Exploring the experience of horizontal violence among nurses working in mental health settings in Saudi Arabia

Abstract

Background: In Saudi Arabia, horizontal violence (HV) among nurses remains an unexplored yet significant issue, particularly in mental health settings (MHS). While nursing is recognised as a caring profession, the lived experiences of nurses often include internal conflicts, interpersonal tension, and peer hostility. HV, encompassing behaviours such as exclusion, verbal aggression, and unjustified criticism, may have serious emotional and professional consequences. Understanding how nurses interpret and respond to such experiences is essential to promoting healthier workplace environments. Aim: To explore the lived experience and personal meaning of HV among nurses working in a mental health setting in Saudi Arabia. Methods: Methods: A qualitative study using in-depth interviews (n=15) with nurses working in MHS in Saudi Arabia. Participants shared personal accounts of their experiences with HV in the workplace. Interpretative Phenomenological Analysis (IPA) was used to analyse the interview transcripts and identify key experiential themes. Findings: A comprehensive description of participants’ experiences with HV was constructed from the data, revealing five group experiential themes: recognising HV without using formal terminology; encountering HV through interpersonal and structural dynamics; identifying its workplace causes; understanding its emotional and professional effects; and employing coping strategies. Nurses described HV as a daily challenge that affected relationships, trust, and performance. Despite these impacts, some demonstrated resilience through teamwork, professional values, and commitment to patient care. Conclusions: This study provides insight into how mental health nurses in Saudi Arabia experience and respond to HV. Although unfamiliar with the formal term, participants identified harmful behaviours tied to workplace culture, leadership, and system issues. HV had emotional, physical, and professional effects, prompting various coping strategies. The findings highlight the need for supportive leadership, team collaboration, HV education, and a zero-tolerance policy. These measures align with national efforts to enhance care quality and staff well-being.