It would be great if the treatment process could be addressed with a few difficult psychological situations as possible. Unfortunately, conflicts among patients and health care personnel are not a rare thing. It is important for nursing staff, as well as for other participants of the process, to understand how to manage conflict situations. This paper discusses the case of strong disagreement between a nurse and a patient regarding the use of antibiotics as a treatment method for a viral infection.
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The situation described in this paper took place at the University of Miami Hospital (Home, 2017). The conflict including a patient and a nurse practitioner built around the unwillingness of the former to accept the fact that he would not be prescribed antibiotics to treat him from flu. This conflict was at the felt stage, as both parties presented their opposing points of view, and frustration was caused by this discussion. This conflict stays unresolved since the patient still looks for receiving an antibiotic prescription, yet at this point, he looks for the opportunity to speak with the hospital’s management to support his position.
A middle-aged man came to the University of Miami Hospital last week to see someone from the health care staff to diagnose his state and to prescribe him medicine. A nurse practitioner on duty accepted him and asked several questions regarding his physical state and the progress of the illness. The patient answered that he had a high temperature and some symptoms of a cold. The nurse practitioner measured his temperature and made a blood test that showed this was a typical flu virus that caused the illness. While she made several tests to ensure there were no bacterial causes for his state, the patient insisted on having the prescription for antibiotics since he believed them to be the proper treatment. His wish was explained by the fact that his parents always used antibiotics in such cases and they had more authority in his view that the nurse practitioner did. The nurse practitioner said that she was not going to prescribe antibiotics since that would be a bad treatment that would do more harm than help the situation. The patient was frustrated, and after several minutes of dialogue, he went away. However, he returned several days later to seek someone from the administration as, according to him, he did not feel better and still wanted to get the prescription. The conflict is unresolved at the moment since the patient is still not satisfied.
Four Stages of Conflict
According to Finkelman (2006), there are four stages of the conflict. Every following stage is mostly an outcome of the previous one. The first stage is the latent conflict. This is a situation where there are factors that could potentially cause a collision of interests. For instance, in this situation, such a factor was the patient’s belief that antibiotics are the best treatment practice for a variety of illnesses. The second stage is the perceived conflict. It happens when one of the parties realizes the possibility of frustration or a simple disagreement of another person. What needs to be understood here is that the latent conflict is not a necessary condition for this stage.
Usually, the perceived conflict arises when there is a lack of communication between parties. The third stage is felt conflict. It is usually characterized by an open disagreement over a certain policy or situation. The case described in this paper is subject to this stage. The nurse practitioner’s response was limited due to professional ethics, yet the patient expressed his frustration openly. The final stage is the manifest conflict. It happens when two parties behave in a way that provokes a response from each other. It is a rare condition among patients and nurses since the latter must keep their behavior within the professional frames.
The conflict described above was by no means related to delegation. Nurse practitioners can prescribe medicine and draft treatment plans, which was done by this particular specialist (Stewart & Denisco, 2015, p. 7). It was her responsibility to refuse the prescription of antibiotics. Although the patient could address another nurse practitioner another day, he would receive the same response.
According to studies, there are six strategies for resolving conflicts (Marquis & Huston, 2009, p. 494). These are compromising, competing, cooperating or accommodating, smoothing, avoiding, and collaborating. One or several of them can be used depending on each case to find the best possible solution to the problem.
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The compromising strategy lies in giving up some of the ideas by each party that they find important to reach a consensus. However, this model has some drawbacks. For instance, both parties may feel like they lost an argument and the level of satisfaction will below.
Competing is possibly the worst strategy for resolving conflicts. It leaves one of the parties deeply unsatisfied with the outcomes. Competing is often addressed with anger and aggression. This approach should not be practiced in relation to clients. Thus, the hospital ground is not a place for this strategy. Cooperating is much better in such cases since the goal is to leave patients satisfied with the treatment and hospital personnel should feel valued.
Smoothing may work when a conflict has reached a critical level. It is easier to negotiate in a calm atmosphere. Avoiding conflicts should be exercised whenever possible. Finally, collaborating is also a good strategy. It allows changing the behavior of the power holder by convincing him or her that the outcomes of the position could be adverse for everyone.
For the case reviewed above, several strategies should be combined. Firstly, the nurse practitioner should try to smooth the conflict. The patient must hear her message without trying to interrupt and understands the negative sides of using antibiotics. Secondly, there should be a process of collaboration. In this case, the patient holds power since he can affect the hospital’s reputation by leaving negative feedback in public. Nevertheless, the nurse practitioner is responsible for his health, and she should try to deliver her thoughts delicately. The hospital’s management team is now also involved in this process, and it should try to collaborate with the patient as well. The nurse practitioner should collaborate with her leader to plan the best strategy for resolving this conflict. A leader would have much responsibility, as he or she is in charge of the situation now, and the following actions will determine the outcomes of the conflict.
The issue of conflicts between patients and health care personnel come up regularly. It is important to have the basic knowledge of strategies of how to avoid and solve such situations. This case describes the conflict that is already in the felt stage, which is best resolved through smoothing and collaboration. No compromising is acceptable in the practice of health care when the issue deals with health safety.
Finkelman, A. W. (2006). Leadership and management in nursing. Upper Saddle River, NJ: Pearson Prentice Hall.
Home. (2017). University of Miami Hospital. Web.
Marquis, B. L., & Huston, C. J. (2009). Leadership roles and management functions in nursing: Theory and application (6th ed.). Philadelphia, PA: Lippincott Williams & Wilkins.
Stewart, J. G., & Denisco, S. M. (2015). Role development for the nurse practitioner. Burlington, MA: Jones & Bartlett Learning.