Nurse-to-nurse horizontal violence during the covid-19 pandemic and its impact on turnover intention: A cross-sectional study.

BACKGROUND
Nurse-to-nurse (N2N) horizontal violence has been documented among the main determinants of nurses' turnover intention. Even with its utmost importance, inadequate attention has been thus far drawn to the way crisis-induced pressure added to work environments, such as the coronavirus disease 2019 (COVID-19) pandemic, can impact horizontal violence, and then give rise to turnover intention.


AIM
The present study was to investigate the relationship between N2N horizontal violence along with its dimensions and turnover intention among clinical nurses.


METHODS
A cross-sectional survey was conducted utilizing the Turnover Intention Questionnaire (TIQ), developed by Kim et al. (2007), and the Negative Acts Questionnaire-Revised (NAQ-R; Einarsen, Hoel, & Notelaers, 2009). The participants, recruited by random sampling, included 295 clinical nurses working in referral hospitals for COVID-19. The data were also analysed using the SPSS software package (ver. 19), via descriptive and inferential statistics, Pearson correlation test and multiple linear regression.


RESULTS
The study participants obtained the mean scores of 52.50 ± 11.85 and 45.38 ± 13.24 for turnover intention and horizontal violence, respectively. Among the dimensions of horizontal violence, the highest value belonged to "work-related bullying," with the mean score of 51.04 ± 15.23, and the lowest was associated with the "physically intimidating bullying" dimension, with the mean value of 15.90 ± 5.96. The Pearson correlation test results correspondingly showed that turnover intention was positively correlated with work-related bullying (r = 0.73), person-oriented bullying (r = 0.72), physically intimidating bullying (r = 0.53) and overall horizontal violence (r = 0.74). The regression analysis outcomes additionally demonstrated that the work-related and person-oriented bullying dimensions of N2N horizontal violence could predict turnover intention in nurses (F = 184.66, p < 0.001).


IMPLICATIONS
The study findings help nursing managers and policymakers to immediately formulate sound measures and guidelines to prevent or at least manage the problems, viz., N2N horizontal violence and turnover intention. These measures can be thus in the form of training programs focused on communication, stress reduction and conflict resolution techniques, especially during crises, together with obvious procedures for reporting the incidents of horizontal violence.