Academic journal article Creative Nursing

Horizontal Violence and the Socialization of New Nurses

Academic journal article Creative Nursing

Horizontal Violence and the Socialization of New Nurses

Article excerpt

This article discusses research on horizontal violence in nursing, focusing on the cycle of horizontal violence within nursing education and how it impacts the socialization of newly graduated nurses. Michel Foucault's (1969,1980) work is used to provide a framework for understanding the socialization of nurses and for addressing horizontal violence experienced by nursing students, to help them prepare for the work environment.

The U.S. Bureau of Labor Statistics determined that of all occupations, registered nursing has the largest projected growth in numbers from 2008-2018 (Lacey & Wright, 2009). However, the Health Resources and Services Administration, Bureau of Health Professions (2002) indicate that by 2020, the U.S. nursing shortage will grow to more than 800,000 registered nurses (RNs). A wealth of research has examined recruitment and retention of RNs in the workforce to address concerns about the supply of RNs meeting the nationwide demand. The American Association of Colleges of Nursing (AACN) has described factors contributing to the RN shortage including shortage of nurse faculty, slow rate of growth in number of RNs, increasing average age of RNs, and increased demand for RNs to care for an aging population (AACN, 2008).

Other factors contributing to the RN shortage include stress levels, decreasing job satisfaction, and high turnover and vacancy rates (AACN, 2008). Horizontal violence, a factor associated with job dissatisfaction and turnover, is an issue in the nursing profession that is often discussed but is insufficiently investigated. The effects of horizontal violence have been reported in nursing literature for almost 30 years (Duffy, 1995; Roberts, 1983; Skillings, 1992). Previous research in the nursing profession had determined that horizontal violence occurs, but research has not clearly determined its impact on job satisfaction, job turnover, and retention.

Horizontal violence is defined as overt and covert nonphysical hostility, such as criticism, sabotaging, undermining, infighting, scapegoat, and bickering (Duffy, 1995). Horizontal violence refers to the harsh reality experienced by some nurses beginning their careers in nursing; Roberts (1983) describes it as "eating our young." Horizontal violence includes forms of nonphysical intergroup conflicts that are manifested in overt and covert behaviors of hostility (Duffy, 1995; Freire, 2000). Acts of horizontal violence can range from intimidating body language to sarcastic comments and abusive language. Horizontal violence includes all acts of unkindness, discourtesy, divisiveness, and lack of cohesiveness. Examples include belittling gestures, verbal abuse, gossiping, sarcastic comments, faultfinding, devaluing comments, disinterest and discouragement, and controlling behaviors. Horizontal violence is psychologically, emotionally, and spiritually damaging behavior and can have devastating long-term effects on its recipients (Wilkie, 1996).

The concept of horizontal violence evolved from Paulo Freire's work on oppression. In the 1970s, he defined horizontal violence as the behavior of oppressed people who coped with feelings of powerlessness by displacing negative emotions and aggressiveness onto each other rather than onto the dominant social group (Freire, 2000, pp. 45-47). Freire (2000) also suggested that maintenance of oppression is achieved by an educational system, which reinforces the belief that the dominant group's characteristics and abilities are the most important summary. Because nursing practice occurs in predominantly medical institutions, oppression is an issue that some members of the nursing profession struggle with on a daily basis. When nurses internalize stereotypes portraying them, it may become difficult for them to overcome those negative images. Therefore, nurses may feel powerless and displace negative emotions and aggressiveness onto each other.

HORIZONTAL VIOLENCE IN NURSING

Several qualitative studies have explored horizontal violence in the workplace. …

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