Horizontal Violence in Nursing: A Research Funding Proposal
This paper presents a research funding proposal addressing horizontal violence (HV) in the nursing profession. It defines HV as nurse-to-peer bullying involving behaviors that humiliate and demean colleagues, then outlines the core problems: a cycle of silence among victims, long-term psychological damage including depression and low self-esteem, and estimated annual costs of approximately $24 billion in the United States alone. The paper reviews theoretical frameworks—including the wounded healer, nursing as an oppressed discipline, and disenfranchising work practices—alongside empirical studies. It proposes a mixed-methods research design using online surveys, interviews, and hospital performance data, and closes with a detailed budget justification for the requested funding.
- Introduction to Horizontal Violence in Nursing: Definition and scope of nurse-to-peer bullying
- Problem Statement: Silence, psychological damage, and financial costs of HV
- Significance and Feasibility of the Proposal: Rationale for funding agency involvement and support
- Literature Review: Theoretical frameworks and empirical studies on HV
- Research Design and Methodology: Survey design, data collection plan, and budget breakdown
- Conclusion: Summary of proposal and budget request
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What makes this paper effective
- The paper grounds its argument in concrete financial data — citing cost estimates ranging from $114.64 million to $35.9 billion — giving the funding agency a tangible rationale for investment.
- It uses multiple theoretical lenses (wounded healer, oppressed discipline, low self-esteem, disenfranchising practice) to explain the root causes of HV rather than treating it as a purely behavioral problem.
- The proposal is well-structured for its audience: it moves logically from problem identification through significance, literature support, research design, and budget, mirroring the conventional grant-proposal format.
Key academic technique demonstrated
The paper demonstrates audience-aware argumentative writing. Because the target reader is a funding agency rather than an academic journal, the author consistently frames scholarly evidence in terms of institutional cost and practical impact. Citations are used not merely to establish credibility but to justify financial investment, showing how academic sources can be deployed strategically for persuasive, applied purposes.
Structure breakdown
The paper opens with a definition and context section, followed by a multi-faceted problem statement covering silence, psychological damage, and financial cost. A brief significance and feasibility section bridges the problem to the proposed solution. The literature review is split into theoretical frameworks and empirical studies. The research design section introduces a conceptual framework with independent and dependent variables and a null/alternative hypothesis. The methodology covers sampling, data collection and analysis plans, and a detailed budget. The conclusion synthesizes the argument and reiterates the budget request.
Introduction to Horizontal Violence in Nursing
Horizontal violence (HV) has been defined by many authors, and despite variations in definition, the term is most commonly described as actions, words, or other behaviors directed at one's peers (Becher & Visovsky, 2012; Dumont, Meisinger, Whitacre, & Corbin, 2012). These specific behaviors, words, and actions are intended to humiliate and injure the recipient's dignity. Horizontal violence is aimed at demeaning individuals and showing total disrespect toward them.
Tedone (2020) defines horizontal violence in nursing as nurse-to-peer bullying. The author argues that bullying among nurse peers is an uncivilized act that has persisted over the years and has been termed a plague in the nursing profession. It is unfortunate that demeaning a fellow nurse has become an acceptable act carried out without fear of consequence. One of the most important questions one might ask is whether human psychology allows one nurse to bully another. Nurses are always under pressure to provide optimum care to patients, and most are mentally prepared to carry out their responsibilities without interruption. However, when they encounter stress from the clinical environment or from external factors, the quality of their care decreases — a critical issue affecting overall performance.
This paper presents a proposal to a funding agency addressing the problems that nurses encounter in their profession and establishing reasons for the requested funding.
Problem Statement
One of the major problems with HV among nurses is that a cycle of silence surrounds it. Tedone (2020) states that most nurses prefer to minimize confrontation with peers because they fear being labelled as snitches by their colleagues. Despite the existence of a code of conduct in the nursing profession, HV has become so entrenched that crucial strategies may need to be implemented to mitigate its effects.
Another significant problem is that HV results in long-term damage among nurses. Tedone (2020) argues that nurses have been accused of "eating their young ones" — a phrase used to describe the mistreatment of newly qualified nurses. The victim, "the young one," ends up suffering psychological trauma and low self-esteem. A report by Sanner-Stiehr and Ward-Smith (2014) shows that HV is not only a workplace stressor but also causes long-term psychological damage. Victims are likely to experience depression, very low self-esteem, reduced productivity, and absenteeism. Bloom (2019) concurs with these findings and adds that victims are likely to suffer from poor concentration, increased stress levels, and frequent frustration.
The financial cost of horizontal violence among nurses is a problem the funding agency must understand. A study by Hassard, Teoh, Visockaite, Dewe, and Cox (2018) found that the total cost of psychological aggression in the workplace ranges from $114.64 million to $35.9 billion, based on data from five developed countries: the United States, the United Kingdom, Spain, Italy, and Australia. The study notes that incivility among nurses in the United States costs approximately $24 billion annually, and that the cost per nurse in the ICU is approximately $145,000. These figures encompass both the cost of treating nurses who have been bullied and the productivity lost by health facilities as a result of HV.
Stopping the cycle is a key challenge for healthcare institutions. Many institutions prefer not to publicize the fact that nurses are mistreating their junior colleagues, as this may damage their public image. It would seem contradictory to the public that caring professionals fail to care for one another.
The most significant barriers that victims of HV face include confronting their aggressor, making a formal complaint to the organization, taking legal action, seeking help from their employer, and regaining control of their situation. HV is most commonly associated with intimidation, and those affected are often new nurses. New nurses may require motivation and empowerment to advocate for their rights. Psychological trauma is a serious concern, as it can have lasting negative effects on both performance and the long-term wellbeing of an individual (Weaver, 2013). The trickle-down effects of HV on institutions accumulate gradually and cause both psychological and financial harm.
Significance and Feasibility of the Proposal
The significance of this proposal is to encourage the funding agency to address the grievances of nurses who are substantially affected by HV. The proposal also aims to inform the funding agency about the healthy work environment that nurses require in order to care effectively for patients. Achieving this will require considerable financial and psychological support from institutions or willing sponsors.
Assessing the types of violent and abusive words and behaviors present in healthcare institutions will provide a clear picture of the overall problem and enable the development of strategic steps toward mitigating HV and creating a healthier work environment for nurses.
A funding agency would be the most reliable institution to help nurses who have already experienced HV recover from its effects. The funding agency would act as a sponsor for nurses dealing with psychological problems including depression, aggression, and low self-esteem.
Evidence gathered through the proposed research will help establish the extent to which nurses in the healthcare sector have suffered as a result of HV. The funding agency's support is needed to help cover the cost of treatment for affected nurses and to help bridge the resulting productivity gap in healthcare institutions.
Conclusion
This paper presents a proposal to a funding agency addressing issues related to horizontal violence in nursing. The evidence establishes that horizontal violence is experienced across hospitals and other health facilities and has detrimental effects on its victims. Drawing from the literature reviewed — particularly the studies by Egues and Leinung (2013) and Bloom (2019) — it is clear that HV imposes heavy costs on both health facilities and the individuals affected. HV can trigger mental health disorders, low self-esteem, oppression, and elevated stress levels, all of which contribute to trickle-down effects such as diminished quality of patient care.
Many healthcare institutions are reluctant to draw public attention to incidences of HV among their staff. While respecting institutional privacy is important and measures to that end will be incorporated into the research, it is equally important to promote the wellbeing of nurses who have been victimized. This proposal makes the case for external funding to address both the research and the support needs of affected nurses, and includes a detailed budget covering personnel, equipment, transportation, accommodation, and conference costs.
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Bloom, E. M. (2019, January). Horizontal violence among nurses: Experiences, responses, and job performance. Nursing Forum, 54(1), 77–83.
Christie, W. & Jones, S. (2014). Lateral violence in nursing and the theory of the nurse as wounded healer. Online Journal of Issues in Nursing, 19(1), 27–36.
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Weaver, K. B. (2013). The effects of horizontal violence and bullying on new nurse retention. Journal for Nurses in Professional Development, 29(3), 138–142.
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