Peer Mentoring: Horizontal Hostility In Nursing

work relationships in nursing to find a solution. The result of that investigation stated that horizontal violence in nursing is commonplace and experienced by nursing students, nurses with limited experience, and seasoned nurses equally.

Nurse bullying is not limited to the new nurses being the victims. Bully behavior is a learned process and a choice. A new nurse might observe and embrace the bully behavior in hopes to fit in a little bit more (Rocker, 2008). Cliques may form on nursing floors which are the vehicles for nurse bullying. Cliques help a bully hide and gain support. It seems easier for people to join the group instead of fighting against it (Rocker, 2008). This is why workplace bullying is a growing statistic.

In 2009 unspecified electronic survey was conducted with factors such as type, frequency, perpetrators, and professional/personal concerns on bullying identified (Quine, 2001). The results revealed that out of 330 RN respondents, 72% reported positive to bullying at various occasions in line of their career. Of this segment, clear hostility seemed most frequent in surgical/medical, operational rooms, emergency, obstetrical areas of care and adolescent residential behavioral/ mental health units. The main culprits to these act are non-other than; charge nurses, senior nurses, physicians and nurse managers. This is impartial research among others that have been

As Finkelman (2006) stated, “Mentoring, and important career development to that can be used by nurses any type of set or specialty, can be used to develop the critical leadership skills needed by nurses. All successful leaders have had mentors are our mentors” (Finkelman,2006, p. 390).

Moreover, another type of violence which nurses experience is horizontal violence. Horizontal violence is described as “hostile, aggressive, and harmful behavior by a nurse or group of nurses toward a co-worker or group of nurses via attitudes, actions, words, and behaviors” (Becher & Visovsky, 2012, p. 210). Horizontal violence not only involves nurse-nurse violence but includes nurse-physician and nurse-supervisor violence. The perpetrator displays behaviors associated with horizontal violence which may include refusing to lend assistance, criticizing, intimidation, gossiping, name-calling, and ignoring (Becher & Visovsky, 2012). The American Nurses Association sets the expectations for nursing standards. According to the American Nurses

There has been much research done on the prevalence of bullying in the nursing workplace. Smith, Andrusyszyn, and Laschinger (2010) report that up to 90% of nurses encounter bullying in the workplace. Because this has become so commonplace within the nursing environment, many nurses turn a blind eye, or passively participate in bullying, accepting it as a normal occurrence in the workplace

Bullying is a serious problem in the nursing profession, it decreases nurse productivity, creates adverse patient outcomes, and overall lack of job satisfaction. It can be seen anywhere in the nursing profession. Bullying includes emotional and physical abuse as well as, putting others down, intimidation, spreading rumors, etc. “Research findings suggest that bullying frequently occurs among RNs [6] to the extent that up to 40% of nurses report an intent to leave because of it [7]; this is significant especially for new nurses, in that new RNs reported being bullied at work which resulted in 30% of

The Nursing and Midwifery Council (NMC) defines the role of a mentor as a nurse with specific training who is able to facilitate learning, and supports and supervises students in a practice setting (NMC 2008). Mentorship plays an integral part in the next generation of practitioners and nursing professionals play a vital role in guiding a process that allows the transference of knowledge, skills and attributes from healthcare professionals to the students they are working with (English National Board and Department of Health 2001).

Nursing is a profession that is based on the principles of caring and ethics. For years nursing has been continuously ranked as the most trusted profession (Riffkin, 2014). Nurses advocate for patients even if it means standing up to doctors and hospital administrators. Shockingly, for a job rooted in compassion, horizontal violence is a devastatingly common occurrence in the nursing profession. Horizontal violence, or workplace bullying, is defined as repeated incidences of aggressive behaviour intended to intimidate, degrade, humiliate, and offend a person or group of people (Ontario Nursing Association, 2012). Nurse-to-nurse aggression can range from yelling, withholding information, refusing to help, undermining a fellow nurse 's work ability and threatening unnecessary disciplinary action (Rocker, 2008). In Canada, 50% of nurses reported being verbally abused and 46% experienced hostility or conflict with colleagues (Statistics Canada, 2005). While many nurses are victims of bullying, many do not report the incidents and develop poor coping strategies. When a nurse does not report a bully, they are putting their mental health at risk. Nursing programs must implement educational programs for student nurses. They rely on safe clinical placements to develop and practice essential nursing skills. However, the toxic environment that bullying creates jeopardizes not only their education but their mental health as well, spurring on ramifications that last a lifetime.

Nurses continually strive to bring holistic, efficient, and safe care to their patients. However, if the safety and well-being of the nurses are threatened or compromised, it is difficult for nurses to work effectively and efficiently. Therefore, the position of the American Nurses Association (ANA) advocate that every nursing professional have the right to work in a healthy work environment free of abusive behavior such as bullying, hostility, lateral abuse and violence, sexual harassment, intimidation, abuse of authority and position and reprisal for speaking out against abuses (American Nurses Association, 2012).

A Nursing Times survey identified that, while mentors are aware of the value of mentoring students (Gainsbury, 2010), they are challenged as to how to commit fully to the role within the constant demands of their core job. They identified that work demands had a significant impact on their ability to engage in mentor activities, such as mentoring students and attending updates and relevant courses. Mentors have also expressed concerns about accountability and supporting failing students (Duffy and Hardicre, 2007). Mentorship preparation and the ongoing development of nurse mentors www.nursingtimes.net / Vol 107 No 21 / Nursing Times 31.05.11 15 Nursing Practice Review 5 key points 1 Nurses and midwives have a responsibility to continually develop themselves for professional growth Mentors play a pivotal role in protecting the public by ensuring students are fit for purpose and practice 2 3

“The first step in teaching nurses how to decrease bullying by others is to help them understand what to do and what not to do when confronted by a bully” (Rocker, 2008, Education, para. 13). Nurses need to be aware of how to recognize horizontal violence, and how to be able to stop it. Furthermore, Baltimore (2006) explained that nurses need to try and resist the temptation of participating in gossip which could ultimately result in people losing respect for nurses (p. 35). Nurses also need to be respectful and value differences among other nurses. Each nurse is unique and may have different ways of implementing his/her type of care. Therefore, it is crucial that nurses respect these differences (Rocker, 2008, Policy, para. 14). If nurses are able to be consciously aware of these small things, it can make a huge difference on how they treat other coworkers, and how others view them. Not only is it important for nurses to understand what horizontal violence is, but managers of hospitals need to be well educated of this as well. Brunt (2011) stated that managers have a key role in preventing and altering horizontal violence in the workforce. It is important that managers create an environment where staff members feel comfortable coming to the managers with concerns. Managers need to be educated about how to deal with the negativity of horizontal violence (p. 7). Managers can improve relationships, trust, and productivity and reduce tension by

Bullying is a serious issue that frequently happens during a nursing shortage. Since hospitals need to recruit new nurses when their nurses left. Therefore, new nurses are usually the target of bullying by the old nurses. Accordingly, bullying can cause even more burdens to the challenges that the novice nurses or new nurses have to face on the daily basis. As the findings in this research, the bullying acts may be on personal attack, competence or work tasks. And the consequences of this issue can cause diminished self-esteem, distress that lead to physical and emotional damages for these nurses; that is why more nurses want to leave their job because of job dissatisfaction, or else, they will put their patients' safety in danger (Olender,

144). The mentor is usually referred to as an experienced and competent staff nurse who can serve as a role model and resource for the new staff member or perhaps an experienced nurse who has entered a new realm of the field. According to Greene and Puetzer, “the complexity of the nursing career requires a substantial and consistent support system to ensure success, satisfaction, and retention” (2002, p. 69). It is no wonder, then, that the role of the mentor should be as complex and fluid as the career for which it is mentoring.

Mentoring has been established in a variety of fields for many years. Within nursing, the term ‘mentor’ denotes “A nurse, midwife or specialist community public health nurse who facilitates learning and supervises and assesses students in a practice setting”, (Nursing and Midwifery Council (NMC) 2005). The essay will explore the role of the mentor in the field of nursing, with personal reflection on the authors experience as a mentor in my current role as a community mental health nurse (CMHN). The mentor-mentee learning relationship will be explored and the application of teaching and learning strategies will be examined.