"Horizontal violence among nursing students and newly graduated nurses: A systematic review".

BACKGROUND

Workplace violence is prevalent among healthcare professionals. Horizontal violence, defined as aggression between individuals of equal hierarchical status, is a significant issue in nursing. Nursing students and newly graduated nurses are particularly vulnerable due to inexperience, lack of coping strategies, and personal risk factors such as young age.

OBJECTIVE

To synthesize current literature on horizontal violence experienced by nursing students and newly graduated nurses, determining prevalence, manifestations, consequences, and intervention strategies.

METHOD: A systematic-narrative hybrid review was conducted PRISMA 2020 and SWiM guidelines. Primary studies published between 2015 and 2025 were searched across CINAHL, Web of Science, Scopus, PubMed, DIALNET, and LILACS databases. Study quality was assessed using the Joanna Briggs Institute Critical Appraisal Tools.

RESULTS

The review included 34 articles. Horizontal violence prevalence ranged from 11.8% to 91.5% among nursing students and from 54.8% to 60% among newly graduated. Manifestations included disrespect, public humiliation, excessive demands, verbal insults, social exclusion, and sexual harassment. Consequences encompassed psychological and physical distress, decreased job satisfaction, burnout, increased turnover intention, and compromised patient safety. Proposed interventions highlighted simulation-based training, conflict management and integrating resilience training into nursing curricula.

DISCUSSION: Horizontal violence is a multifactorial issue rooted in clinical learning environments and professional hierarchies, deeply impacting nurse wellbeing, professional development, and patient safety.

CONCLUSIONS

Prevention and early intervention are essential fosters safe educational and clinical environments where early career nurses can reach their full potential, ultimately reducing attrition and ensuring high quality patient care.