Conflict is a protracted disagreement or argument that often leads to disharmony. It comes about as a result of disparities in interest or demand from work or within the family. In a healthcare setting, conflict may arise between nurses, staffs, doctors, family members or patients. Finkelman (2016) argued that disputes might range from irrelevant or inconsequential factiousness to engagement in the fight and severe disagreement amongst physicians.
In my practice setting, I identified disruptive physician as a conflict. This took place where a physician had disgusting and horrible habits that displeased the staff and the patients as well. More often than not, physicians are trained and instructed on the work skills required in their occupation and are obliged to act as per the teachings. The healthcare facility may incur additional charges in the presence of disruptive physicians in places of work due to non-correspondence of the fellow staff members or patients hindering the efficacy of the nurses in their daily procedural undertakings. In the most recent matter of an operation room with a reprimanding physician by the name James who immodestly kept indulging in loud and senseless conversations and talks regarding his scholarly excellence. Since he was a fresh graduate, the experienced physicians looked down upon him thus igniting tension in the setting. This resulted in miscommunication between staff and patients. As a result, staff retained revitalizing and stimulating data to the patients due to apprehension. James faced isolation and attempted to hit back by disrespecting and insulting as well as other forms of retaliation such as failing to help in the procedure. This almost resulted in an operation failure and a fight in the theatre if it were not for Mukai, a caring surgeon, who vehemently operated with the help of nurse Annett and other physicians. Afterwards, I chaired a session with the nurses involved in the operating room in presenting the conflict. I explained the responsivities required of each and the code of ethics and conduct needed in the operation room. The parties involved agreed to behave dutifully and dependable, and I also talked to James in private where he explicitly accepted to receive training on ethical behaviour in the workplace and more so in the operating room.
In most cases, descriptive physician cases arise in high-stress specialties such as obstetrics, surgery, and cardiologist. It negatively influences staff retention and safety of the patient. There should be mediation to resolve the habit in areas where disruptive physician cases are noted. According to Judith (2017), failure to timely curb the menace will depict obliviousness to overlooking the unprofessional behaviour. Clinicians with immoral or unethical conduct pose a significant threat to the life of the patient, termination of the nurse career due to dissatisfaction, and increasing medical errors.
The first stage of conflict as depicted in Finkelman (2016) is a latent conflict. It involves the possible rationale for a conflict to occur. Finkleman referred to this type of conflict as anticipation or inert conflict. It is often triggered by competition or miscommunication due to resources or amenities. In my example explained above, latent conflict is evident where James was unwilling to follow the standard procedure. In the operating room, his presence created a change in the setting with the other staff failing to understand why the physician on duty failed to appear for the process, even though I did not feel the same. This condition might have triggered the conflict that resulted later.
The second stage of conflict is the perceived conflict. Perception offers an understanding of whether there are conflict and the possible ways of resolving it. According to Finkelman, conflict at this stage is seen but not felt. Referring to my illustration presented above, the fellow physicians identified James, but they may have projected conflict unlike the surgeon on duty who in some way did not perceive any conflict occurring during the operation.
Stage three is the felt conflict. Finkelman (2006) explained that there are contention and anxiety that is felt. Regarding my example, the operation room was filled with anxiety when James began responding rudely to the other physicians despite the constant alarm from Mukai which could have avoided the next phase of the conflict.
The final stage of conflict is the manifest conflict. Finkelman (2016) argued that this is a stage where the parties involved react. It can either be constructive or destructive. Constructive reactions involve changing the wrong attitude, proper concentration and encouragement from peers while destructive reactions include damage, brutality, ignoring commands or procedural withdrawal from the operation. In the illustration provided above, the operation could not have been successful had it not been for the surgeon avoiding the worst scenario for the sake of the patient and understanding from peer physicians. Besides, I talked politely to James until he remained calm in the process. When I had a personal talk with James, he collaborated and promised to change for the better. The Human Resource Manager agreed that it is wise to train the medical practitioners. The different stages of conflict start from latent to the manifest conflict as Finkleman described them relate to the disruptive behaviour of physicians phase by phase.
In the conflict presented above, a delegation of responsibilities can be seen as the root cause of all the problems that resulted in disruptive behaviour. In any healthcare setting, adequate professionals ensure that there is minimal or no cases of conflicts or disagreements. Duty delegation to James with less experience and newness to the facility prompted tension about his possible expertise which later led to conflict.
Strategies for resolving conflicts include collaborating in the medical procedures and placing the health and well-being before their interests. Withholding any kind of crucial information regarding the mode of treatment and patient can be fatal to the welfare of the patient. James was unwilling to take part in the operation since he had centered his individualistic idea. In order to mitigate conflicts, there should be rules and regulations enacted and fully reinforced policies that govern the nursing and care profession ranging from the code of standards to departmental laws which should be appropriately outlined for better understanding. The laws should have abiding penalties to those who break the law. In this regard, there should be a structured protocol for an operation to curb conflict with the knowledge that anticipation bleeds conflicts. Ignorance, verbal misuse, sexism and imbalances in racial, and senseless principles and desires should be avoided. Administrators also neglect their duties, fail to properly organize activities and failure to mend their faults (Almost et al., 2016).
According to Almost et al. (2016), there is an improved safety of patients, increased staff morale, quality work when conflicts are handled efficiently and effectively, thus reducing stress to caregivers. In conflict resolution and management, there should be proper communication between all levels and classes with an understanding of how to tackle any disagreements that may arise in due course. In order to accommodate diverse ideologies, nurse leaders should interact with staff, management, and patients. This can be managed by the interactive forum as opposed to the administrative technique. Thomas (2015) suggested that there should be suitable training for all attendants in the medical setting across all ages and levels. In the example explained earlier, I was involved in the operation room as a nurse manager and therefore witnessed the talks and took prompt measures to prevent conflict and stop the reoccurrence of the same. Nurse leaders should be watchful for any conditions that may threaten the credibility of medical procedures.
To sum up, the differences in interests and ideologies should not affect how medical practitioners are carried out. Operative procedures should be put forward in a manner that everyone is in a position to understand. These laws and policies should have severe consequences for the offender to avert cases of conflict. It is hypothesized that about 2% to 4% of cases of disruptive physician cases are witnessed every single day (Judith, 2017). In as much as the medical profession needs intellectuals, the conflicting anxieties could decoy their credentials. Medical procedures need to be undertaken with the seriousness they deserve as the consequence of the opposite is disastrous. Adequate training should be provided to all attendants and medical practitioners to integrate essential information needed. Whenever conflicts arise or transpire, they should be solved through accommodating-to maintain relationships and harmony, compromising- to reach to a consensus, collaborating- to find a mutual solution and avoiding conflict-to let parties cool down (Finkleman, 2016). Indications of any manner either through physical expressions or verbal means that could result in dispute should be controlled to avert the detriment that can be triggered.
Almost, J., Wolff, A. C., Stewart‐Pyne, A., McCormick, L. G., Strachan, D., & D'souza, C. (2016). Managing and mitigating conflict in healthcare teams: an integrative review. Journal of advanced nursing, 72(7), 1490-1505.
Finkelman, A. W. (2016). Leadership and management for nurses: Core competencies for quality care (3rd Ed.). Boston, MA: Pearson.
Judith, H. A. (2017). Communication, Collaboration, Negotiation, and Conflict. Public & Community Health Nursing Practice: A Population-Based Approach, 265-281. doi:10.4135/9781483328669.n18
Thomas, T. (2015). Management and leadership for nurse administrators. Jones & Bartlett Publishers.