Conflicts happen between people who have different points of view and different approaches for the same situation. Amestoy et. al. (2014) write that, in a work setting, “conflict implies disorganization of all team members and causes incased stress owing to the lack of participation in decision making, lack of management support, over-work, and rapid technological change” (p. 82). It is a well-known fact that conflicts often take place in a hospital setting among medical and nursing personnel due to various reasons and disagreements, as it is an immensely demanding profession.
One of the most common reasons for conflicts in this field is prioritizing key tasks. While one nurse may think that it is important to focus on a particular patient or problem at the moment, their co-worker may find it non-essential and urge everyone to help with a different matter. Nurses struggle with prioritizing and agreeing on their key tasks and where to place their attention, especially in a hectic atmosphere. Consequently, this was the reason why a conflict between two nurses occurred at the University of Miami Health System.
There are different types of conflict in healthcare organizations. According to Alshammari and Dayrit (2017), “some of the potential types of conflict prevalent in hospitals include:
- Role conflict – a type of conflict that occurs when roles are identified with two people with different statuses and delineation of duties is unclear;
- Communication Conflict – a form of conflict that happens when individuals’ failure to discuss their differences lead to problems with communication, where communication is viewed as a collaborative or collective activity that occurs between two people in agreement;
- Goal Conflict – a category of conflict which arises when two opposing goals have different levels of relevance to an individual or several individuals;
- Personality Conflict – a variety of conflict that exists when incompatible or opposing personalities present in the workplace clash;
- and Value Conflict – a kind of conflict that develops when action from an individual belonging to one moral order (i.e., set of practices, patterns of belief, language patterns) is regarded as unacceptable by another from a different moral order” (p. 45). The conflict that I am going to describe can be identified as a goal conflict.
The essence of the aforementioned conflict was that one nurse insisted on helping a patient who had just arrived at the hospital with an acute respiratory infection. The patient needed immediate examination and guidelines on further treatment. At the same time, there was a different nurse who was treating a patient that had been diagnosed with SARS and hospitalized for a while. The latter nurse claimed that this patient needed constant care and serious treatment. The majority of the personnel were busy and the second nurse had to help the first nurse with the new patient but she refused to leave the patient diagnosed with SARS without supervision.
Clearly, the two nurses had different priorities and could not agree on whose condition and situation out of the two patients were more important at that moment. The conflict remained unresolved, as the nurses went to work separately on their patients, meaning that they both decided not to confront their disagreements. Moeta and Du Rand (2019) write that “this behavior symbolizes a person avoiding the responsibility of managing a conflict, maybe in order to avoid tensions or maintain relationships in the unit rather than confront the problem” (p. 7). Either way, the nurses never got back to discussing this situation again, so there is concern that this miscommunication might cause more conflicts between them in the future.
Finkelman (2016) differentiated four stages of conflict: latent, perceived, felt, and manifest. The ‘latent’ stage is the stage of the anticipation of the conflict. In this case, it happened when the patient with a respiratory infection arrived at the hospital, and there were not enough personnel to take care of him beside the two nurses. The second nurse was already mildly stressed out because of the patient she had been supervising.
The ‘perceived’ stage took place when the nurses realized that there were two patients who needed examination and treatment at the same time. This is the stage where stress and disagreement started to arise. In the ‘felt’ stage, the first nurse explained why she needed the help of the second nurse and why it was important to help the newly arrived patient. The second nurse seemed to care more about her patient than her colleague’s concerns. Finally, the ‘manifest’ stage broke out when the second nurse refused to help the first nurse and left her behind to go back to her patient. The second nurse exhibited constructive behavior by walking off and putting the first nurse in a stressful situation.
There are various approaches and strategies for the resolution of such conflicts. Alshammari and Dayrit’s (2017) study shows that the most common types of strategies are the “compromising, collaborating, and accommodating types” (p. 246), and, occasionally, assertiveness, which are the positive strategies. The negative and less effective strategies are the competing and avoiding strategies. Evidently, the conflict implied the collaborating or the compromising type of strategy.
Communicating the problem to the nurse leader was also necessary since nurse-leaders engage “all members of the team not only in decision making processes but in the elaboration and planning of strategies for work and problem solving” (Amestoy et. al., 2014). I am sure that, if the two nurses asked the nurse-leader for help, the conflict would evolve more smoothly and the nurses would get the help they were seeking. Instead, they decided to keep the conflict at a personal level, which might affect their relationship and even interfere with the treatment of their patients.
In my opinion, this conflict could have been solved simply by communication. It was obvious that each nurse cared more about their own patient, but it is important to come together and seek the best outcome in a situation like this. If I were the first nurse, I would try to search for someone who is capable of seeing and examining the newly arrived patient as soon as they are done with their duties.
If I was the second nurse, I would ask the lead-nurse to take care of the patient with SARS, provide her with all the necessary information and supplies for the period of my absence and try to help my colleague as quickly as I can. After all, this profession is about teamwork, it is crucial to be there for each other, back each other up and eliminate any conflicts before they escalate into personal grudges and interfere with the workflow.
References
Ahmed, R., Fakhry, S., Saad, N. (2019). Conflict Resolution Strategies Training Program and its Effect on Assertiveness among Nursing Students. Egyptian Journal of Health Care, 10(2). 237–249.
Alshammari, H., Dayrit R. (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.
Amestoy, S.., Backes, V., Thofehrn, M., Martini, J., Meirelles, B. & Trindade, L. (2014). Conflict management: challenges experienced by nurse-leaders in the hospital environment. Revista Gaucha de Enfermagem, 35(2), 79–85. Web.
Finkelman, A. (2016). Leadership and management for nurses: Core competencies for quality care (3rd. ed.). Upper Saddle River, NJ: Pearson Education.
Moeta M., Du Rand, S. (2019). Using scenarios to explore conflict management practices of nurse unit managers in public hospitals. Curationis. 42(1). Web.