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Ask the expert: Finding out whether horizontal hostility is present in your unit

Nurse Leader Weekly, November 2, 2009

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This week Kathleen Bartholomew, RN, RC, MN, talks about horizontal hostility and discusses indicators that show whether it is present on your unit.

Q: How can I tell whether horizontal hostility is a problem on my unit?

A: Researchers often use the word "insidious" to describe horizontal hostility because it has existed as an undercurrent of the nursing profession for years. Not only is the behavior hidden, but the costs are hidden as well, as the financial impact lags behind the actual events. And when its destruction becomes obvious, it is usually too late—a high turnover results not only in a mass exodus of staff but also in a crucial break in the unit's knowledge base.

Here are indications that horizontal hostility could be present on your unit:

Poor employee satisfaction scores: Satisfaction surveys differ in content from facility to facility, but there are usually some similarities. The scores you should be most interested in are ‘intent to leave,’ ’sense of belonging,’ ’meaningful work,’ ‘morale of self,’ and ’morale of others.’

High turnover rates: This is an obvious indicator of horizontal hostility. Staff who feel that they belong will clearly want to stay—and vice versa. The key to preventing a mass exodus is to follow up with an employee the moment you get the heads up that he or she may be leaving.

To read the rest of the indicators, click here.

Editor’s note: Do you have a question for our experts? E-mail your queries to Editorial Assistant Sarah Kearns at skearns@hcpro.com and see your name in print next week! In the meantime, head over to our Web site and view a growing collection of advice from our experts.

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