Search Strategy

Problem Description

Nurse incivility, violence and bullying have a significant impact on the overall performance of medical institutions and individual nurses.  The American Nurse Association (ANA) published a position paper that recognize the negative impact on nurse incivility, bullying and violence. Nurse incivility is characterized by rude activities like gossiping, spreading rumors or refusing to offer help to a colleague in urgent situations. Incivility is a possibility given the nature of the working environment, which is busy and fast paced. Stress and fatigue can lead to nursing incivility.  Bullying is a form of violence that is intentionally directed at a colleague with the aim of causing distress and suffering to the victim. It is a common occurrence in the workplace.

Significance

Nursing incivility, violence and bullying have a significant impact on the performance of nurses. Nurses are already prone to fatigue and stress due to the fast-paced nature of their work, which makes the addition of violence and bullying a dangerous threshold.  The victims of bullying and violence are placed in jeopardy that makes it difficult for them to fulfil their responsibilities. In the end, patients and nurses are at risk because a stressed victim is likely to make a huge mistake.  Proper measures should be taken to reduce the frequency of nurse incivility and prevent violence and bullying.

PICOT Question: What is the impact of horizontal violence among staff nurses on the working environment and its connection to the intent to leave?

Purpose

Understanding the factors affecting horizontal violence among staff nurses lays the foundation for developing sound intervention strategies.  Horizontal violence has the potential to cripple activities at a critical time because it hampers teamwork. The sensitive nature of the medical environment demands effective teamwork because everyone has a role to play in ensuring patient care meets the highest standards of quality.  The purpose of this is to understand the impact of horizontal violence and whether it pushes some nurses to opt for a change of working environment.

Levels of Evidence

The paper seeks to understand the impact of horizontal violence and its connection to the decision to leave by some nurses.  Does horizontal violence contribute to a negative working environment that can lead to the loss of valuable members of the workforce.  Are there effective intervention strategies that can be applied to prevent horizontal violence? What is the connection between horizontal violence and poor communication at the workplace?   The main question aims at understanding the impact of horizontal violence, which in turn paves way for the exploration of factors that might help reduce or increase cases of horizontal violence among staff nurses.

Horizontal violence has a multifaceted impact, which includes the impact on the unit, institution and the individual.  It has a significant impact on the professional responsibilities of a nurse. Armmer and Ball (2015) found a positive correlation between the intent to leave and horizontal violence. According to the Armmer and Ball (2015), horizontal violence is experienced in different forms, which include the spread of false rumors, being confronted in front of colleagues, and the lack of acknowledgment from colleagues. Horizontal violence can lead to nursing attrition (Armmer & Ball, 2015).  Reynolds, Kelly and Singh (2014) found a positive correlation between horizontal violence and poor patient outcomes. Poor communication is among the factors that positively influence horizontal violence and bullying among staff nurses (Reynolds, Kelly, & Singh, 2014).  The frequency of horizontal violence depends on the working unit as demonstrated in the study conducted by Reynolds and her co-workers.  Studies show that the best way to deal with horizontal violence is to create a working environment that encourages nurses to share their experience and talk about any form of mistreatment (Armmer & Ball, 2015; Reynolds, Kelly, & Singh, 2014). The workplace should be a safe place for all stakeholders.

Search Strategy

Search terms: horizontal violence, nursing incivility, nurse bullying

Database: Ebscohost, Google Scholar

The use of the identified search items was critical in finding the right studies to answer the question asked. The decision to select the main papers was based on the nature of the study and how well it answers the main question. A review of search result was undertaken by going through abstract to get a gist of what the study entails. In some cases, a deep analysis of the study objectives and the result was undertaken to determine whether it answers the question or not.  The process led to the selection of two articles that define the impact of horizontal violence and bullying on the workplace environment. Both studies recommended the creation of a safe working environment for all staff nurses. Poor communication is one of the factors that promotes incivility and violence among nurses.

The two relevant articles selected for the study focus on the impact of horizontal violence among staff nurses. One article is specific to the impact on horizontal violence among nurses in prenatal care.