The Bully Within and Without: Strategies to Address Horizontal Violence in Nursing

PROBLEM: Pervasive horizontal violence in the nursing profession has bred the aphorism "nurses eat their young." Nurses must make a concerted effort to advocate for change in the existing professional culture. Such change can begin with embracing helpful tips in overcoming bullying and modeling successful positive behaviors. This paper defines horizontal violence in nursing and explores strategies to address it based upon shared information. METHOD: Multiple workshops across the country have allowed nurses to exchange information about their experiences with horizontal violence. Nurses have examined their roles as bystander, perpetrator, and victim in discussing contemporary perspectives, employing methods of engagement, promoting debate, and using practical resource advice in dealing with the experience and prevention of horizontal violence. FINDINGS: Workshops, evaluated through pretests/posttests and written evaluations, revealed increased knowledge about concepts of horizontal violence and their application to the workplace, recognition of horizontal violence, and methods of dealing with horizontal violence in nursing. CONCLUSIONS: Across the profession, nurses need exposure to practical approaches to curtailing horizontal violence in nursing. A similar workshop approach could be adapted across educational programs and workplaces based on the individual needs of each environment.