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How can I assess whether horizontal hostility is a problem on my unit?

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The following are effective methods you can use to evaluate your staff and to assess the problem of horizontal hostility. If after assessing these areas you feel that your team is in good shape, continue to monitor the environment:

  • Use questionnaires to assess the cohesiveness, productivity, and psychological safety of your team. Such questionnaires do not have to be extensive, and they should always end with an open-ended question. They often help with assessment because although we might think that we have a good handle on the climate, we often do not. Because horizontal hostility is insidious, because we have an intense workload and because this behavior has been accepted as normal for years, it often exists outside of the realm of our awareness. Simply "checking in" with managers or staff is empowering because it sends the message that you want to know the truth.
  • Use nominal group technique to facilitate input. In this process, a question or problem is written down on the board and team members write down their ideas/solutions. Then each person reads one idea off his or her list, with no discussion, and the ideas are listed for everyone to see. Team members assign points to the most important idea/solution, and the votes are tallied on a flip chart (Scholtes 1988).

—Kathleen Bartholomew, RN, MN