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

Background: In Saudi Arabia, horizontal violence (HV) among nurses remains an underexplored yet significant issue, particularly in mental health settings. While nursing is recognised as a caring profession, the lived experiences of nurses may include internal conflict, interpersonal tension, and peer hostility. HV, which includes behaviours such as exclusion, verbal aggression, and unjustified criticism, can have serious emotional and professional consequences. Understanding how nurses interpret and respond to such experiences is essential for promoting healthier workplace environments.

Aim: To explore the lived experience and personal meaning of HV among nurses working in mental health settings in Saudi Arabia.

Methods: A qualitative study was conducted using in-depth interviews with 15 nurses working in mental health settings in Saudi Arabia. Participants shared personal accounts of their experiences of HV in the workplace. Interpretative Phenomenological Analysis (IPA) was used to analyse the interview transcripts and identify key experiential themes.

Findings: The analysis generated 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 work performance. Despite these impacts, some participants 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 many participants were unfamiliar with the formal term, they clearly identified harmful behaviours linked to workplace culture, leadership, and organisational factors. HV had emotional, physical, and professional consequences, leading nurses to develop various coping strategies. The findings highlight the importance of supportive leadership, team collaboration, HV education, and the implementation of zero-tolerance policies. These measures align with national efforts to improve healthcare quality and staff well-being.