Case-Styudy: Vertical Violence in Nursing

Case-Styudy: Vertical Violence in Nursing

Case-Styudy: Vertical Violence in Nursing

Week 4 discussion As a nursing administrator, how will you prevent horizontal and vertical violence in nursing and healthcare? Identify two strategies you would use as a nurse administrator to create a zero tolerance for horizontal or vertical violence. Analyze what you believe are two reasons nurses do not report horizontal or vertical violence in healthcare organizations. Determine what you believe are two linkages between horizontal or vertical violence and impacts on quality of care and patient safety.

Combating bullying in schools and workplaces (the hospital) is a topic that we’ve heard a lot about, especially recently.  When it comes to the work environment, bullying involves an abuse or misuse of power. Specifically, it refers to the repeated, unreasonable actions of an individual directed towards an employee, which are intended to intimidate, degrade, humiliate, undermine, or create a risk to the health or safety of the employee.

Workplace bullying behavior creates feelings of defenselessness and injustice in the victim and undermines an individual’s right to dignity at work. It’s important to distinguish bullying from aggression. Whereas aggression may involve a single act, bullying involves repeated attacks against the target, creating an on-going pattern of behavior.

“Tough” or “demanding” bosses are not necessarily bullies as long as they are respectful and fair, and their primary motivation is to obtain the best performance by setting high yet reasonable expectations for working safely.

Horizontal vs. Vertical Violence

Also sometimes called horizontal violence, horizontal bullying refers to acts perpetrated over time by co-workers on the same level. (e.g., staff nurse to staff nurse, nurse manager to nurse manager).

Vertical bullying, or violence, is defined as acts such as yelling, withholding pertinent information, ignoring, humiliation, or making rude comments, which occur between two or more persons on different levels of the hierarchical system and prohibits professional performance or satisfaction in the work environment. Vertical violence occurs between individuals at different power levels on the nursing hierarchy and may be directed downward (e.g., nurse manager to staff nurse) or upward, (e.g., staff nurse to charge nurse).

Both horizontal and vertical violence is considered nurse-on-nurse aggression, expressed through abusive verbal and nonverbal behaviors intended to inflict psychological pain. Abuse of formal and informal power by individuals or cliques of coworkers are behaviors that undermine the work of a nurses and the entire healthcare team.

Impact of Bullying

Some examples of workplace bullying are:

• unwarranted or invalid criticism
• blame without factual justification
• being treated differently than the rest of your work group
• being cursed at
• exclusion or social isolation
• being shouted at or humiliated
• excessive monitoring or micro-managing
• being given unrealistic work deadlines.