Introduction
Most nursing jobs, regardless of specialization, take place in highly intense environments and are connected with much pressure, many tasks and responsibilities on a daily basis. As a result, conflicts may arise in many different situations between nurses or groups of nurses. Very often, such conflicts may affect a single person and occur internally instead of happening between two or more professionals. The focus of the present paper is to describe and evaluate a real-life conflict that was observed in a healthcare setting. The setting that was chosen for observation is a hospital setting in Miami. The conflict that will be discussed in this paper happened between several nurses working in the acute care unit and produced negative effects on several patients.
Conflict Description
The conflict in question involved several nursing professionals and had been in progress for several days. In particular, two nurses who worked in acute care unit left their jobs. As a result, nurse-to-patient ratio shifted as the number of nurses became insufficient for the number of accommodated patients. In order to address this problem, the remaining nurses had to cover for the missing staff members. Consequently, excessive workloads occurred immediately. Nurses’ responses to this change were quite negative as they already had much work and stress. The shift seemed to have occurred rather unexpectedly, so there was no exact plan as to which nurses were to cover which patients. Over the next days, several nurses working in this unit clashed with one another due to mix-ups in their tasks, roles, and schedules. The problem in question can be characterized as a recurring interpersonal conflict that resulted from excessive workloads and an increased level of occupational stress inflicted by the insufficient nurse-to-patient ratio.
Details of the Conflict
On the first week, a patient who suffered from chronic pain was administered his pain-management treatment three hours later than needed because nurses were not sure whose role it was to deliver his medication. This incident resulted in an argument between two nurses whose scheduled got mixed up. A couple days later, a patient’s family was left to wait for a long time for a nurse to come and speak with them due to another mix-up. Throughout the entire day, two nurses were in conflict refusing this role because they were not sure whose task it was. Next week, three nurses had a clash of an unclear nature that could have resulted from their increased occupational stress. Further, nurses complained about insufficient work-life balance and exhaustion.
During the observed series of interpersonal conflicts, nurses argued about their roles. Sometimes, when one professional tried to remind another about a certain task, nurses took it negatively as an attempt to displace someone else’s responsibilities on them. They shut each other down saying that certain things were not their jobs or responsibilities. It could be noticed that due to exhaustion and a high level of stress, nurses’ morale started to go down as they had to prioritize their own needs to the needs of their peers and patients. Many professionals noted that their job satisfaction became much lower and their turnover intention increased.
This conflict remained unresolved as the unit is still understaffed. This means that the nurses are still forced to cover for the missing staff members and work long hours taking over more tasks than expected. Many nurses had lost some of their days off due to this situation which produced a negative impact on their moods. The interpersonal tension between the remaining staff members increased and more conflicts and mix-ups could be expected.
Four Stages of Conflict
The first stage of conflict is “latent”. In the given situation, it occurred when two nurses left their jobs which resulted in understaffing for which the remaining staff had to compensate. The “perceived stage” of conflict started when the remaining staff became aware of the insufficient nurse-to-patient ratio and the upcoming excessive workloads. At this stage, some nurses started to complain and predict chaos and pressure that were to come. The next stage is “felt conflict” when nurses started to experience exhaustion, nervous tension, and job dissatisfaction because of the current imbalance. Finally, the “manifest stage” began when the nurses started to clash with one another, argue about their responsibilities and roles, and mix up their tasks failing to provide a high level of care to patients.
The staff of nurses in this particular setting includes a group of nursing students and nurses of lower qualifications. Under the present circumstances, it was possible to reassess the current tasks and responsibilities of all the nurses and move some of them to nursing students and nurses with lower qualifications in order to alleviate the burden causing the unit nurses to burnout. This way, the problem in question was related to the issue of delegation.
Conflict Resolution Strategies
Occupational stress is known as one of the major factors that tend to impact employee performance and thus decrease the performance of an entire organization or a department (Long, Kowang, Ping, & Muthuveloo, 2014). The excessive workloads observed in the present situation are known to be one of the in causes of occupational stress (Dalri, Silva, Mendes, & Robazzi, 2014). Moreover, excessive workloads are also recognized as a cause of work-related conflicts between nurses (Akpabio, John, Akpan, Akpabio, & Uyanah, 2015). Also, negative patient outcomes are said to be another result of heavy workloads carried out by nurses (MacPhee, Dahinten, & Havaei, 2017; Shah, 2017).
In the situation in question, it was noticeable that collaboration was missing from the interactions of nurses. However, collaborative strategies are recognized as an effective method of conflict resolution (Baddar, Salem, & Villagracia, 2016). This strategy is usually put into practice through teamwork fostering (Alshammari & Dayrit, 2017). Collaborating with a nurse leader in order to resolve the present conflict, I will inform them about the problem and note that the overworked nurses are more likely to make hasty decisions and errors exposing patients to risks and dangers.
Further, I will propose a plan that would include such stages as communication with the acute unit nurses, the creation of a list of their duties, the reassessment of duties, and their reassignment via delegation to nursing students and nurses with lower qualifications. The communication stage will help collect information about the tasks that can be delegated without risks and the other stages will allow putting the reassignment into practice. Thus, the nurses will be alleviated from their excessive workloads and a more peaceful and balanced environment will be established.
Conclusion
The situation in question is based on the problem of understaffing among nurses that causes negative outcomes for staff members and patients. Conflicts that were observed in this case are the results of excessive workloads and mixed up roles. The problem can be resolved by means of fostering teamwork and delegating some of the duties of the overworked nurses to their peers with lower qualifications. This solution strategy requires communication with the nurses and evaluation of their present roles and tasks. In order to deal with this issue more effectively in the future, the communication and assessments stages need to be implemented every time a unit faces understaffing.
References
Akpabio, I., John, M., Akpan, M., Akpabio, F., & Uyanah, D. (2015). Work-related conflict and nurses’ role performance in a tertiary hospital in South-south Nigeria. Journal of Nursing Education and Practice, 6(2), 106-114.
Alshammari, H. F., & Dayrit, R. D. (2017). Conflict and conflict resolution among the medical and nursing personnel of selected hospitals in Hail City. Journal of Nursing and Health Science, 6(3), 45-60.
Baddar, F., Salem, O., & Villagracia, H. (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.
Dalri, R., Silva, L., A., & Robazzi, M. (2014). Nurses’ workload and its relation with physiological stress reactions. Revista Latino-Americana de Enfermagem, 22(6), 1-8.
Long, C. S., Kowang, T. O., Ping, T. A., & Muthuveloo, R. (2014). Investigation on the impact of job stressors on nurses in Malaysia. Asian Social Science, 10(4), 67-77.
MacPhee, M., Dahinten, V., & Havaei, F. (2017). The impact of heavy perceived nurse workloads on patient and nurse outcomes. Administrative Sciences, 7(7), 1-17.
Shah, M. (2017). Impact of interpersonal conflict in health care setting on patient care: The role of nursing leadership style on resolving the conflict. Nursing and Care Open Access Journal, 2(2), 1-4.