Nurse Wars: Vertical and Horizontal Hostility

Nurses seem like patient, compassionate angels to many patients, but just like in any profession, there are conflicts of personality and maybe even some instances of hazing within the world of Registered Nurses and Certified Nurse Assistants. However, because a hospital relies on efficiency to save lives, petty issues between employees may cause larger problems that could affect the health of patients. In order to prevent or resolve these conflicts, it is important to understand how they may affect the workplace.

In the United States especially, diversity in the workplace may potentially have a negative impact in a professional environment by causing various conflicts. Whether it is from cultural or communicative breakdowns, conflicts may arise within the nursing profession. If information is not properly communicated and processed, the patients can suffer. It is important to keep the health of the patients above any trivial disagreements or misunderstandings between coworkers.

Many of the common conflicts within the nursing community can be solved with appropriate conflict resolution techniques. For example, many conflicts can be resolved simply through improved communication. Especially in a hospital setting, it is important for a person who is speaking to be sure that listener has processed and properly understood the message. The person listening must also make an effort to fully understand the information, and can do this by asking questions and by staying away from assumptions. Better communication increases overall efficiency, and makes everyone’s job easier, which improves the vibe and the feeling in the professional environment.

In the nursing community, there is a long-standing history of hazing incidents between veteran nurses and newcomers. Just like any other forms of hazing, it can be in good fun or it can be hurtful and cruel. Hazing between nurses can be especially harmful, as new nurses may feel overwhelmed with responsibility or lack the confidence needed to perform their necessary duties. In order to maintain a smooth working environment, nurses should avoid hazing in any form. There are no known positives of hazing, but the negatives may be severe and affect the treatment and care of patients.

Hazing between peers, also called “horizontal hostility,” is the belittling of fellow nurses and is often used to demonstrate dominance over others. Some people may deliberately perform annoying actions toward other nurses just to get a reaction. It can also be used to manipulate the balance of power in the professional relationship. While horizontal hostility may not be as serious as some of the violent or traumatic hazing that can occur in fraternities, it can be very emotionally detrimental to new nurses. With such a high demand for nursing staff it would be irresponsible to partake in these activities, as it can result in a high turnover rate within the community.

“Vertical hostility,” referring to hazing to nurses in a subordinate position, is the act of hazing nursing students, rather than peers. This usually occurs to nursing students during clinicals, and is executed by veteran workers in the workplace. A more common term for this is “eating the young,” a figurative description of the belittling of new nurses. One study shows that, due to incidents of hazing, one out of three nursing students have considered leaving the profession. In these situations, the stress of overbearing superiors outweighs the years of hard work many nursing students invest into their career.

To combat hazing amongst nurses, some hospitals have implemented a “zero tolerance” policy regarding horizontal and vertical hostility. In order for this to work, hospital management must maintain an environment that maintains open lines of communication, especially about hazing concerns and incidents. This will encourage an efficient hospital where nurses will not have to resolve conflicts themselves, and targeted nurses will have some support during these conflicts.

Though conflicts will arise in any profession, nurses have a particularly important role in the medical field and do not need the added stress of upsetting work relationships. Staying away from conflict as much as possible will not only improve relationships between co-workers, but will also help with patient-nurse relationships. If the nursing staff is happy, the patients will be too. Not only because their nurses are more friendly, but also because, through improved efficiency, they will be receiving better healthcare.