Handling Conflict: Nursing Management

Running head: NURSING MANAGEMENT
Handling Conflict: Nursing Management
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1NURSING MANAGEMENT
Introduction
Conflicts are recognized as the differences in opinion between two or more individuals or
groups as a result of differences in values, attitudes, beliefs and behaviors. In relation to
workplace settings, conflicts are found to be arising from two different sources; staff to manager
interactions and staff to staff interactions. Interpersonal conflict is perceived to be a
disagreement involving dissatisfaction, the outcomes of which might be drastic. Workplace
conflicts experienced in the healthcare settings are complicated due to the fact that they involve
complex relationships based on emotions of individuals. In such a setting professionals are to
engage in communication with the diverse human resources who have different opinions and
beliefs. It is crucial that professionals attempt to prevent conflicts among them for promoting
best quality health care delivery. Divergences and disagreements exiting in healthcare settings
hold the potential to have a negative impact on the process of care delivery as a result of
communication gap. It is therefore essential that healthcare professionals, including nurses, aim
to identify sources of conflicts and implement suitable measures to resolve the same at the
earliest. The present paper is based on a conflict witnesses in a clinical setting that holds
importance in terms of patient care delivery. The paper provides details of the scenario setting
and the conflict scenario at the initial stage. The contributory factors of conflict are then outlined
in the paper. The next section is an analysis of the conflict scenario and takes into consideration
the impact on patients, nurses and the organization. A root cause analysis of the scenario is
then presented. At the end, suitable conflict resolution strategies are outlined that can resolve
the concerns. A conclusion is drawn at the end of the paper.
Scenario setting
Nursing placement in healthcare settings are vital for understanding issues that are
commonly faced by professionals in diverse scenarios. Placements are the opportunities to
engage in learning skills for addressing real-life scenarios that can guide nursing practice. For
my clinical placement I was required to work in the Intensive Care Unit (ICU) in a reputed
hospital in Saudi Arabia. ICUs are the special department of a health care facility that is
responsible for providing intensive treatment to patients. Professionals are to cater to the needs
of patients suffering from life-threatening and severe health conditions requiring close support
and monitoring for ensuring better outcomes. I had joined the Medical ICU (MICU) in the setting
that aimed at being committed to provide excellent care with compassion and teamwork. The

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unit could accommodate ten patients as its maximum capacity. Three staff nurses were to be at
duty in each shift, and the unit also had one manager and one medical officer to take in charge.
Patients were to be transferred directly into the unit from the emergency department if needed,
or from the general ward in case of deterioration in the condition of the patient. MICUs are to
provide interdisciplinary care to those requiring continual care in a technologically advanced
setting.
Scenario
Having worked at the MICU for a few days there was a realization that the nurse’s
turnover rate was considerably high in the unit as compared to that of other professionals at the
unit and at other units of the same setting. The contributing factors for the same were poor level
of communication among the coworkers, inappropriate attitude of the physician towards the
nurses, lack of acceptance, bullying, and lack of respect. There were more than one instances
when conflict among the professionals was evident that had far reaching complications. The
ultimate outcome was dissatisfaction on the part of the patients due to poor health outcomes.
On a particular day while I was on duty, the physician had come on round at the unit to
follow up his patient who had been complaining of urinary tract infection at that time frame. The
patient was a 76 year old woman admitted to the general ward at the initial stage due to
pneumonia. She had later been transferred to the MICU for deterioration in her condition. Her
medical history included type 2 diabetes diagnosed twenty years previously. Upon assessing
the patient based on her complaint, the physician shouted at the nurses regarding failure to
catheterize the patient in early shift. The reason for his anger was that catheterization was
recommended at the time of admission of the patient. To this the nurse manager showed
disagreement regarding the inessential need of catheterization for the patient. She mentioned
that her decision was based on previous experiences of similar patient situations.
It was further pointed out by the physician that the nurses had also missed administering
the insulin dose to the patient. The nurse manger who was responsible for the overseeing the
concern related to the error previously had differences of opinion with the physician. Further, the
manager also had interpersonal conflicts with the nurses working at the unit. She therefore did
not address the concern of medication mismanagement and inappropriate catheterization as
deemed fit. No clear instructions were given to provide care for urinary tract infection and the
nurse manager demonstrated poor leadership skills. She disregarded the concerns of the
professionals and the patient put forward at different point in time. As a result of the conflict

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there was a rapid deterioration in the condition of the patient and had to remain admitted at the
MICU for further seven days. In addition, it was noticed that in case nursing professionals put
forward a complaint regarding interpersonal problems, the manager adapted an avoidance
strategy. This further deteriorated the working environment in the unit. During my placement one
nurse had resigned from her job due to dissatisfaction related to poor work environment.
Contributory factors of conflict
Significantly, healthcare teams function on the basis of contribution of different
professionals, and so is the case for MICUs. Nevertheless, conflict is common in teams where
professionals respond to different clinical situations in different manner. Since teamwork in
clinical settings is highly complex, the sources of conflicts are also varied. In an MICU, the
contribution of each professional is crucial, and thus the chances of conflict are amplified to a
great extent Zerwekh, and Garneau (2017). McKibben (2017) commented that different
personalities of healthcare professionals collide under the circumstances where critical
decisions are to be taken, leading to conflicts. Some of the underlying causes of conflict include
lack of inter-professional respect, disagreements, negative emotions, lack of resources and lack
of suitable leadership. Healthcare teams constitute key members who bring in particular skills
and knowledge to care delivery process. As a result they demonstrate different perspectives on
how a particular situation is to be addressed (Brown et al., 2011).
According to Pecanac and Schwarze (2018) collegiality stems from working relationships
that lead to respect for other’s ability. This entails collaboration and apt critical decision making
between healthcare professionals. Conflict arises when mutual recognition is lacking. Some
examples include blaming for perceived poor outcomes and whistle blowing by a professional
regarding a misstep. The behavior is the cause of escalation of conflict and one feels injured
due to hurtful behavior whereas the other feels anger. In the present case the physician took in-
appropriate approach for addressing the concern poor treatment being given to the patient
suffering from UTI. As he shouted at the nurses the nurse manager felt un-recognized and
underestimated.
Disagreements between professionals regarding treatment procedures are also a
noteworthy cause of conflict. Decisions regarding treatment processes are related to
intervention options and professional judgment on the basis of outcomes experienced earlier
(Aberese-Ako et al., 2015). In the present scenario the cause of conflict was also attributed to