Discussion postWorkplace incivility

Identify two strategies you would use as a nurse administrator to create a zero tolerance for horizontal or vertical violence.

Two directions of violence, two reasons it is not reported, two links to patient safety. The prompt is precise, and the non-reporting question is the one with real content.

Editorial process

Last reviewed · August 25, 2026

Written by

Maren Caldwell

MSN, RN, CNE

Medical-surgical nursing, pharmacology and NCLEX preparation

Reviewed by

Dr. Tessa Redmond

DNP, RN, CNE

Evidence-based practice and clinical education

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Interpret the task
Assignment instructions
Deliverables
Proposed outline
Research plan
Reference shortlist
Final review

Horizontal and vertical are not the same problem

The two terms describe different problems and the strategies that address them differ accordingly. Horizontal violence runs between peers and shows up as exclusion, undermining, withheld information and public criticism, and it is sustained by group norms; vertical violence runs down a hierarchy, from a manager, a physician or a senior nurse, and it is sustained by the power differential itself. A zero-tolerance strategy that works on one may not work on the other, since a reporting route that goes to the manager is useless when the manager is the source, and that observation alone will make the strategies section concrete. Both are common enough to be measured, and reporting the prevalence rather than asserting that the problem exists is worth doing early. The distinction also decides who has to own the solution, since a peer norm and a power differential are not addressed by the same intervention or by the same person.

The non-reporting question is where the discussion earns its place, and the reasons are documented rather than speculative. Nurses do not report because they expect nothing to happen, which is a rational inference where previous reports produced no visible outcome; because they fear retaliation, particularly where the perpetrator holds influence over assignments, references or evaluations; because the behaviour has been normalised as part of the culture, so it is not recognised as reportable; and because the reporting route is unclear or leads to the person involved. Note that these are properties of the reporting system rather than of the nurses, which is what makes them addressable by an administrator. The patient safety linkages then follow from the same mechanisms: a nurse who avoids asking a question because of how the answer will be delivered does not get the information, and communication failure is among the most commonly cited contributing factors in serious safety events.

Likely learning objectives

Distinguish horizontal from vertical violence and their different sustaining forces.
Design strategies that work when the manager is the source.
Attribute non-reporting to the reporting system rather than to individuals.
Trace a safety linkage through communication failure.

Assignment instructions

Read the full question

Review every instruction before using the planning guidance that follows.

NSG 6630 Week 4 DQ 1 As a nursing administrator, how will you prevent horizontal and vertical violence in nursing and healthcare? Identify two strategies you would use as a nurse administrator to create a zero tolerance for horizontal or vertical violence. Analyze what you believe are two reasons nurses do not report horizontal or vertical violence in healthcare organizations. Determine what you believe are two linkages between horizontal or vertical violence and impacts on quality of care and patient safety.

Course-wide instructions that accompany this question

ADDITIONAL INSTRUCTIONS FOR THE CLASS Discussion Questions (DQ) Initial responses to the DQ should address all components of the questions asked, include a minimum of one scholarly source, and be at least 250 words. Successful responses are substantive (i.e., add something new to the discussion, engage others in the discussion, well-developed idea) and include at least one scholarly source. One or two sentence responses, simple statements of agreement or “good post,” and responses that are off-topic will not count as substantive. Substantive responses should be at least 150 words. I encourage you to incorporate the readings from the week (as applicable) into your responses. Weekly Participation Your initial responses to the mandatory DQ do not count toward participation and are graded separately. In addition to the DQ responses, you must post at least one reply to peers (or me) on three separate days, for a total of three replies. Participation posts do not require a scholarly source/citation (unless you cite someone else’s work). Part of your weekly participation includes viewing the weekly announcement and attesting to watching it in the comments. These announcements are made to ensure you understand everything that is due during the week. APA Format and Writing Quality Familiarize yourself with APA format and practice using it correctly. It is used for most writing assignments for your degree. Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for APA paper templates, citation examples, tips, etc. Points will be deducted for poor use of APA format or absence of APA format (if required). Cite all sources of information! When in doubt, cite the source. Paraphrasing also requires a citation. NSG 6630 Week 4 DQ 1 I highly recommend using the APA Publication Manual, 6th edition. Use of Direct Quotes I discourage overutilization of direct quotes in DQs and assignments at the Masters’ level and deduct points accordingly. As Masters’ level students, it is important that you be able to critically analyze and interpret information from journal articles and other resources. Simply restating someone else’s words does not demonstrate an understanding of the content or critical analysis of the content. It is best to paraphrase content and cite your source. LopesWrite Policy For assignments that need to be submitted to LopesWrite, please be sure you have received your report and Similarity Index (SI) percentage BEFORE you do a “final submit” to me. Once you have received your report, please review it. This report will show you grammatical, punctuation, and spelling errors that can easily be fixed. Take the extra few minutes to review instead of getting counted off for these mistakes. Review your similarities. Did you forget to cite something? Did you not paraphrase well enough? Is your paper made up of someone else’s thoughts more than your own? Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for tips on improving your paper and SI score. Late Policy The university’s policy on late assignments is 10% penalty PER DAY LATE. This also applies to late DQ replies. Please communicate with me if you anticipate having to submit an assignment late. I am happy to be flexible, with advance notice. We may be able to work out an extension based on extenuating circumstances. If you do not communicate with me before submitting an assignment late, the GCU late policy will be in effect. I do not accept assignments that are two or more weeks late unless we have worked out an extension. As per policy, no assignments are accepted after the last day of class. Any assignment submitted after midnight on the last day of class will not be accepted for grading. Communication Communication is so very important. There are multiple ways to communicate with me: Questions to Instructor Forum: This is a great place to ask course content or assignment questions. If you have a question, there is a good chance one of your peers does as well. This is a public forum for the class. Individual Forum: This is a private forum to ask me questions or send me messages. This will be checked at least once every 24 hours.

What Week 4 DQ 1 asks for

01How you as a nursing administrator would prevent horizontal and vertical violence.
02Two strategies to create zero tolerance for horizontal or vertical violence.
03Two reasons nurses do not report horizontal or vertical violence.
04Two linkages between this violence and impacts on quality of care and patient safety.