Date of Award

Fall 12-2011

Degree Type


Degree Name


Degree Program

Curriculum & Instruction


Curriculum and Instruction

Major Professor

Kieff, PhD, Judith; O'Hanlon, PhD, Ann

Second Advisor

Bedford, PhD, April

Third Advisor

Sheehan-McHugh, PhD, Patricia


The United States has been experiencing a nursing shortage since the mid-1990s. The shortage is expected to deepen as the provisions of the 2010 Patient Protection and Affordable Care Act are enacted. Horizontal violence is a negative phenomenon in the nursing workplace that contributes to difficulty in recruiting and retaining nurses in hospitals. Horizontal violence has been described as a form of mistreatment, spoken or unspoken, that is threatening, humiliating, disrespectful or accusatory towards a peer. The effects of this nurse on nurse aggression can be devastating for the nurse involved and also for the patients under the nurse's care.

Nursing and social science literature have advanced oppressed‐group behaviors as a motivating factor driving this phenomenon in nursing. Workplace stress has also been implicated in these negative behaviors. This study used a grounded theory approach to examine how nurses explain, through semi‐structured and open ended interviews, the phenomenon of horizontal violence in the nursing workplace. The primary outcome of this study was a small scale theory focused specifically on horizontal violence in the nursing work environment. The theory that emerged from this analysis was that horizontal violence can be influenced by other environmental factors beyond oppression theory. The results from the data indicated that these behaviors, described as horizontal violence, may be employed as a method of manipulating the care environment in an effort to enhance patient outcomes while maintaining group or individual perception of security through a sense of environmental control.


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