Identifying Factors Associated With Horizontal Violence Among Registered Nurses

Background/Significance: Horizontal violence (HV) is a global phenomenon with individual, organizational, and financial impacts. Individual impact includes emotional aspects, such as anger, decreased self-esteem and lack of motivation. Social impact includes strained relationships and low interpersonal support. Depression, stress and burnout create a psychological impact, which can result in physical manifestations of illness (Bartholomew, 2014). Patient safety is also at risk. The American Nurses Association (ANA) has issued a statement regarding the detrimental effect of disruptive behavior of both patients and nurses and has identified solutions to address the problem (ANA, 2015). It is imperative that definitive action be taken to address the problem of HV and its impact on health professionals and patients.

Method: The purpose of this cross-sectional design study is to examine what factors contribute to the occurrence of horizontal violence (HV) perceived by nurses in a hospital setting. Specific aims are to examine the relationship between nurses’ demographic factor, their beliefs and behaviors consistent with oppression, their perception regarding the amount of organizational empowerment, and HV they experience at work. The conceptual model used will identify the relationships between nurses’ personal characteristics, oppression, horizontal violence, and empowerment. Three established research questionnaires (Nurse Workplace Scale, Negative Acts Questionnaire, and Conditions for Workplace Effectiveness Questionnaire). and a demographic questionnaire will be sent to all registered nurses working at an urban health system. Descriptive statistics will include sex, educational preparation, race/ethnicity, age, years of nursing experience, certification and division.

Results: Responses will be analyzed using SPSS software, including descriptive statistics, univariate analyses, and multivariate regression model. Each variable will be summarized using descriptive statistics such as means, standard deviations, frequencies, and percentage. Univariate analyses (t tests and Pearson’s correlations) and analysis of variances (ANOVAs) will be performed to test for associations between nurses’ personal characteristics and the three constructs of oppression, empowerment, and HV.

Discussion: The first step in eliminating HV in the nursing workplace is to identify factors associated with this phenomenon. It is imperative that definitive action be taken to address the problem of HV and its impact on health professionals and patients. Data from this study will be analyzed to identify strategies to decrease the incidence of horizontal violence.

Conclusion: This study will replicate a study done by Mahr (2015) in a larger setting to identify if the results are similar. In this model HV represents the harmful behaviors nurses exhibit toward one another in the workplace. It is assumed that nurses’ personal characteristics influence the degree to which they experience oppression, empowerment, and HV in their workplace. Oppression is another factor that may affect the amount of HV experienced in the workplace. The proposition in this model is that oppression is positively related to the prevalence of HV. As oppression increases, so does the amount of HV nurses experience. Finally, this model proposed that empowerment has an inverse relationship with HV, so as nurses become more empowered, they are less likely to commit acts of HV. This study will share information that will help colleagues throughout the world improve global health by identifying factors contributing to HV and creating strategies to improve the work environment. Nursing implications will be shared based on the results.