Horizontal Violence in Nursing: Prevalence and Workplace Impact
This paper presents a research proposal investigating horizontal violence in the nursing workplace. The proposal defines horizontal violence — including behaviors such as sabotage, destructive criticism, scapegoating, and verbal confrontation — and argues that its prevalence among nurses contributes to job dissatisfaction, high turnover, and the broader nursing shortage. Using a quantitative survey methodology modeled on prior research into workplace sexual harassment, the study targets 100 nurses across local hospitals. The proposal outlines sampling techniques, data collection instruments, and statistical analysis methods. It situates the study within a limited but growing body of literature and aims to fill critical empirical gaps that currently prevent healthcare administrators from developing evidence-based policies to address horizontal violence effectively.
- Introduction: Context for horizontal violence and nursing shortage
- Problem Statement and Literature Review: Research gaps and prior studies on horizontal violence
- Hypothesis and Research Design: Study hypotheses and quantitative survey framework
- Sampling, Participants, and Data Collection: Random voluntary sampling and survey distribution plan
- Data Analysis and Instruments: Statistical methods and survey instrument design
- Conclusion and Reflections: Research findings, limitations, and future directions
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What makes this paper effective
- The proposal clearly articulates a research gap — noting that while workplace harassment is well-studied, horizontal violence among nurses specifically lacks empirical grounding — which justifies the study's purpose.
- The researcher demonstrates self-awareness by explicitly identifying personal bias and explaining how it will be managed, strengthening the credibility of the proposed methodology.
- The decision to model the survey instrument on a well-known federal study (Erdreich, Slavet, & Amador, 1994) provides a principled rationale for instrument design rather than building from scratch arbitrarily.
Key academic technique demonstrated
The proposal demonstrates effective use of a methodological analogy: the researcher maps the structure of an existing, validated study on sexual harassment in the federal workplace onto the new domain of nursing horizontal violence. This technique — borrowing an established instrument framework and adapting it to a novel context — shows how researchers can build methodological legitimacy when no purpose-built instrument exists for an emerging field.
Structure breakdown
The paper is organized as a formal four-task research proposal. It opens with a problem description and justification for a quantitative approach, then progresses through sampling rationale, data collection methods, and instrument design. The final section consolidates all components into a complete proposal with abstract, literature review, hypothesis, methodology, and a reflective conclusion. An appendix provides the draft survey instrument, grounding the proposal in a concrete, testable tool.
Introduction
In order to provide the best quality care for patients, nurses must be able to focus entirely on their patients' needs. Anything that distracts from that focus has the potential to significantly reduce the quality of care a patient receives. It has long been recognized that a nursing shortage exists and that there are not enough nurses to care for a population with growing healthcare needs. This is particularly true in the areas of long-term nursing and geriatric care. As the Baby Boomer generation ages, its members will require healthcare, and currently there are not enough nurses to meet that demand, let alone the growing needs of the future. It is therefore important to understand what creates job satisfaction and career longevity in the nursing profession.
Horizontal violence in the workplace is a growing problem. It is a particular concern for new graduates and new nurses. It can incorporate physical or nonphysical acts such as sabotage, destructive criticism, backbiting, undermining, scapegoating, and verbal confrontation. Victims feel ridiculed, demeaned, and humiliated. Even tenured nurses are not free from this type of victimization. The harasser tends to be an experienced nurse who feels overburdened by job stress and the long hours that have become a difficult reality of the profession. This research explores the problem of horizontal violence in the workplace as it relates to job satisfaction, retention, and longevity in the nursing profession.
References
Erdreich, B., Slavet, B., & Amador, A. (1994). Sexual harassment in the federal workplace. U.S. Merit Systems Protection Board. Washington, D.C.
McKenna, B., Smith, N., & Poole, S. et al. (2003). Horizontal violence: Experiences of registered nurses in their first year of practice. Journal of Advanced Nursing, 42(1), 90–96.
Thompson, S., & Burk, R. (2009). Junior nursing students' experiences of vertical violence during clinical rotations. Nursing Outlook, 57(4), 226–231.
Appendix I: Survey Instrument
Demographic Information
1. What is your gender? _______ Male _______ Female
2. What is your age? _______
3. How many years have you been in the nursing profession? _______
4. How many years have you been at this facility? _______
5. Is your position supervisory? _______ Yes _______ No
Survey Questions
1. Do you feel you have ever been the victim of horizontal violence in your position at this facility? _______
2. Have you ever said something to someone else and then later thought that perhaps you should not have said it because it might hurt them? _______
3. Which of the following do you consider to be unacceptable behavior from colleagues?
_______ Pressure to perform procedures for which you have not been trained
_______ Demeaning statements about your work or personal life
_______ Threats of termination or punishment for not conforming to something that is not hospital policy
_______ Being blamed for something you did not do
_______ Being excluded from conversation at lunch
_______ Being singled out for something that the entire department has done wrong
4. If you feel you have been the victim of horizontal violence in the workplace, what did you do about it?
_______ Nothing — just put up with it
_______ Told a supervisor
_______ Confronted the person myself
_______ Talked about them behind their back
_______ Got revenge
_______ Would rather not say
5. Do you feel administration would have taken your complaint seriously and acted on it? _______ Yes _______ No _______ Don't Know
6. Does your hospital have a written policy that addresses horizontal violence in the workplace? _______ Yes _______ No _______ Don't Know
7. If it does, do you feel this policy is effective? _______ Yes _______ No _______ Don't Know
8. If you have been the victim of horizontal harassment, was your harasser a group of people? _______ Yes _______ No _______ Don't Know
9. Was your harasser a supervisor or higher in rank? _______ Yes _______ No _______ Don't Know
10. Was your harasser equal to you in position? _______ Yes _______ No _______ Don't Know
11. Was your harasser older than you? _______ Yes _______ No _______ Don't Know
12. Do you feel horizontal violence made you want to leave your job? _______ Yes _______ No _______ Don't Know
13. Have you ever left a job due to harassment from others? _______ Yes _______ No _______ Don't Know
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