Horizontal Violence and the Student Nurse

Abstract

Horizontal violence is the overt or subtle aggression from one colleague to another in a verbal, physical, or emotional manner. Horizontal violence is becoming a growing concern in the nursing profession and several studies have indicated this might be a cause of students leaving the profession. This study aimed to examine St Lawrence College’s Bachelor of Science in Nursing (BScN) students’ experience/perception of horizontal violence during their clinical practice. The study received ethical clearance from the College’s Research Ethics Board and students from all four years of BScN program were invited to participate in a qualitative online questionnaire, administered via the student Learning Management System; Blackboard. Questions addressed students’ experiences with horizontal violence, its forms, frequency, suspected reasons and experienced effects. 94 students responded to the survey. 80% of students experienced horizontal violence with years 3 and 4 showing the highest incidences. Of those who experienced violence, 47% did not report the incident. The most common forms of violence were: belittling or undermining work (50%) and destructive criticism (41.5%). The most common effects of violence on students were: stress or illness (63%), fear or embarrassment (57%), poor self-esteem (43%) and thoughts of leaving the program (30%). Suspected reasons of violence were: rite of passage when entering nursing (56%) and desire for power (41%). We conclude horizontal violence has negative impacts on students’ overall clinical experience. Collaborative efforts by academic institutions and clinical placement organizations are necessary to strengthen/reinforce the policy of zero tolerance of violence in clinical settings.