In nursing, like in any other profession, there are many kinds of conflicts that can occur in the workplace and cause much stress. The most common conflicts in which a nurse might be involved are those with patients, nursing colleagues, superiors, and a director of a hospital, other healthcare professionals, and patients’ family members. Each of these conflicts can be considered recurrent, as no matter how hard a nurse tries to avoid them, they will always recur in a slightly different form (Chan, Sit, & Lau, 2014). Thus, all these types of conflicts require particular strategies that a nurse must apply to resolve them.
A Conflict General Description
Not long ago, I observed a conflict between a nurse and a physician at South Miami Hospital. The nurse had been working for many years at that hospital before the conflict. Her colleagues considered her an experienced, responsible, and reliable person. According to her patients’ feedback, she was kind, sympathetic, and thorough. The physician had also been working for many years before that conflict. She was also regarded as a professional, reliable, and responsible doctor. Her patients were grateful to her and almost always left positive feedback about her after the discharge from the hospital. However, these two people managed to create a conflict for no reason. This was an interpersonal communication conflict. Moreover, it is remarkable that both people had already had years of experience of working at the hospital and still did not understand how to handle conflicts at work, especially when they are not serious.
Thus, one day the physician approached the nurse asking about the blood pressure medications for a certain patient. She asked why the nurse had not given those medications which she prescribed to the patient. The nurse said that she had heard the physician telling her to wait for the results of the analyses and only then prescribe blood pressure pills. The physician was already nervous and said that she had told the nurse to give those medications until the results of the tests arrived. The nurse was becoming nervous as well saying that the physician had not told to give the medications. The physician began to speak loudly and accuse the nurse of being irresponsible. The nurse said that she had done as she had been told to and walked away.
Thus, the conflict was unresolved, as both the physician and the nurse were trying to prove their point of view instead of trying to find out who was responsible for the misunderstanding and deal with the problem. Certainly, the previous day was difficult for both of them, as they had many patients to manage and by the end of the day, they had been very tired. Therefore, either the nurse could have misheard what the physician had said about the blood pressure pills or the physician made a slip of the tongue when she was explaining to the nurse what to do.
In any case, it was impossible to find out for sure if there had been no witnesses nearby. However, their main mistake was that they were wasting time arguing instead of fixing the problem by caring for the patient. Eventually, they were reconciled with each other, but they should have been more professional and done it immediately after the conflict had occurred. As for the patient, he was given blood pressure pills and in a week, was discharged from the hospital. Additionally, although the conflict slightly influenced the patient’s health, the main issue was not the delegation, but miscommunication between two healthcare professionals.
Four Stages of Conflict
In 1967, Louis Pondy introduced his model of conflict resolution. It consists of four stages of conflict development, and the fifth stage, which is a conflict resolution (McKibben, 2017).
According to Pondy, the first stage of conflict is called latent conflict. At this stage, the factors that can cause a potential conflict to appear, and the situation, in which these factors can become a problem appear. This is the stage on which the participants are not yet aware that a conflict exists. Therefore, on this stage, conflicts can be easily avoided. Additionally, Pondy distinguishes four types of latent conflict, namely, role conflict, the divergence of goals, drive for autonomy, and competition for scarce resources (McKibben, 2017). In terms of the analyzed conflict, the latent stage was when the physician and the nurse misunderstood each other but were not yet aware of it.
The second stage of the conflict in Pondy’s opinion is called perceived conflict. This is the stage when one party perceives that the other party is likely to disrupt their goals. In some cases, this stage can be the first stage, without latent conflict preceding it. It occurs as a result of a misunderstanding between the parties as to their true position (McKibben, 2017). Thus, the analyzed conflict can be interpreted in a way that it skipped the latent stage began from the perceived stage when the physician saw that the nurse had not given the blood pressure pills to the patient.
The third stage of conflict according to Pondy is called felt conflict. This is the stage when the conflict is felt and recognized by all parties involved in it. Basically, on this stage, the conflict personalization occurs, which makes people be concerned with it and understand that it must be resolved somehow.
There are two main reasons for the conflict to be personalized. The first reason is the anxiety that can be caused by the internal or external pressure on an individual. Thus, this individual sometimes needs an outlet to remain calm. The second reason is the complete involvement of an individual in intimate relationships, which can easily provoke hostile feelings (McKibben, 2017). As for the analyzed conflict, this stage occurred when both the nurse and the physician understood that they had miscommunicated with each other.
The fourth stage in Pondy’s point of view is called manifest conflict. This stage is characterized by the complete involvement of all parties in the conflict. Their behavior is usually characterized by sabotage, rage, apathy, aggression, and other negative feelings. At this stage, the parties are engaged in a situation where each of them is trying to prove their rightness (McKibben, 2017). In the analyzed situation, this stage was when both the nurse and the physician argued with one another, where each was trying to prove their point of view.
Strategies to Resolve the Conflict
The fifth stage of conflict according to Pondy is conflict aftermath. Basically, on this stage, the conflict is resolved. However, before the resolution of the conflict, it can be properly managed (Huber, 2013). According to Pondy, there are five main types of conflict management. Thus, there are assertive and unassertive and cooperative and uncooperative methods of resolving conflicts. The assertive and cooperative method is collaboration; assertive and uncooperative is competition; unassertive and cooperative is accommodation; unassertive and uncooperative is avoidance; and the best method that comprises all the techniques is a compromise (Huber, 2013). Thus, in the analyzed situation, the physician chose competition and started arguing, whereas the nurse chose avoidance and walked away.
Certainly, the analyzed conflict like any other conflict could have prevented. It could have also been resolved by improving the communication skills of both parties. All kinds of conflict management mentioned above are effective in particular situations. However, in the analyzed situation, considering the type of profession where the lives of patients are at stake, the best method of conflict management is a collaboration (Chan et al., 2014). Thus, both parties have to quickly find a solution in crucial situations so as not to endanger the life of a patient. Moreover, the primary commitment of both the nurse and the physician is to the patient. Therefore, they have to learn to ignore their feelings and do what they must. Although in the analyzed case, the patient was not in danger, as he had chronic hypertension, the situation could have been different, and, as a result, the consequences of this minor conflict could have been much worse (Hartog & Benbenishty, 2015).
In conclusion, it can be stated that in general, conflicts spoil relationships and disrupt the process of work in any profession. Particularly, in the medical profession, conflicts must be taken much more seriously, as they can create situations where patients can suffer. Therefore, it is imperative to follow different strategies to prevent conflicts, or if they have already occurred, resolve them. In the analyzed situation, the most effective method of resolving conflicts is collaboration. Thus, all healthcare professionals must collaborate to provide the best care for their patients.
Chan, J. C., Sit, E. N., & Lau, W. M. (2014). Conflict management styles, emotional intelligence and implicit theories of personality of nursing students: A cross-sectional study. Nurse Education Today, 34(6), 934-939.
Hartog, C. S., & Benbenishty, J. (2015). Understanding nurse–physician conflicts in the ICU. Intensive Care Medicine, 41(2), 331-333.
Huber, D. L. (2013). Leadership and nursing care management (5th ed.). St. Louis, MO: Elsevier.
McKibben, L. (2017). Conflict management: Importance and implications. British Journal of Nursing, 26(2), 100-103.