Horizontal Violence: Nursing’s Rite of Passage or Shameful Behavior?

By Marti Kessack, PhDc, M.S.N./Ed., RN, Full-Time Faculty Lead in HealthCare and Nursing 

CTU HealthCare Degrees - Horizontal Violence in NursingIt is a memorable moment when a nurse realizes she has finally been accepted into the collective unit. Every nurse has experienced it, that magical turning point when s/he no longer has to endure cold shoulders, heavy sighs when clocking in at the beginning of a shift, or unfair workload assignments. Finally, the nurse has come through the ordeal of being the “newbie nurse” and is an accepted and respected member of the unit.

This typical nursing behavior is not just reserved for new graduate nurses (although their patient load in the unit culture can be a heavy one). Rather, this behavior is extended to any nurse, regardless of his/her experience, who is entering a unit. It’s known throughout nursing as “eating our own,” or, “horizontal violence.” Nursing is the one profession that engages in this behavior consistently and collectively.

Horizontal violence has been defined by Jennifer Becher and Constance Visovsky in their 2012 article, “Horizontal Violence in Nursing,” as, “any unwanted abuse or hostility within the workplace.” Horizontal violence can take many forms, from ignoring the nurse’s requests for assistance and overt verbal bullying, to demeaning the nurse either privately or in front of others. It can also include criticizing the nurse in front of others, intimidation, blaming, pitting one nurse against another and any behavior the nurse may perceive as threatening.

This violence can come from staff nurse peers, managers or even the ancillary staff. It is theorized that nurses engage in horizontal violence due to lack of control over decisions made for the workplace, decreased self-esteem, and the perception that the registered nurse is oppressed in the workplace by policies of administrators.

The perfect group of nurses to combat this workplace problem is nursing educators who can create new, caring models in the curriculum to deliver to their students. Nursing educators have a true opportunity to mold nursing’s professional attitude and direction for the future. By recognizing the tendency toward horizontal violence in ourselves as professionals, we can hope to extinguish this age-old practice. It might just start with something as simple as extending a heartfelt, “I am sorry,” and, “I appreciate all you do.” It might just result in that once-victimized nurse willingly taking the extra step to help make your day easier.


CTU Adjunct Faculty - Marti KessackMarti Kessack, PhDc, M.S.N./Ed., RN, has served for more than 26 years in the nursing field, specializing in emergency and oncology nursing for most of her career. She earned a B.S. in Nursing from Wright State University and an M.S.N./Ed in Nursing Education from Walden University, and is presently writing her dissertation to attain a Ph.D. in Nursing Education. She currently serves as the full-time faculty lead in HealthCare and Nursing for Colorado Technical University.



Image credit: Flickr/OnCall Team


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