Prevalence of horizontal violence in

the nursing workforce

Proponents:
Julie Anne Bautista
Jennifer Beran
Chona Cherry Cepeda
Julius Bryan Lingan
Rosario Margarita Ordona

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 Order of Presentation

 Introduction
 Research Attributes
 Variables
 Theoretical Framework
 Review of Literature/Hypothesis
 Research Questions
 Significance of the Proposed Research
 Open Forum

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 Introduction

Horizontal violence
is harmful behavior via attitudes, actions,
words and other disruptive behavior that is
directed to us by colleagues. (Conti-O’ Hare & O’Hare, 2006)*

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 Introduction

 Horizontal violence is a significant problem that is facing

the workplace today. It is a problem among nurse’s as well
as other disciplines.
 In many forms, it has been present in nursing for many
years.
 Historically, it has been a means of socializing new staff
members into the work culture. *
 Today, however, the phenomenon had become more
complex and it can have negative impact and long-lasting
effects on the nurse, the patient and the organization. *

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 Question

Do we share the same commonalities? *

Is it possible that horizontal violence is less a part of the

nurse-colleague behavior in the Philippines? *

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 Research Attributes

Field of Specialization: Nursing

Research Approach: Quantitative
Research Method: Descriptive
Corpus of Data: Survey Questionnaire *
Research Domain: Occupational Health and Safety
Research Foci: Prevalence of Horizontal Violence

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 Variables

• horizontal violence (2) • mental abuse (14)

• lateral violence (3)
• workplace violence (7)
• bullying (2)
• physical violence (12)
• verbal abuse (15)
• perpetrators (9)
• sexual abuse (2)
• nurses’ health and well-
being (8)
• job performance (4)
• patient care (3)
• silence/under-reporting (6)

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 Theoretical Framework

The Oppressed Group Theory

 Oppression

Silence (Non-reporting)
 Conspiracy of Silence

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 Review of Literature

Effects on Nurses

McKenna, et al. (2002)

Reduced confidence and self-esteem

Fear, anxiety, sadness, depression, frustration, mistrust,

nervousness, use of antidepressants
Weight loss, fatigue, headache, hypertension, angina

Disillusionment with the nursing profession

Move to another area of practice or express intentions to leave

nursing or reluctantly stay with the issues unresolved.
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 Review of Literature

Taylor and Barling, (2002)

 Stress, burnout syndrome, emotional exhaustion,
depersonalization, tiredness, insomnia
 Thinking of other career option and specific problems.
 Increase likelihood of medical errors

Roche, (2009)
 Others developed intentions to leave their present positions.

Senuzun, et al., (2005)

 Took sick leaves

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 Review of Literature

de Castro, et al., (2009)

 Developed injuries, forcing them to take absence from
work.

Leymann, (1996)
 Inability to communicate
 Inability to maintain social contacts
 Detriment to reputation
 Detriment to occupational satisfaction

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 Review of Literature

 Detriment to health

 Compromised patient safety

 Unreported errors

 Individual physical and emotional consequences

 Increased financial cost and health care members seeking

employment elsewhere.

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 Hypothesis

H1: The higher the incidence of horizontal violence

experienced by the nurse leads to a negative state of health
and well-being.

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 Review of Literature

Effects on Patient Care and Job Performance

Vega and Commer, (2005)
 Reduced productivity, efficiency, creativity and innovation

International Council of Nurses (ICN)

 Violence in the workplace threatens the delivery of effective
patient care services and, therefore, patient safety.

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 Review of Literature

Longo, et al., (2002)

 Nurses will be less likely to ask for help from their
colleagues.
 Increase likelihood of medical errors

 Leave the organization

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 Hypothesis

H2: The negative state of health and well-being of the nurses

results to a lower level of job performance

H3: A level level of job performance results to a poorer

quality of patient care.

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 Review of Literature

Silence/Under-reporting

Horizontal violence most commonly takes the form

of psychological harassment, which creates hostility,
as opposed to physical aggression.

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 Review of Literature

Harassment includes:
 Verbal Abuse
 Threats
 Intimidation
 Excessive criticism
 Exclusion
 Denial to opportunity
 Disinterest
 Discouragement and withholding of information

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 Review of Literature

de Castro, et al., (2009)

 Low incident reporting was due to respondents feeling that
the injury was not significant
 Injury was “part of the job”

Leung, et al., (2006)

 Hong Kong: 82% experienced verbal abuse and confide
with their friends, family and colleagues; 42% ignored the
incident; 40% reported physical assault; 29% reported
verbal assaults, 24% reported sexual harassment

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 Review of Literature

Duncan, et al., (2001)

 70% of nurses do not report abuse referring to an
acceptance of culture of violence in hospitals, particularly
by mid and late career nurses
McKenna, et al., 2003
 Under-reporting may be because of fear of retaliation

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 Hypothesis

In the context of the effects of remaining silent after exposure

to horizontal violence, we put forth the following
hypothesis:

H4: The lower incidence of violence reporting results to a

static state of nurse’s health and well-being.
H5: The lower incidence of reporting results to higher
incidence of horizontal violence.

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 Research Questions

The major purpose of the study is to determine the

prevalence of horizontal violence in the nursing workplace.
Other objectives include:
1. Identify the effects of horizontal violence on the nurses,
job performance and patient care.
2. Determine the incidence of silencing/under-reporting and
its relationship to the occurrence of horizontal violence.
3. Examine the effect of increased and repeated incidences of
horizontal violence on the nurses’ health and well-being.

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 Significance of the Research Proposal

The study aims to:

 Fill the major information gap and assist in the worldwide
study of its prevalence thereby helping with the
development of sound policies and practical approaches for
the prevention and elimination of horizontal violence in the
health sector.
 Locally, this study hopes to guide health care organizations
through the complexity of issues and provide them with
information to be considered when developing anti-
violence policies and strategies for all work-settings.

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