Organisational antecedents, policy and horizontal violence among nurses: An integrative review.

AIM: To explore the organisational antecedents related to horizontal violence among nurses and the extent to which policy initiatives reduce its incidence. BACKGROUND: Organisational re-engineering initiatives affect registered nurse roles, adding complexity to organisational antecedents related to horizontal violence and policy. No previous systematic review has examined the role of organisational policies in reducing horizontal violence among nurses. METHODS: An integrative review was undertaken, beginning with a search through 18 electronic databases and reference lists of key articles. The studies included were quality appraised. RESULTS: 1,423 abstracts were screened, resulting in 22 studies being included. Emergent themes were the influence of working conditions, relational aspects of teams and leadership, organisational culture, climate and role of structural processes, leadership role and decision-making authority, and the relationship of organisational structures to anti-horizontal violence policy. CONCLUSION: Further research exploring historical health care organisational hierarchies that inadvertently propagate oppressive nursing work conditions is needed. IMPLICATIONS FOR NURSING MANAGEMENT: If nurse managers understand the impacts of organisational antecedents and climate on registered nurse roles, they can advocate for the breakdown of hierarchies and power inequalities that keep registered nurses in oppressed positions. This awareness and advocacy could facilitate a new understanding of horizontal violence inclusive of organisational roles and the creation of effective anti-horizontal violence policies.

Does participative leadership reduce the onset of mobbing risk among nurse working teams?

AIMS: To evaluate the advancement of knowledge on the impact of an empowering leadership style on the risk of mobbing behaviour among nurse working teams. The secondary aim was to evaluate, along with leadership style, the contribution of other organisational- and individual-related mobbing predictors. BACKGROUND: The style of leadership in reducing the onset of mobbing risk in nurse working teams still remains a matter of discussion. Nurse working teams are particularly affected by mobbing and studies exploring individual and organisational inhibiting/modulating factors are needed. METHODS: An empirical study involving 175 nurses of various public hospital corporations in northern Italy. Data were collected via structured and anonymous questionnaires and analysed through a logistic regression. RESULTS: Organisational, individual and participative leadership variables explained 33.5% (P < 0.01) of variance in the onset of mobbing. Two predictive factors emerged: a participative leadership enacted by nursing managers and the nursing shortage as perceived by clinical nurses. Results confirmed that the contribution made by a participative leadership style in attenuating the onset of mobbing risk in working teams was significant. CONCLUSIONS AND IMPLICATIONS FOR NURSING MANAGEMENT: A participative leadership style adopted by the nurse manager allows for the reduction of tensions in nurse working teams. However, mobbing remains a multifaceted phenomenon that is difficult to capture in its entirety and the leadership style cannot be considered as a panacea for resolving this problem in nurse working teams.