![]() ![]() Both are part of a category called disruptive behavior and are extremely hurtful to the patient – because human beings can’t think straight when they are upset. Horizontal hostility is used to describe disruptive behaviors between peers. Bullying is a term used when someone has more perceived power than you do like your manager or a doctor. Gestures such as raised eyebrows, cliques, sarcasm and eye-rolling have a profound and detrimental effect on teamwork, retention, quality, safety and satisfaction and are the source of a great deal of conflict.Ī core tenant of all health care workers, whether physician or nurse, is “First Do No Harm”. Horizontal behaviors can be overt or covert and are extremely hurtful. ![]() But neither of these strategies is effective, and the responsibility for creating a professional work environment ultimately lies with each individual nurse. Because resolving the quarrels that result from poor relationships can be exhausting and time consuming, many managers tend to ignore nurse-to-nurse conflict, or act like a third party and negotiate compromise in order to end an energy-draining situation quickly. This data is no surprise to managers who spend 30-40 per cent of their workday dealing with some form of workplace conflict (Thomas). Nurses who report the highest degree of conflict also experience the highest degree of burnout (Hillhouse). Relationship conflict affects morale, satisfaction, patient safety, and quality of care. Significant research exists to confirm the damage caused by relationship conflict in healthcare particularly aggression, verbal abuse, and horizontal hostility. We know so much about our patients, yet so little about how we ourselves function as social animals in groups (Oppression Theory). And the second major cause is power: when any group of people has been without the power to improve or change their situation over many decades, they unconsciously lash out at each other. Why would these behaviors happen more frequently in healthcare than the general workforce? Because they are directly linked with stress and the medical field abounds with high stressors, both internal and external: increased acuity of patients, decreased length of stay in hospital, more chronic and complex illnesses, not enough resources, sick time and the emotional work of nursing. And according to one study (Porath), it is higher in Canada than the United States (perhaps because Canadians have a cultural norm of being much more polite so the behaviors are driven further underground.) While roughly 10 per cent of all professions report disruptive behaviors, the number is higher in healthcare – about 30 per cent. A significant body of research suggests these behaviors are prevalent and destructive to the team, yet hidden from view.
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