Horizontal Caring In Nursing and a Narrative Community Experience
Arle, Lesley L.
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Difficulties in nurse working relationships have concerned nursing leadership in the United States and internationally since the early 1980s. Research in this area has increased lately, focused primarily on the definition of the problem. Interpersonal conflict among nurses (R.N.), or horizontal violence, can include overt and covert hostile behavior from one nurse to another. Negative effects can be severe, leading to increased stress, emotional distress, physical and psychiatric illness (Jackson et aI., 2002, Jezuit, 2002), reduced job satisfaction, burnout, and increased intent to leave the workplace (AbuAIRub, 2004, 2002, Farrell, 1999, Quine, 1999). Costs to others include reduced quality of patient care, reduced patient satisfaction, and increased costs to health care employers due to increased turnover, absences due to stress, decreased efficiency, patient care errors and litigation. Researchers have routinely encouraged nursing leaders to implement effective strategies to increase cohesion, support, and aspects of horizontal caring among nurses. Advanced practice psychiatric nurses' skills could be utilized in this process. A research demonstration project using Narrative Community R.N. groups (Schoessler & Tanner, 2003), where nurses gather in small groups to confidentially share stories from their practice, was implemented over a four-month span of time in a 400-bed medical center in the northwestern U.S. Responses to the intervention were positive. Horizontal caring, based on the presence of Watson's (1979) Ten Carative Factors, was observed between participating nurses.