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Horizontal Violence

Until facilities recognize the problem of lateral violence among nurses, low staff morale and high turnover will continue

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Horizontal violence is a significantly increasing epidemic in the workplace; it is an undesirable and negative phenomenon that has been proven to be associated with decreased job satisfaction and retention of novice nurses, and high turnover rates of nurses.

In the literature, horizontal violence is also referred to as horizontal hostility, verbal abuse, bullying, intimidation and lateral violence. All of these terms are indicative of behaviors that are demoralizing and unsettling for the victim.

What is Horizontal Violence?

Horizontal violence is a form of consistent and aggressive behavior between coworkers at the same level of authority, which is done to "control, diminish, or devalue a peer."1

Any action, verbal or nonverbal, from one group member directed toward another staff member who in turn has a feeling of humiliation is considered horizontal violence. In nursing, verbal abuse is the most common form of horizontal violence. Verbal abuse, yelling, rumors, name-calling, displacement, and belittling others are all examples of overt behaviors.

Horizontal violence is categorized as overt and covert. Covert behaviors may be exhibited as isolation, refusal to help or work with a staff member, making fun of or mocking, changing assignments, and non-verbal innuendos such as eye rolling and sighing.

Horizontal violence impacts the victim, as well as the organization. Individual problems may be psychologically, emotionally, socially, physically and spiritually devastating for the victim. These stressors can lead to long term consequences such as PTSD, cardiac arrhythmias and other maladaptive responses.

Within the organization, horizontal violence can lead to financial disadvantages related to workers' compensation claims, medical leave absences, low productivity of staff members, frequent recruitment efforts, and high turnover rates.

Common Occurrence

Horizontal violence has affected an estimated one in six employees, impacting retention and turnover rates of nurses.

An alarming 78 percent of nurses who have been victims of horizontal violence do not turn to their nurse manager to report their coworkers. Approximately, 60 percent of new nurses leave their first job within 6 months of employment due to horizontal violence.2

In the U.S., 43 percent of nurses reported they intend to leave their job within 1 year, and internationally one in three nurses have left their job due to bullying and other forms of horizontal behaviors.


Horizontal Violence

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