of hazing from my peers as they were
belittling me due to lack of skills. They were demonstrating their feelings about dominance
towards me, and this will become my major theme. My reaction towards their unprofessional
behavior was anger and anxiety. Some of the peers used to go further and perform annoying
actions so that they can get a reaction (Siwula, 2016). Upon getting a reaction, the peer would
use it against us. As they were on permanent assignments, they would use the reaction realized in
manipulating the balance of power; during the short stints of the internship period. This act
becomes an emotional detrimental to trainee nurses. For the fear that in the next internship
period the facility will fail to take us in, it resulted in us harboring the anger and anxiety in
conducting our daily chores (Siwula, 2016).

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Horizontal hostilities generally occur in groups whom one would think and expect that
they are closely knit and have close affinities. They usually happen when the medical
professionals feel that their status quo are being challenged. The radical groups in the workplace
think that they are extremely passionate about each other and they build coalitions that makes it
able to further their alliances. The alliances are able to advance their cause in hazing the interns.
Nevertheless, the structure of the coalitions are possibly inherently unstable; this is because their
bickers always contemplate on the best ways of achieving their common goals (Siwula, 2016).
Analysis of the Journal
The nursing profession has a long-standing history of molestation of younger nurses by
the veteran nurses. In some cases, it is fun while on most occasions it becomes hurtful and cruel.
Essentially this workplace molestation is generally harmful. It is fun in case a veteran nurse
looks at the timidity that a young nurse undergoes due to fear and lack of requisite professional
skills. Fear notwithstanding, a new nurse is entitled to perform their duties (Siwula, 2016).
Sometimes as an intern there is a feeling of being overwhelmed with responsibility, or the lack of
confidence which is necessary for carrying out the daily chores and thus being on duty with a
peer that mistreats during on job training is bad. The feelings that we used to get as novice nurses
affected the delivery of services to patients. I cannot believe that there is any positivity of hazing;
nevertheless, the negatives become severe and affect the care and treatment of patients (Siwula,
2016).
Nurses, sometimes they look like the patients they are treating as they harbor
compassionate feelings for them. Moreover, like in any other profession, conflicts are
surrounding this noble profession between the Registered Nurses and the Certified Nurse

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Assistants. As the hospital puts on reliance on efficiency to save lives on them, the small issues
they encounter on a daily basis may cause an operational crisis that can affect service delivery to
patients. It is salient to know how they affect the operations in the workplace (Davis, 2014).
Embracing diversity in the workplace is potentially important though it sometimes may
cause conflicts in the professional setup. Due to communication breakdowns, pressures may
emanate from different quarters in case the information is not properly communicated and
processed. In case such rivalry results in the hospital setting the patients are always at the losing
end (Condie, 2016). Thus, it is paramount that no matter the magnitude of misunderstanding
between coworkers, the health of the patients should be above all the disagreements. The wrong
rites of passage impact on self-esteem (Davis, 2014).
Most of these rites of passage include alcohol consumption; when such a demand is made
to a student who has never indulged in that activity, many of her cognitive processes will be
affected. Thus, hazing affects the self-esteem of that intern, and their moral development and
identity will be affected. There is a notion that trying to fit in an organization where such rituals
are made, results in justifying it (Condie, 2016).
Horizontal hostility has ever been a tradition that the nurses have always accepted for
many centuries without question. The proponents of it believe that it is a necessary rite of
passage that makes the nurses create and bond in a group. This is not always true, nevertheless,
the misconception is still in existence. The perpetrators of these heinous acts often believe that
while they are conducting these acts, they are not likely to get caught. The heinous act is mostly
solidified by the “code of silence” that is very prevalent in the groups that haze the interns. In
many a time, personalities mostly express their sadistic feelings, and they rationalize it by

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justifying that “I have the right and duty to do onto you what was done to me.” There are
generally many psychological reasons that are brought to the fore in support of the haze
(Chrisman, Azubike, Stone, & Davis, 2014).
Reflections
In this assignment, the model of reflection is the Gibbs reflective model
Action
The common problems in the nursing profession can be addressed while following
appropriate conflict resolution techniques. One is that the existing haze can be solved using
improved communication techniques. The registered nurses can set up their plan of embracing
the medical interns as their fellow workmates and assist them whenever they call upon them for
assistance (Chrisman, Azubike, Stone, & Davis, 2014). For example in a hospital setting, the
peers should ensure that the trainees have received the proper instruction they are passing to
them to avoid the magnitude of errors that can result. I believe that even making the trainee
repeat on what they have been requested to do is important to avoid the hurdles (Spaulding,
2015).
On the other hand, the trainee should take it upon themselves to ensure that they are keen
and they are able to take up the information and process it well. The intern can seek for
clarification from the peer by asking questions and by at all times avoiding assumptions. I
believe that when interns engage in making many assumptions, it becomes the root cause of haze
with their peers (Booth, 2017). In achievement of better communication, it will result in
increases in efficiency on service delivery. This results in making every person job to become

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easier and chances of conflict hugely reduced. The vibe and the good feeling at working in such
an environment is boosted (Kavanagh, 2014).
Description
As the role of nurses is critical in a hospital setup, the added stress resulting from upset
working relationships should not be condoned. Staying away from conflicts in a way it is going
to improve the relationships among coworkers while boosting their morale (Spaulding, 2015).
When nurses put hazing away the productivity of the interns will be boosted. In case this fails to
happen instances of negligence and confusion will suffice. In case both the peers and the interns
are happy, the patients are also going to be happy. This is because the nurses are going to be
keen on them and they are friendlier. Thus, the patients are going to be happy as they will be
receiving better health care (Bertalan, 2017).
Evolutionary Theory on Hazing
This theory was proponent by Aldo Cimino, in the theory he explains that the veteran’s
members of the Nursing usually ensure that the initiates do not enter into the organization with a
free pass. This makes them start on hazing rituals that they make it look like that they have to
have a demonstration of worthiness by ensuring follow a series of challenges (Wolf, et al,. 2018).
The Symbolic Significance of Hazing
This is a theory that was developed by Stephen sweet, and he indicates that the initiates
into the nursing profession must follow a crucial time of molestation before they are initiated
into the group. He indicates that the interns should be paddled, made to purchase drinks and they
are underpinned on all occasions. There are totems that they are made to follow, and it does not

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matter the hospital organization they are working (Spaulding, 2015). The theory further
indicates that all the challenges that the young initiates go through carrying a symbolic weight.
He indicates that they are given different pledges from these professionals mostly in the sphere
of social interaction with each other (Aul, 2015).
Feelings
Cut-throat Behavior
This is my own theory on hazing, and I believe that these fraternities portray a cult-like
behavior towards their younger professionals the nature of restrictions that were given includes
forbiddance to take showers or even to speak to anyone (Spaulding, 2015). The hazers usually
do exhibit negligent behaviors which are dangerous in nature, and they make these interns to
pledges which are invincible. The most shocking thing is that when those interns graduate into
the system, they eagerly await the newcomers they subject them to what they went through
themselves. This means that this is a never-ending cycle. This cycle is generally referred to as the
cycle of reciprocity. That is what is done to us now; then we will do unto others (McGee, 2014).
Evaluation
The Perfect Storm Theory
Meteorologists generally allude to a perfect storm when specific conditions come
together into a deadly and a rare storm. Meaning that there are specific elements that merge in
order to create chaos that is a characteristic of a perfect storm (Spaulding, 2015). The psychology
behind hazing pertain to several elements; these elements collide within a particular framework

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in order to cause the “perfect storm” increasing the probability of hazardous hazing events. The
following are the conditions of this theory (Sidhu, & Park, 2018):
Human Nature
This is well captured Charles Darwin theory of “survival of the fittest” that creates the
need for an individual to seek a group in order to identify with it. This group tends to protect the
individual and thus to increase his chances of survival. Therefore, maybe hazing is somehow part
of that group process, which is it determines the person that will fit into a certain group. Thus the
act of forming alliances with a group is generally common, and humanity shows that all humans
are social animals and they seek group activities in order to get an identity (Rust, 2016). Though
the way an individual seeks an alliance with a group differs from a person to another and from a
group to another.
Thus, the methodology notwithstanding the result is the same. After the member has
undergone all the hazing problems, the member then feels that now he is a member of a larger
group does accept him and incorporates him as one of their own (Spaulding, 2015). Thus, it is a
symbiotic relationship that will serve the group and the individual and they, therefore, accept him
hence, and he gets an identity. The group essentially distinguishes itself from the other groups,
and they solidify “us versus them” mentality which will create boundaries, nevertheless false,
which creates the urge in feeling safe within the group. Therefore, the act of joining a group is to
gain protection from the outsiders, and when one joins, one assumes that the members of this
same group are going to protect them from agitation towards one another (Frederick, 2014).
The perfect storm can be defined as a particular set of conditions that occurs in a special
sequence which when they are combined they give out an extreme event. Every one of the

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meteorological conditions can exist alone, or in following some combination, they can produce a
storm; nevertheless, it is not a storm of extraordinary circumstances (Engelbrecht, Heyns, &
Coetzee, 2017).
Conclusions
Ending Horizontal Hostility
Nurses are given, and they are professionally required to be compassionate caregivers. So
it raises questions as to the reason they harbor abusive and demoralizing acts against each other
due to seniority brings confusion.it is generally known that the hospitals are stressful workplaces
as the conditions of the patients worsen every minute. It is therefore important that the supply of
the nurses to be increased as the peers are getting older (Owens, 2017). It is, therefore, better
than the interns to realize where horizontal hostility starts so that they can start the corrective
action. Hostilities subsisting among nurses stems from their peers; when doctors yell at them
they tend to bring it down to the interns in case they have stayed for longer periods without
debriefing. Another cause that results in strife is when values differ, and the communication
styles clash. Conflicts arise when hospitals mishandle the integration of the interns, this is a
common occurrence due to the nursing shortage (Goff, 2018).
Take Action
The nurses’ interns can be able to come together and defeat the culture of hostility. This
can take three levels that entail personal, unit and organizational. This is the way it should
follow: start by speaking up. When hostility develops and graduates into an issue in the work
environment. One should make themselves known. This will entail talking to a senior medical
practitioner or the supervisor about what one is passing. The second step is to confront the

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offender (Engelbrecht, Heyns, & Coetzee, 2017). This will include engaging in a passive-
aggressive behavior of talking to one's colleagues or the third parties who are not in a position of
solving the situation. It is even salient to request the senior peer to step away from the duties or
attending to the patients so that the matter can be talked about. The peer should acknowledge this
uncouth behavior and assure the trainee that stern action will be taken. There should be an
understanding of the differences that exist in terms of skills, and the senior administrator should
start working with you in seeking the solution of the matter (Ayasreh, Youssef, & Ayasreh,
2015).
The sharing of skills with the senior administrator is a way of ensuring that everyone is
able to gain skills that may be missing. Here it very critical as the trainee should ensure that they
are not the one causing the haze. This means that they should check on their behavior to ensure
that the initiate is not the instigator. The trainee should arm themselves with information so that
in the solution of the case they will be having more information than their molesters (Ayasreh,
Youssef, & Ayasreh, 2015). This is achievable by conducting a lot of research and reading. At
the near solution of the problem, there is a need for creating shared values. In creating them, one
works with colleagues so that you can come up with a unit philosophy. This philosophy states
the acceptable, unacceptable and the shared values, and it goes further to articulate the
consequences that will enable people to be accountable for their actions (Price, 2015).
Lastly, it is prudent to seek the indulgence and the support of the management in
creating a healthy organizational culture. This means that all that has been created in an
organizational culture that comes from the top. It is paramount that in the creation of that cultural
document there should be consultation to the document known as the AACN’s healthy work

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environment initiative so that it can be formal and justifiable. The consultation of that document
ensures that excellence in the nursing activities is achieved (Taylor, 2016).
Finally, it is prudent to be persistent and patient, as the cultural change can occur
nevertheless it happens so slowly. Horizontal utility generally has a profound influence on the
job satisfaction and wellbeing of the initiates in a hospital set up. This brings in the ill calls and
affects the turnover rates of the institution directly. Thus the leaders should be always be updated
on the potential for a compromised work setting that is generally related to horizontal hostility.
The financial viability of a hospital setup cannot be underestimated, and therefore intimidating
behaviors like haze should not be condoned, and the perpetrators should even be persecuted
(Taylor, 2016).

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References
Aul, K. (2015). A Comparison of Perceptions of Incivility among Nursing Students and Faculty
in Pre-licensure Nursing Programs. Robert Morris University.
Ayasreh, I. R., Youssef, H. A., & Ayasreh, F. A. (2015). Perception of Nurses toward
Horizontal Violence in Health Care Settings in Taif City, Saudi Arabia. International Journal of
Science and Research, 4(4), 1017-1023.
Bertalan, R. A. K. (2017). Student skill evaluation: nursing education culture and
instructional leadership (Doctoral dissertation, University of Alabama Libraries).
Booth, C. (2017). Nurse Educators' Perceptions of Nursing Students' Bullying Behaviors
in Traditional and Online Education Settings: A Phenomenological Study (Doctoral dissertation,
North-central University).
Chrisman, J., Azubike, N., Stone, A., & Davis, C. (2014). Is your work place
toxic? Nursing made Incredibly Easy, 12(3), 22-29.
Condie, S. (2016). Registered nurses' lived experiences of peer to peer incivility in the
workplace. Widener University.
Davis, N. P. (2014). Nursing Faculty Descriptions of Horizontal Violence in Academe.
Engelbrecht, N., Heyns, T., & Coetzee, I. M. (2017). South African undergraduate
nursing stude
Frederick, D. (2014). Bullying, mentoring, and patient care. AORN journal, 99(5), 587-
593.