Conflict resolution process is of great importance due to the fact that it helps restore normal conduct in any work setting, provided the participants react adequately. A hospital can be a highly stressful environment, which affects inter-personal relationships and conflicts can arise rather frequently. Therefore, it is paramount to reflect on different conflicts to identify patters of their flow and develop solutions for the future. This paper will concentrate on one conflict case, review its development through the stages, and discuss strategies for resolution.
The recurring conflict of note happened in the hospital where I practiced as a nurse. The conflict often happened between nurses and a physician (P). The latter sometimes miscalculated the dosages of painkillers for patients. Nurses called him to make a note of that and ask for a correction to be made. P would always yell at them for calling him at such late notice (when P was called at night in the event of an emergency). Despite the fact that this was in his line of duty to check and double-check the dosage, P often claimed that he ‘knew all the dosages by heart.’ In addition, P was also obliged to be available for calls at any time of the day. P was approximately 58 years old, which can be a reason for his dosage confusion.
Yet the heart of the conflict is the fact that nurses often disliked calling P due to his harsh reaction to dosage miscalculations. Many, if spoken to about it, admit feeling ‘intimidated’ to call P and did it in case it was an absolute emergency. The issue due to such a gap in communication was a constant threat to patients’ condition as sometimes the speed of decision making is of the essence. To my present knowledge, the conflict is still unresolved as P continues to work at the same hospital in the same position. His nurse colleagues, with whom I often communicate, confirm that his reaction to calls for corrections has not changed.
The conflict appears to be inter-group in nature. In this case, P seems to act as a representative of his profession. Professional conflicts often arise between nurses and physicians due to both groups possess little knowledge of the roles of each other. Their judgment about one another is often subject to stereotypes. In addition, there is more than one person involved from the other side. Multiple nurses are united in their evaluation of P as a rude person with poor knowledge of professional ethics and negligence to his responsibilities. All of them had issues with contacting him. Therefore, the conflict can be considered inter-group.
The first conflict stage known as latent conflict when sides are unaware of it seems to be in the fact that P has the tendency to prescribe wrong amounts of drugs. Issues of him occasionally confusing dosages were noticed during his shift before, and no adverse reaction was recorded. Therefore, nurses had no reason to be negative towards him.
They passed to the next, perceived, stage when one of the nurses had to call P for the first time during his night on call. Confronted with the inadequate reaction to a protocol situation a nurse became a part of a conflict. It is noteworthy that at this stage, the conflict was inter-personal in nature since other nurses did not have a negative experience with P previously. Certainly, there is a possibility that a nurse who contacts P that night passed her experience to other team members. Yet, none of them was personally involved.
Felt Stage occurred when the same nurse had to call P for the same reason at the same time of the day. Both sides felt discomfort. A nurse was intimidated to call recollecting an adverse experience in the past. P was irritated the second time as he was disturbed late again. At this stage, the communication between sides became tense. P probably thought that he was disturbed for no reason and nurses may have changed the dosage themselves despite the fact that they are obliged to get the confirmation. Therefore, he was more prone to be toxic during his shifts. Nurses are also having in mind the negative communication experience were less inclined to contact him until it was absolutely necessary.
The manifest stage was identified when P openly voiced his discontent about night calls asking all nurses to ‘leave him alone at least during the night.’ The conflict was then made public and a few other staff members overhead this conversation. The protocol of communication was completely severed, and nurses tend to avoid communicating with P. Instead, they ask other people to contact P if something happened, which might be the case of delegation.
Strategies to Resolve the Conflict
One of the strategies is to authorize nurses with sufficient experience to change dosages of medication. This measure will help nurses feel more empowered and avoid unnecessary interprofessional conflict of judgment (“Conflict in the workplace: Resolving the nurse-physician clash,” 2015). The fewer occasions on which nurses had to communicate with P, the less stress will they feel in adverse patient situations. Such an authority could be granted to a nurse leader. Provided someone from the team notices a discrepancy in dosage, they can contact their manager.
Another strategy is to eliminate the source of the problem. The reason why P apparently gets irritated during calls is the fact that he possesses limited knowledge of his on-call status and duties. It could probably be best if someone with higher authority such as a head physician or someone from hospital administration reminded him that it is his duty to answer calls at any time of the day. Especially, if the matter involves his professional judgment.
Also, a possible strategy can involve intense interprofessional collaboration training for physicians and nurses. Many researchers argue that there is a serious gap in professional education concerning role recognition (Baddar, Salem, & Villagracia, 2016; Galletta, Portoghese, Battistelli, & Leiter, 2013). Therefore, it could be effective for both parties to learn to communicate with each other.
It appears that the best strategy is to change corporate culture to less hierarchical and give certain freedoms to nurse leaders. The knowledge and experience of nursing staff have risen manifold since the time when nurses were just instruments for carrying out physicians’ orders (Tang, Chan, Zhou, & Liaw, 2013). The mere fact that nurses can detect discrepancies in dosage speaks to their ability to make good calls.
All things considered, this conflict made me realize the fragile nature of interprofessional relationships. When two equally competent professionals are forced to communicate through the prism of hierarchy, the tension can become critical. Most importantly, such state of affairs endangers health and wellbeing of patients. In future, I will advocate for the rights of nurses before hospital administration in order to prevent such issues from occurring.
Baddar, F., Salem, O. A., & Villagracia, H. N. (2016). Conflict resolution strategies of nurses in a selected government tertiary hospital in the Kingdom of Saudi Arabia. Journal of Nursing Education and Practice, 6(5), 91-99.
Conflict in the workplace: Resolving the nurse-physician clash. (2015). Web.
Galletta, M., Portoghese, I., Battistelli, A., & Leiter, M. P. (2013). The roles of unit leadership and nurse–physician collaboration on nursing turnover intention. Journal of Advanced Nursing, 69(8), 1771-1784.
Tang, C. J., Chan, S. W., Zhou, W. T., & Liaw, S. Y. (2013). Collaboration between hospital physicians and nurses: An integrated literature review. International Nursing Review, 60(3), 291-302.