Horizontal Hostility

Nurses General Nursing


We've had a long history of horizontal hostility (AKA bullying, horizontal violence, etc.) on our unit. So we decided to try to make some changes. We started by purchasing and showing a video re: nurses and horizontal hostility. Now our nurse manager is wondering which way to go to enact something to cause changes. I personally believe administration has to develop a policy and then find a way to enforce it and show people that they mean business.

What have your hospitals/organizations done to conquer horizontal hostility? Thanks for any and all feedback.



301 Posts

Well, at my facility they have progressive discipline.

First offense could be a counseling, second a written warning,

third, could be a suspension, fourth dismissal. They also receive points, like for certain offenses could receive 3 or 6 points depending on the severity and type of incident and receiving 12 points is the limit....another offense that could cause that person to have over 12 would then be an automatic dismissal. So if you have several different types of offenses but they total 12 points they would then be terminated at the next offense if it gave that person another 3 points. But just another counseling or a written warning, depending on what it was might not put the total over 12...just depends on what it is.

Then stand by their word and follow the policy.

pagandeva2000, LPN

7,984 Posts

Specializes in Community Health, Med-Surg, Home Health.

I don't believe that my facility has really addressed this issue properly. Oh, sure, they have showed the films, had the discussions and had everyone sign, but not much has changed...sorry to say.


985 Posts

Specializes in Med/Surg, ICU, educator.

We have progressive discipline where I work as well. Unfortunately, at a small hospital, in a small town, it's not always fair. I'd like to hear anyone's ideas in a situation like this. But I agree, horizontal aggression/hostility should never be tolerated. You think we'd learn to take care of each other. Sometimes we only have each other.


19 Posts

Thanks for all of the replies so far. I'm hoping to get more ideas. I'm afraid, like in Strong-willed's hospital that we'll end up "talking the talk" and not able to "walk the walk".

CatlynLPN, does your institution start w/ a written policy and then inservice all the staff or do you know how your discipline policy was created? Do people report other people who have "bullied" them and that "bully" then gets points? I don't think I quite understand.

Thanks for any and all help!:yeah:


trixie333, ASN

92 Posts

Specializes in Emergency, critical care.

It occurs to me that punitive measures may not be desirable or even that effective in the long view...it would be interesting to experiment with 're-education' or 're-programming' efforts.... for example, mandated charm school classes and exercises till it hurts or works, with bonuses upon succussful modeling of appropriate workplace behaviors (like a gift certificate for ice cream at Friendly's?)...( a workplace visit from a clown like Ronald McD?) also, this is a group action to change the culture: how about the person singled out for 're-education" has to choose 2 coworkers to accompany them?...would light a fire under the peer-pressure power...I would also like your nurse manager to dedicate a goal-oriented bulletin-board on your unit...something fun, of course(with bouquets, balloons, angels, and gold stars?) just thinking....personally, I want to see your thread go someplace new and helpful...

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