Critique of lateral violence in nursing research

Right," Gaffney et al. (2012) examine how nurses respond to workplace bullying. The authors point out that although the consequences of workplace bullying include diminished performance and rises in problems like absenteeism and turnover, there is limited research and limited information about workplace bullying in the healthcare sector. In fact, the purpose of this study is to help administrators improve patient outcomes by reducing workplace bullying or aggression, which reflects a hostile work environment. This is a qualitative study with research questions related to the prevalence and specific manifestations or types of workplace bullying, and also the strategies nurses use to minimize or mitigate workplace bullying. Gaffney et al. (2012) set out to examine what workplace bullying looks like in different scenarios, how workplace bullying is perceived and responded to by both nurses and patients, and how nurses respond to bullying that targets either themselves or colleagues. The research questions are clearly stated prior to the methods section and within the introduction.

Because there is a dearth of literature on workplace bullying in nursing, the authors do not provide a comprehensive review of literature. However, it would have been better had the authors cited studies on workplace bullying in other fields. Because the research is exploratory in nature, there are no directional hypotheses; the authors seek to understand the phenomenon and provide directions for future research and strategies for nurse management. The study is directly relevant to the healthcare practice because of the clear impact bullying has on the workplace environment and on patient outcomes too.

2. Constructivist grounded theory methods are used, whereby the researchers identify how participants construct their social realities subjectively and objectively via qualitative research collected in online and offline settings. Data collection methods included a 30-item online survey, with informed consent. In total, 81 different participant narratives were collected and analyzed. The narratives were systematically coded for content, themes, and patterns. A theoretical coding process was also used to discover relationships between the different categories that emerged during the process of data collection.

3. The study population included nurses that "existed both online and offline," meaning no disembodied consciousness participants were permitted (Gaffney, et al., 2012, p. 3). In spite of the reliability and validity problems with soliciting participants online, the researchers do not identify how they restricted participation to nurses. Although the sample size of 81 was adequate, it is impossible to know whether the participants were actually nurses because their identification and credentialing could not be collected due to the need to protect anonymity, privacy, and confidentiality. Moreover, the researchers do not indicate the professional status, degree of experience, and nurse role of any participant.

4. The data collection method included coding the responses, and no statistical tests or analyses were necessary. There is some degree of validity and reliability with the structured interview type method using theoretical coding, and this method happens to be appropriate for this research. However, there is a low degree of validity and reliability in the study overall due to design weaknesses.

5. The authors do include a table with the categories and subcategories relevant to the research. There were no statistics collected, and therefore no need to explain the results of statistical tests. Results of the study do show there are some core categories and subcategories of bullying. The core category is "making things right," divided into four main issues: the placing of bullying events, assessing the situation, taking action, and judging others. Subcategories include being a newbie or odd nurse out, being a witness, reflecting on the self, speaking up, getting support, moving out of the toxic environment, and being ignored. The researchers fail to provide numbers for the responses, and there is no indication of the frequency of each of these themes in the responses. However, the authors uniformly found that nurses acknowledge the detrimental effects of bullying on unit performance. Nurses also claimed that bullying had an adverse effect on patient care.

6. Although there was no directional hypothesis in the Gaffney et al. (2012) study, the constructivist theoretical viewpoint does imply that the authors do expect that nurses actively respond to and therefore socially construct their bullying experiences or their experiences as witnesses to bullying in the workplace. To this degree, the hypothesis was substantiated. However, this was an exploratory research. Gaffney et al. (2012) sought some clarity on the phenomenon and how nurses respond to workplace bullying, in the hopes that nurse administrators can establish protocols for minimizing instances of bullying and maximize effective responses to bullying including disciplinary action. The authors generally conclude that the nurses who try to "make things right" are those that develop keen self-awareness and take responsibility for their roles in creating the workplace environment. Many nurses do not know how to respond to bullying events, but those who do are willing to take action. The authors conclude also that concept of support is critical to effective responses to bullying.

7. The authors respond to potential limitations of the study with a lack of thoroughness or thoughtfulness. For example, Gaffney et al. (2012) state, "Given the virtual nature of the research environment, only respondents with Internet access could participate which could be considered a limitation," (p. 8). The main limitation of the study is that the researchers did not adequately control for fraudulent participation or misidentification as a nurse.

8. Recommendations for future research and practice are included, and focus on changes to the workplace environment and to the organizational culture of healthcare.

9. The findings have limited generalizability, something that the authors seem minimally aware of as their confidence in their research remains strong throughout the article.