Horizontal bullying can be defined as bullying that has been passed down from superiors or those in charge but cam also occur between coworkers with similar titles. Bullying can be singling out a single individual to harass or mistreat, exhibiting hostile/aggressive and otherwise harmful behavior from one nurse to other coworkers by way of action, attitude, words or general behavior/demeanor. There is no age limit for bullying and its prevalence in the workplace is increasingly rising. This form of bullying can be not only physical or verbal, due to advances in technology it can now be social or cyberbullying. Horizontal bullying is referred to by many in this profession as “nurses eating their young.” Many young or new nurses feel like they are not being accepted by their peers. Rather than assist and motivate new nurses to reach their full potential, older nurses feel as though their experience or longevity at this particular establishment makes them superior or their skills greater than others in a similar position.
Many new nurses starting at the hospital particularly enter a preceptorship that partners them with a senior nurse. This should be an opportunity for growth and advancement within the profession and ask questions before mistakes are made. More experienced nurses that exhibit trusting behaviors and are open to assisting new nurses allow them to feel that they are being supported and encouraged to succeed. When selecting preceptors, managers need to know their employees and only choose those that will facilitate learning as well as provide genuine support. Those nurse that do report bullying in any form usually experience the greatest amount of bullying during this time.
More cases of bullying occur each year than are reported to the facility and there are many reasons why this might happen. Most nurses have either been bullied, been the bully or have witnessed bullying in some form or another. Some that have witnessed have reported the incidences and others have chosen to ignore then with the hope that it will not happen again. Failure to report such an act only encourages those that are participating in this cruel behavior to continue the behavior. It is the responsibility of each nurse to help eradicate this behavior by recognizing it, refusing to participate in it, and to report it if witnessed. The establishment as well is responsible for indicating what bullying behavior is in detail as well as what the consequences for participating or facilitating the behavior. Many nurses that are bullied make a conscience decision not to report being bullied because they wish to keep it a secret or possibly for fear that the level of bullying might increase.
Possible reasons cited for horizontal bullying include the hierarchy system where the bully feels they hold a superior power over their target. This power or authority is often misused and creates feelings of intimidation within the subordinate staff. Seniority is also another possible reason for bullying. These nurses retaliate to being assigned a new staff member by choosing to observe from the sideline rather be a source of guidance and support. Senior nurses may sometimes feel as though they may be training their replacement and are their insecurities take over. Some nurses even feel that no other nurse can provide the same level of care to patients that they have formed an attachment with. This feeling is not only displayed against new nurses but also other nurses with equal amounts of experience and education.
Having these feelings potentially put the care of the patient in jeopardy because nurses will withhold information necessary for effective/efficient patient care. Differences in level of education among the nursing staff can also be a reason for arrogant behavior. Being quick to make a first impression of new staff is a huge culprit where bullying is concerned. The effects of bullying can cause more than just feelings of inadequacy. It can manifest itself as headaches, stress, anxiety, sleep disturbances, depression, fatigue, inability to concentrate, and PTSD. Nurses who are bullied usually experience more than one effect. Determining the full impact of bullying is difficult to determine because of the varying degrees of bullying or attributing the effects to another source.
Nurses in supervisory positions to other nurses in non-managerial positions is one of the highest rated incidence of bullying among those cases reported. Bullying by someone in this position could be repeatedly checking on the nurse when performing tasks, criticizing the way a skill is implemented, belittling for being naive about a particular topic, blaming that nurse for something that was outside of their control or current scope based on knowledge deficit or intentionally sabotaging their chances of longevity within the organization. It has been determined that it is partially the responsibility of nurse educators to break the cycle. They should educate new nurses in ways to deal with bullying, steps to take should this occur and most importantly ways to prevent bullying. Nurse educators that were surveyed felt that they were responsible for teaching their nursing students how to interact with their peers.
Nurses that were surveyed indicated that appreciating, understanding, and celebrating the difference among them was necessary for facilitate improved workplace conditions. They feel it is imperative for all individuals within the organization to take responsibility for creating a positive environment. The organization should align policies with their goals and mission statement of the establishment. Support and education of new nurses can also help to prevent and possibly eliminate horizontal bullying but holding themselves and their peers accountable for their behavior whether positive or negative is key.
Being aware of what bullying looks like will ultimately help to improve the incidence of it occurring. We have to be supportive of each other regardless of the level of education or amount of experience we possess and encourage the growth of new staff members. Welcome new nurses with open arms and give them the benefits of our experiences rather than allowing them to fend for themselves, the “sink or swim” phenomenon. The future of good nurses is in our hands and we must give them all of the positive support and encouragement needed to grow in the profession and be a positive role model for those coming behind us.