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Format:
Print
Author:
Medina, Jena S. Katzman
Dept./Program:
Nursing
Year:
2010
Degree:
MS
Abstract:
The term horizontal violence has emerged in the nursing literature to describe aggression, conflict, and destructive behavior between nurses. It includes any type of nurse-against-nurse aggression ranging from bullying to backstabbing to overt physical assault. Horizontal violence is well-understood to have a negative impact on the nursing profession, as it is related to decreased job satisfaction and performance, premature burnout, and problems with recruitment and retention. Prior research indicates that students and novice nurses are the most frequent victims.
While previous studies have documented the experience and effects of horizontal violence on undergraduate nursing students, no study to date has explored the experience of graduate nursing students or master's-entry program in nursing (MEPN) students. The purpose of this qualitative study was to explore the experiences and perceptions of horizontal violence among MEPN students in a new master's-entry program at the University of Vermont (UVM) during the pre-certification registered nurse (RN) year, throughout the advanced practice portion of the program, and in the workplace as new RNs. Using Margaret Newman's Theory of Health as Expanding Consciousness as a theoretical framework, nine current graduate nursing students at UVM who became RNs through the MEPN were interviewed regarding their experiences and perceptions of horizontal violence and the impact it has had on them personally and professionally.
Four major themes emerged regarding the experience of horizontal violence among UVM MEPN students. These were Not Feeling Welcomed, Personal and Professional Toll, Systems Failures and the Role ofGender, and Callfor Action. All of the participants reported personally experiencing and/or witnessing horizontal violence and believed that much of their experience of horizontal violence hinged on the nature of the MEPN and its novelty to the Vermont nursing community. They perceived that nurses had underlying eoncerns about patient safety due to a lack of clinical preparedness among MEPN students. They also believed that nurses felt threatened by the MEPN because it presented a new and different route into advanced practice nursing, and there was concern that this new educational path could or would render more traditional paths obsolete.
Finally, the majority of participants indicated that their experiences of horizontal violence diminished their self-esteem and self-confidence as novice nurses. Perceptions of feeling "less than" as a result of horizontal violence were common. Moreover, horizontal violence caused participants to feel disillusioned with nursing and limited their ability to embrace the nursing profession. These results have broad implications for the future of advanced practice nursing, graduate nursing education, nursing research, and health care policy.