Horizontal violence among nurses in the operating room

AORN Journal,  Dec, 2003  by Herbert Dunn

• E-mail
• Print
• Link

One study attempted to find the degree to which perioperative nurses perceive their work as stressful. (21) This researcher distributed questionnaires to 191 potential participants and achieved a response rate of 90% (n = 171). Slightly more than 90% of the respondents (n > 154) reported that they perceived their work as stressful. Additionally, study results suggest that there might be a positive relationship between the negative effects of stress at work and job dissatisfaction. An assumption, therefore, is that nursing members in the perioperative area commit and are victimized by widespread horizontal violence.

Another study sought to identify the most important factors that attract and retain perioperative staff nurses. (17) A combined random and purposive sample resulted in a 36.5% return rate from a mixture of RNs, licensed practical nurses, and scrub technologists. Seventy-four percent of respondents were seriously dissatisfied with their respective work situations. When asked for the most important suggestion from each participant as to how an OR supervisor could decrease staff turnover, the most common suggestion was to improve communication. This study suggests that therapeutic methods of communication may be related to increased success in nurse recruitment and retention.

PURPOSE AND RESEARCH QUESTIONS

Although sabotage and other manifestations of horizontal violence have been described in the general nursing population, (1,2,5) additional work has focused on the OR, where it is widespread. (3,6,22) This may be due to the elevated levels of stress and anxiety inherent in this specialty area. (17,23-25) For this reason, perioperative nurses are the focus of this study.

The previously mentioned studies describe potential links between job satisfaction and various factors in the nursing work environment, but none of them question the existence of ties between the degree of nurses' job satisfaction and the presence of horizontal violence in the workplace. If horizontal violence is related to job satisfaction, however, and job satisfaction is related to nursing retention, (17,19,20) demonstrations of horizontal violence in the workplace may be related to nursing retention.

This correlational study asked the question, "Is there a relationship between the self-perception of the degree that sabotage exists in the workplace and the degree of job satisfaction as demonstrated by perioperative nurses?" The incidence of demonstrations of sabotage as perceived by the study participants is used as a measure of the occurrence of horizontal violence in the workplace.

METHOD

For the purpose of this study, horizontal violence was measured with Briles' Sabotage Savvy questionnaire to determine OR nurses' perception of whether they are victims or perpetrators of sabotage in the workplace. (26) Job satisfaction was measured with the Index of Work Satisfaction (IWS) questionnaire.

DESIGN AND SAMPLE. A descriptive, correlational design was used to examine the possible relationship between perceived acts of sabotage in the workplace and levels of job satisfaction as reported by perioperative nurses. A sample of 500 potential volunteers was randomly generated from an AORN membership list of 1,523 perioperative nurses living in New Jersey. This state was chosen for reasons of convenience and geographic homogeneity. Surveys were mailed to the 500 potential volunteers with an expected return rate of 25% to 30%.