Horizontal violence in nursing – theoretical underpinnings

In theory, models such as oppressed-group and task-time theories explain the occurrence of horizontal violence in nursing. According to the oppressed-group model, nurses are perceived to have lower power compared to the groups they work with such as physicians (Roberts, 2000). Nurses might thus tend to counteract the perceived lack of power by overpowering colleagues (Sheridan-Leos, 2008). The task-time theory is based on the perspective that nursing is a rule-oriented profession where performance of tasks is limited by time. Accordingly, daily tasks may overwhelm a nurse leading to the nurses’ depersonalization; subsequently, the affected nurse does not perceive colleagues as individuals to whom s/he owes respect (Sheridan-Leos, 2008).  The affected nurses could thus lash their frustration out on their colleagues as a way of coping with stress (Sheridan-Leos, 2008).

Horizontal violence has its roots at the onset of the nursing profession. Stevens (2002), for instance, notes that “nursing has always condoned intimidating behavior” since nursing became established at a time when public health was perceived as a reform movement where practitioners had to act in a bossy and controlling manner to instruct their “lower orders” about health (p. 189). Published analysis into horizontal violence in nursing however arose much later, in 1984, when Smythe’s, in her book, Surviving Nursing, presented advice on how nurses can manage stress associated with negative behavior at their workplaces (cited in Stevens, 2002, p. 190). Subsequently, horizontal violence has become a widely-recognized challenge to effective provision of care, with various models being proposed to explain its prevalence in nursing (Sheridon-Leos, 2008). Heightened concern with horizontal violence in nursing has, for instance, been evident with nursing organizations in various countries (e.g. the U.S. and Canada) issuing statements that discourage such behaviors (CNA & CFNU, 2008; Center for American Nurses, 2008).  Go to approaches to address the issue in Canada.

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