Nurses have to deal with many different varieties of conflicts constantly in care settings. Patients can be aggressive due to various factors such as pain, and other medical professionals can enter into disagreements over matters such as treatment. Such incidents are unavoidable, as conflict is an essential part of work in most organizations. They will also likely be unproductive, as the parties will usually not be interested in compromise or conceding their position. However, it is possible to turn professional disagreements into sources of improvement through discussion and manage patient grievances while maximizing their well-being. To achieve these results, nurses have to be skilled in conflict management and resolution. This paper will discuss a frequent recurring conflict in care delivery settings that occurred in the author’s practice and discuss methods that may be used to address them.
Nurses are medical professionals who are skilled in taking care of the patients’ general needs as well as administering procedures. However, they may lack the expertise necessary to treat a condition at every stage of care, especially with rare, complicated issues. Diagnosing such issues and prescribing answers is the job of the physician, and so they often see themselves as superior in knowledge and authority to nurses. As such, they may override nurse decisions sometimes and insist that care procedures be carried out in a specific manner despite any objections. Furthermore, they may look to nurses who did not make the decision in question for answers on why the specific treatment approach. As such, conflicts would surface, and they would rarely reach a conclusion that is satisfactory to both parties. Confrontations of the variety described above occur somewhat frequently in the author’s workplace, and an example is provided below.
The specific situation used for this paper involves a physician, Mr. A, and a registered nurse, Ms. B, in the inpatient care unit. They have both worked in the department for a considerable time and are known to staff and patients as friendly and professional. Mr. A noticed that the patient’s medical records were indicating unexpected values and decided to investigate, finding that the patient had not received medication for the issue over the past several days. He went to Ms. B, the nurse in charge of the patient, and asked her for a reason behind the decision. Ms. B was not the one responsible for the decision and did not know the reason, aggravating Mr. A further. In the end, he demanded that the patient be administered the medication immediately and left. Ms. B complied, worried that she might have done something wrong. In the end, the patient started receiving the medication, and nobody mentioned the initial decision not to administer it. As such, the reason behind the decision remained unknown, and the matter was forgotten.
Four Stages of Conflict
It is possible to formalize the conflict using a theoretical model so that it becomes easier to analyze it. For this essay, the author will employ the four stages model provided by Finkelmann, which consists of latent conflict, perceived conflict, felt conflict, and manifest conflict. The first stage began when the initial decision not to administer the medication was made, and when the person responsible failed to communicate it to the physician or anyone else. They may or may not have realized that the choice would possibly lead to a confrontation. However, they likely believed that their decision was the correct one, though the rationale behind it is still unknown. However, they knew they would likely not be the person who had to deal with the physician if they anticipated the encounter.
The conflict entered the perceived stage when Mr. A discovered that the patient was displaying abnormal readings that were not being addressed. He likely assumed that the nurses in charge of the patient were not competent enough to recognize the need for an intervention. However, at the time, he had not yet discussed the situation with any nurse, and so he may have felt that conflict was taking place, but it had not manifested. Ms. B remained unaware that any issues existed, perceived or otherwise, as while the patient’s readings were not what Mr. A expected, they did not indicate any immediate danger. She was unaware of the specific details of the condition, and so she could not have known that the deviation was not a part of treatment. As such, she assumed that there was no pressing concern due to the lack of reaction by the nurses who took care of the patient before her.
Once the confrontation started, the third stage, felt conflict, manifested, as both parties’ feelings over the matter began intensifying. Mr. A began getting angry as his suspicions that the nurses regarded the matter as not deserving of an investigation were confirmed. He was further aggravated upon learning that Ms. B knew neither the reason why the patient did not receive medication nor the person responsible for making the decision. On her part, Ms. B felt anxious that she did something wrong and possibly harmed the patient in her ignorance and complacency. As a result, she deferred to Mr. A’s opinion, ultimately avoiding conflict and preventing it from entering the manifest conflict stage. However, the situation remained unresolved because the person who made the decision remained unknown and did not speak out later.
Conflict Management Methods
The confrontation ended in the manner that it did because the nurse deferred to the physician, avoiding escalation. However, a nurse leader would likely develop a better strategy by employing negotiation as described by Finkelman. The critical aspect of the problem is the lack of communication and questioning, with the person who made the decision failing to report the act and the nurses in charge of the patient not questioning the readings. A thorough investigation into the origins of the choice would be optimal, and then, the nurse responsible would discuss her choice with Mr. A. At the same time, he would have to acknowledge that there may be a legitimate cause for withholding the medication.
Ms. B’s use of avoidance shows her lack of confidence in the competence of her colleagues. Pitsillidou, Farmakas, Noula, and Roupa claim that the pressure caused by the lack of power and autonomy may contribute to this behavior. As such, Ms. B assumed that any argument would be meaningless and ultimately only lead to a negative mark left on her record. Similarly, the decision-maker decided that revealing his or her involvement would only lead to a reprimand, a justified opinion due to his or her refusal to consult the physician beforehand. The other nurses decided that it would be best not to pursue the matter further, as no harm had been done in the end. However, these approaches are unproductive for patient well-being, even if they reduce the burden on individual nurses.
Nurses in the unit should receive training that would improve their ability to compromise or work with others for mutual benefit. With these competencies, they can achieve better overall outcomes whenever confrontations emerge. Lahana et al. claim that educated and experienced nurses employ collaboration and problem solving and tend to defer to the supervisor to manage conflicts. Leaders would typically know more about the situation’s context and be more capable of conflict resolution than other workers. Nurses would also be more likely to communicate their decisions to others if they knew that the leader would become involved and investigate the matter. Overall, the conflict would have reached a better resolution more easily with the application of the methods described above.
The investigation of the issue has revealed that the situation is relatively common and enabled by both nurses and physicians. Furthermore, nurses tend to avoid conflict due to the perception that they cannot defend their position. However, the research studied during the assignment’s writing reveals that it is possible to address conflicts between nurses and physicians productively. As such, nurses should learn some confidence in their abilities as well as those of their colleagues and turn confrontations into improvement opportunities. In the future, the author will try to compromise with the other party or to search for a better solution together, involving the supervisor when they feel that their knowledge and abilities are inadequate.
Finkelman, A. (2016). Leadership and management for nurses: Core competencies for quality care (3rd ed.). London, United Kingdom: Pearson.
Lahani, E., Tsaras, K., Kalaitzidou, A., Galanis, P., Kaitelidou, D., & Sarafis, P. (2019). Conflicts management in public sector nursing. International Journal of Healthcare Management, 12(1), 33-39. Web.
Pitsillidou, M., Farmakas, A., Noula, M., Roupa, Z. (2018). Conflict management among health professionals in hospitals of Cyprus. Journal of Nursing Management, 26(8), 953-960. Web.