Date of Award

May 2024

Degree Type


Degree Name

Doctor of Philosophy


Management Science

First Advisor

Edward Levitas

Second Advisor

Nadya Fouad

Committee Members

Romila Singh, Hong Ren


Contrapower, Harassment, Nursing


Workplace sexual harassment is stressful and far too common in organizations. A particular challenge of organizations is to protect their employees from contrapower harassment, or rather, harassment from a person who has less organizational power than the target (Cleveland & Kerst, 1993), such as nurses who are harassed by their patients. The nurse-patient relationship requires nurses to provide care for patients no matter how nurses are treated. Thus, nurses face one of the most unique and stressful forms of harassment. Accordingly, this dissertation examines how nurses are impacted by patient-perpetuated sexual harassment and the role of compassion and social support in alleviating negative outcomes. Conservation of resources theory explains that social support is a valuable resource for harassment targets, while compassion theory explains how work teams use empathic concern and appraisal processes to identify targets, and subsequently provide social support. Together, with the model of consequences of workplace sexual harassment (Fitzgerald, et al., 1997), these theories find that social support alleviates the negative outcomes of sexual harassment. Thus, this dissertation uses these theories to test compassion and social support behaviors in a patient-perpetuated harassment context. Three studies outline the dissertation. Chapter 2, a systematic literature review, identifies the frequency of patient-perpetuated harassment and research testing the model of consequences of workplace sexual harassment within the nurse-patient context. It also describes the organizational and legal protections available to nurses, as well as potential proactive and reactive solutions. Chapter 3 examines the appraisal process of bystanders to identify a case between a nurse and a patient as sexual harassment by manipulating empathic concern and the inhibition of the patient via an experimental design. This study finds that bystanders are more likely to appraise a patient’s inappropriate behaviors towards their nurse as sexual harassment when the patient is aware of their actions, and when the bystander feels more empathic concern. In both instances, bystanders are more likely to provide help to the nurse. The final dissertation study in Chapter 4 uses the critical incident method to examine how nurses have used coworker social support to contend with patient-perpetuated sexual harassment. This study finds that targets of patient-perpetuated harassment experienced negative effects to their job, psychological, and physical health. Targets were more likely to receive instrumental and informational support for patient-perpetuated harassment when they work in highly compassionate teams. In turn, received social support alleviated targets from the harshest effects of patient-perpetuated harassment. This dissertation contributes to research and practice in three ways. First, the dissertation applies management theory to generate change for healthcare practitioners who face a problem that is rarely addressed by management researchers. Second, through an experimental study, the dissertation contributes to sexual harassment research by examining how empathic concern and ethics interact to prompt bystanders’ compassion processes and helping decisions. Finally, the critical incident study examines how team and organization-level factors can be managed to cultivate necessary support for employees with contrapower harassment experiences. Recommendations for practitioners and future research are made.

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