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.
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.
Currently, research into horizontal harassment in the nursing profession suffers from a lack of direction. Similar types of workplace harassment have been studied extensively — sexual harassment being one prominent example. Horizontal violence differs from sexual harassment, and while victims and perpetrators share some similarities, there are also important differences. Horizontal violence among nurses is a relatively new field of study. As such, no clear definition, established prevalence, typical patterns, or other characteristics that are important to understanding the problem and developing solutions have yet emerged. This study will explore the challenge of defining and understanding horizontal violence in the nursing field and its relationship to job satisfaction, retention, and longevity in the profession.
Literature on horizontal violence among nurses is limited. While it is widely acknowledged that the problem exists, few studies have formally examined the topic. Many hospitals have begun developing policies regarding horizontal violence that resemble their policies on sexual harassment or other forms of workplace harassment. It is encouraging that organizations are being proactive, but these policies cannot safely be assumed effective until valid research has been conducted on horizontal violence specifically. There are significant gaps in the knowledge base regarding horizontal violence in the workplace and its effects on nursing staff.
Thompson and Burk (2009) examined horizontal violence in the workplace against junior nursing students and found that it led to high turnover and lower morale. McKenna, Smith, and Poole et al. (2003) found that new graduates experienced horizontal violence across all clinical settings, and that it had a significant effect on decisions to leave the profession and on interpersonal conflict. That study also found that many respondents had received no training on how to manage such behavior.
These research articles are typical of the content available on horizontal violence in nursing. They provide only general information and acknowledge the existence of the problem without offering the specifics needed to develop clear solutions. More detailed research is needed in this area, and the current study aims to fill many of the gaps that exist in the body of literature on the topic.
This research will explore the hypothesis that horizontal violence is prevalent in the nursing profession. It will also explore a secondary hypothesis that horizontal violence among nurses contributes to the nursing shortage by creating a hostile work environment.
The research design for this study involves a quantitative survey methodology that addresses key gaps in the literature regarding horizontal violence in the nursing profession. This design is modeled on study designs used in similar topic areas and will provide definitive answers regarding the scope and defining characteristics of horizontal violence among nurses. The quantitative survey approach is appropriate because it will allow the researcher to statistically analyze the frequency and types of abuse occurring within the research setting. Understanding how and when the abuse is occurring is the first step toward finding solutions.
As researcher, I am already aware that horizontal violence among nurses is a prevalent and important topic. It will be important to ensure that the results of the study are not exaggerated to support personal opinions about the topic. My bias stems from my belief in both the existence and severity of the problem, which may cause me to perceive the issue as more serious or prevalent than the research actually shows. I must remain aware of this bias when writing the final conclusions of the study.
"Random voluntary sampling and survey distribution plan"
"Statistical methods and survey instrument design"
This research proposal explores a topic of great importance to the nursing profession. The available literature suggests that horizontal violence is already considered a significant issue and that some organizations are developing policies to address it. However, it is concerning that these policies are not yet grounded in empirical evidence. Empirical research in this area remains limited, and current knowledge is largely confined to a general acknowledgment that the problem exists. Clearly, more research must be conducted before effective policies can be developed.
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