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Bullying in Nursing and Horizontal Violence

Info: 2893 words (12 pages) Nursing Essay
Published: 11th Feb 2020

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Tagged: violencebullying

  • Ansamma Joseph


PART 1:…………………………………………………3

1.1 Horizontal violence and bullying in nursing:-……………………….3

SUB – TOPIC:…………………………………………….5

1.2 Disruptive behaviour: -……………………………………..5

1.2.1 Importance of study of disruptive behaviour:-……………………..6

PART 2:…………………………………………………7

2.1 Purpose of the article:-……………………………………..7

2.2 Arguments and ideas presented by the authors:-…………………….8

2.3 The quality and value of the article:-…………………………….8

2.4 Brief reflection of using sources:-………………………………9

2.5 Conclusion:-……………………………………………9



The topic is based on the most vital issues faced by the health care settings in relation to employee management and relationships. In the field of nursing practice, horizontal violence and bullying in health care organizations is the areas under study in this assignment. In health care centres, the distribution of power may not be appropriate, the prevailing culture and organisational structure may not favour positive employee bonding. Nurses may be subject to violence such as insult, abuse, poor treatment and rude behaviour from the senior staff members, doctors or by management. Generally nurses prefer not to complain against the seniors, and even after complaint they do not get appropriate solution. So the situation is very worse now a day. In context of horizontal violence and bullying, the current study will extensively focus on ‘disruptive behaviour’ towards nurses.

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1.1 Horizontal violence and bullying in nursing:-

Horizontal violence is the violence made by same level of employees’ arguing. In a health care organisation when a nurse abused physically, verbally or emotionally by the senior nurses, it is called horizontal violence. There are several reasons of creating horizontal violence in health care setting those are sabotage, verbal affront, withholding information, infighting, backstabbing, and failure to respect privacy, non-verbal innuendo, undermining activities and broken confidence (Bartholomew, 2006).

Reason of Horizontal Violence


Verbal Affront


Non Verbal Innuendo

Undermining Activities

Back Stabbing

Withholding Information

Failure to Respect Privacy

Broken Confidence

Figure 1:- Reasons for horizontal violence

(Bartholomew, 2006 p-86)

Bullying in nursing is occur when the senior nurses or senior doctors misuse their power and does insulting behaviour to nurses. In present time bullying is going on continuously and systematically. The nursing supervisor and senior doctors are bullying by offensive abusive, intimidating to the staff nurses. As the nurses don’t have more power so, they can’t say anything to their seniors.

Now a day the nurses complain against the horizontal violence and bulling. According to statistics 48% nurse complain for verbal abuses whereas 43% complain about threaten (www.aorn.org/PracticeResources).

Horizontal violence and bullying badly affect the staff nurses because through horizontal violence and bullying the nurses exhausted mentally and physically and feel threaten, humiliate, upset and this situation break the nurses’ self confidence. Gradually the nurses feel sick by tolerating these types of behaviour. According to the Longo (2007) because of anger, depression, work pressure, insomnia, increasing stress, anxiety, and loneliness are responsible for this bullying. Not only for the senior staff, due to organisational structure and culture may nurses feel stress. Inadequate training, less salary, toxic environment also makes the nurses in trouble.

In the course of horizontal violence and bullying the work place or the health care setting is also badly affect as the nurses are very upset so they can’t provide good services. The service quality is decreasing due to over time and bad work environment. The stressful nurses are showing their angry on the patients and the patients may dissatisfy with their behaviour.


1.2 Disruptive behaviour: –

Disruptive behaviour is mostly unemotional behaviour done by an individual or a group to other person. In a health care organisation when the senior nurses rudely and roughly behave with staff nurses then it is also called disruptive behaviour. These types of behaviour have badly impact on the performance of the staff nurses. As the nurses belong from health care organisation so they should maintain the culture of safety, but because of disruptive behaviour the nurses cannot maintain the culture of safety. In an organisation all the members maintain a good communication by which the staff can provide best services, but as the nurses are stressed so they are not able to serve good care. According to Hughes (2009), this disorderly behaviour involves in verbal communication so the nurses are easily made harsh. Most of the nurses lost their interest in work, increase the rate of absenteeism and also don’t want to sustain in the organisation.

Element of Disruptive


Misbehaviour by Physician

Supervising Nurse

Patients and their Family

Figure 2: – Element of disruptive behaviour

(Hughes, 2009, p-35)

1.2.1 Importance of study of disruptive behavior:-

It is important to study the disruptive behaviour and also must recognize the reason behind disruptiveness. Only the study can give the solution of this problem. Nurses are most important factor in a health care setting, because they provide the services mean they take care the patients. If the nurses are not mentally and physically stable so they can provide proper services to the patients. In the course of study of disruptive behaviour the organisation may know the reason behind the disruptive behaviour and they can take effective decision to avoid this (www.aacn.nche.edu/Media/FactSheets/NursingShortage.htm). According to Hutchinson (2010) in a health care organisation if the organisational management identify the appropriate reason of disruptiveness and give the proper solution, then the patients get proper take care from the nurses and it also possible to decrease the redundant rate of nurses from the organisation. The staff nurses get facilities because of good work environment and they will able to maintain the culture of safety.

Effect of Disruptive Behaviour

Affected entire Organization

Absenteeism and Redundant of Nurses

Patients affected due poor Services

Figure 3: – Effect of disruptive behaviour

(Hutchinson, 2010, p-180)


2.1 Purpose of the article:-

In contemporary scenario horizontal violence and bullying is creating worse situation not only in health care organisation, in every organisation. Due to horizontal violence and bullying the employees are behaving badly and humiliate to same level employees or lower level employees. This situation is creation a worse work culture in the organisation. As the nurses are belonging from health care organisation so by lateral violence and bulling patients are more affected. The nurses get upset with continuous humiliation (Knopper, 2009). They can’t serve in proper way. This situation is badly affecting the reputation of the organisation.

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The researcher had chosen this article because recognizing its importance. In everyday life every person needs the health care organisation and if the employees of health care organisation is not provide proper services then the patient will badly affected. Apart from that this problem is now shown in most of the health care organisation. So the organisational management has to take decision very fast to avoid this bad behaviour by which they create a good and flexible work environment for the nurses and the nurses provide proper services. The organisational management incorporates the reason from the study, so this study is most important.

2.2 Arguments and ideas presented by the authors:-

In contemporary situation as the lateral violence and bullying is sensitive issue so several authors had researched on this topic to identify the actual reason. According to Stowkowski (2008) organisational staffs are the main reason of violence and bulling, because several nurses have poor moral and value in their personal life and the nurses are used those values in professional place so they badly behave with their staffs. Whereas Simmons (2008) argued that all senior nurses are not bad in nature. Excess work pressure and stress make the nurses annoyed and anxiety and for that reason when they will communicate with their staffs it is affected. Insomnia is one of the big reasons of making anxiety of disruptive behaviour.

Randle (2007) opined that the physician, the patient and the family of the patients are also responsible of lateral violence and bullying. Most of the cases the physician abuse to the supervising nurse and they show their anger to staff nurses. Apart from that the patients and their family also misbehave with the nurses and most of the nurses can’t express in front of them. In this situation they feel humiliation and increase absenteeism and redundant. According to Knopper (2009) the physician does miscommunication with the nurses when they go to them for clarify medication prescription.

On the other hand according to Hughes, (2009) the organisation is also responsible for bullying and lateral violence. The organisation paid less salary, demand over time job from the nurses due to less employee recruitment. For those reason the nurses also feel anxiety and result is horizontal violence and bullying, where the author Bartholomew (2006) also add the backstabbing, verbal affront, infighting between the employees, and personal problem also the reason of horizontal violence and bulling.

2.3 The quality and value of the article:-

The overall data used in the topic is up to date and not vague. The information is not manipulated. As this is used for academic purpose not for commercial purpose the researcher used all up to date sources. To make a good and valuable assignment the researchers used secondary data collection method and collect effective information from those data. These information help to the researcher to understand the topic and the reason related to the topic.

2.4 Brief reflection of using sources:-

During the time of researching the researcher had faced several problems. Most of the nurses can reveal their problem to other as they have chance to cut out of job from the organisation. The nurses also don’t want to complain against senior nurses and physician. From the research the researcher also gain lots of social issues. The powerful person always gets more facilities comparing to lower level staff. In a health organisation most important factor is strong work environment and maintaining culture of safety.

2.5 Conclusion:-

From the above topic it is conclude that horizontal violence and bulling in nursing is a big issue that makes a critical situation in health care organisation. The physician, patient and their family, supervising nurses are behave very bad and humiliate to the staff nurses most of the time. This is the reason the nurses get upset and also feel annoyed and anxiety and gradually it increase the rate of absenteeism and redundant.


American Association of Colleges of Nurses (2007, October), Nursing Shortage, Retrieved December 4, 2007, from http://www.aacn.nche.edu/Media/FactSheets/NursingShortage.htm.

AORN, (2006), Creating a Patient Safety Culture. Retrieved January 7, 2008, from http://www.aorn.org/PracticeResources/AORNPositionStatements/Position_Creating a Patient Safety Culture.

Bartholomew, K. (2006). Ending nurse-to nurse hostility, Marblehead, MA 01945: HCPRO, Inc.

Hughes, N. (2009). Bullies in health care beware. American Nurse Today. 3(6), 35.

Hutchinson,M., Wilkes, L.,Jackson,D., &Vickers, M. (2010), “Integrating individual, work group and organizational factors: Testing a multidimensional model of bullying in the nursing workplace”. Journal of Nursing Management, 18(2), 173-181.

Knopper, M. (2009), Putting a stop to medical road rage. Clinician Reviews, 19(1), 8.

Longo, J., & Sherman, R. O. (2007), levelling horizontal violence, Nursing Management, 38(3), 34- 37, 50, 51.

Randle, J., Stevenson,K.,& Grayling L. (2007), Reducing workplace bullying inhealthcare organizations. Nursing Standard, 21(22), 49-56.

Stowkowski,L.(2008), A callto endbullying in theworkplace, Advancesin Neonatal Care, 8(5), 252-253.

Simmons,S.(2008) Workplace bullying experiencedby Massachusetts registered nurses and the relationship to intention to leave the organization, Advances in Nursing Science 31(2), E48 E59.




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Bullying is any repeated and systemic behaviour that expects to victimise, humiliate, undermine or threaten towards others, which can impact on physical and psychological well-being. Bullying has been considered as unaccepted workplace behaviour that affects occupational health and safety, and should not be tolerate in any form.

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