Date of Award


Degree Type


Degree Name

Doctor of Philosophy in Nursing



First Advisor

Patricia Burbank


Horizontal violence (HV), or non-physical intergroup conflict that is expressed in overt and covert behaviors of hostility, is pervasive in nursing and has been discussed in the literature for more than two decades. It is costly and has potentially devastating effects including high nurse turnover rates, increased illness, decreased productivity, and decreased quality of patient care. Recognizing how these behaviors are established and sustained is necessary if nurses are to overcome these types of behaviors. This mixed methods study used an online survey to examine 78 hospital nurse’s experiences and responses to episodes of HV as well as its effect on job performance. Seven of these nurses answered more in-depth questions during a follow-up interview. Critical Social Theory provided the framework for this study as this phenomenon is thought to be the result of oppression within the nursing profession. Nurses reported that manager and staff support and workplace education were the most helpful in reducing horizontal violence. Increased workload and stress and HV being accepted practice on the unit were factors listed as most important in promoting HV. Nurses also cited reasons why they continue on in their jobs after episodes of HV and behaviors that were successful in addressing HV. Intervention studies are needed to test effective ways of reducing this very difficult behavior among nurses in the workplace.



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