Horizontal Violence – Don’t Take it Lying Down!


Horizontal violence (or lateral violence) is increasingly common among nursing.  The impact of such violence can cause detrimental damage to the victim involved and patient care can be de-prioritised.

Various levels of horizontal violence within the medical profession can take shape in various forms, such as bickering amongst staff, verbal abuse, intimidating another peer and blaming, amongst other mediums.  The nurse whom is being victimized will most likely be stressed prior to any form of abuse due to high demands of the role he/she is undertaking. The victim is under increasing pressure to perform to their best potential within their role, and any abuse received will only create further stress and tension.

According to a study conducted by Kathleen Bartholomew, it was estimated that 46 -100 per cent of nurses reported horizontal violence within the workplace.

Horizontal violence sounds harsh, doesn’t it?  A simple scowl from a colleague or refusal to help or assist another nurse is classed as violence.  Physical attacks or contact is rare, however; something as simple as a glare can be classed as horizontal violence within the workplace.  Basically, if anyone who works in the medical sector, whether it be a nurse, Doctor or Physician – inflicting any form of abuse or causing stress to another colleague is within the boundaries of what is classed as such violence.

The Impact of Horizontal Violence

When a nurse becomes a victim of this type of abuse it can be a catalyst for numerous repercussions – not only in the workplace but at home also.  Imagine a hard-working nurse beginning their shift.  They enter their work environment, prepared to give their all – they are feeling positive for the day ahead.  They assume their role and another colleague insults them for doing their job. The individual could be affected by hostility, aggression or simply be disrespected for their efforts.  The impact of receiving such abuse can lead to the individual feeling worthless, sad and unmotivated to continue with the rest of the day.  The most poignant point of horizontal violence is that if the victim performs unwillingly then this will have a knock-on-effect on patient care.  The stress upon the individual will can also promote negativity within the workplace and others will sense the negative atmosphere.

The one affected will probably take the stress of work home with them, and continuous stress can lead to the sufferer developing low self-esteem, depending on the level of violence.  Lack of confidence is another factor that will not only affect the person involved but will evidently show within the work place.  An unhappy worker is not an efficient worker, and this is something that seriously needs to be addressed, especially when patient care and compassion should be on the person’s list of top priorities.


If the abuse continues for the nurse involved then it can lead to the person feeling forced to take time off work – this can also lead to a disciplinary for the victim, which causes more stress.  Furthermore, termination of employment could be a factor if the violence continues.

What Can be Done?

Horizontal violence in nursing can be dealt with by immediately addressing the situation once it has occurred.  More importantly, awareness should be raised about the problem in general. A victim of violence, whether it be verbally or physically should never suffer in silence. By speaking up, the victim is taking a major step in helping to diminish horizontal violence in nursing – awareness is crucial!

To prevent an individual from suffering humiliation or deprecation, management should be whole-heartedly involved in ridding horizontal violence from the workplace. Management can offer support to the individuals suffering and ensure that the whole staff are aware of the consequences of horizontal violence.

It has become more popular for patients to use online diagnosing rather than visiting the hospital for treatment or care. The positive aspects of this are that patients who choose this method will not notice the effects of horizontal violence. More so, a patient could have been in a situation where such infliction has occurred and be hindered by the experience thus choosing to use other methods of care. Sometimes, medical help is needed and examination is detrimental to patient care. If horizontal violence is lessened within the medical sector then patients and nurses alike will feel more at ease, whether that be within a work environment or somebody who needs to receive exemplary care.

Lily Dyer is a freelance health writer working with health organisations and medical professionals to deliver information online.

Matt Vera is a registered nurse with a bachelor of science in nursing since 2009 and is currently working as a full-time writer and editor for Nurseslabs. During his time as a student, he knows how frustrating it is to cram on difficult nursing topics and finding help online is near to impossible. His situation drove his passion for helping student nurses through the creation of content and lectures that is easy to digest. Knowing how valuable nurses are in delivering quality healthcare but limited in number, he wants to educate and inspire students in nursing. As a nurse educator since 2010, his goal in Nurseslabs is to simplify the learning process, breakdown complicated topics, help motivate learners, and look for unique ways of assisting students in mastering core nursing concepts effectively.

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