conflictmngt
TRANSCRIPT
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NURSE-PHYSICIAN CONFLICT AND
ITS MANAGEMENT
Dr. Krupesh Thacker
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INTRODUCTIONDEFINITION
“Conflict is a process that begins when
an individual or group perceives differences and opposition between
him- or herself and another individual
or group about interests, beliefs, or values that matter to him or her.”
(De Dreu, Harinck, & Van, 1999; Wall & Callister, 1995)
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INTRO CONT…
Conflicts occurs in routine lifeDifferent person different personalityChanging health care system – increased interaction- more chances of conflictsEffects-positive& negative
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PHYSICIAN-NURSE CONFLICT
Increased education of nursesMore rights/responsibilities in patient’s treatmentDifficult for physicians to accept such autonomyMay find difficulties to trust diagnosis by nursesNurses feel stress and job dissatisfactionAffect the nurse-physician relationship Conflict may occur
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CONFLICT ASSESSMENT
Framework for the assessment of conflict
The components are PEPRS: Parties involved Events/issues (goals, behavior) Power Regulation of conflict(limiting factors, solution used) Style of management
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Types of conflict
FORTE (1997) JEHN (1995)
Interpersonal
Intrapersonal
Inter group
Intra group
Task content
Emotional
Administrative
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STAGE OF CONFLICT
Latent conflict : conditions present; but not recognizedPerceived conflict : perceive the occurrence Felt conflict : take matter seriously, but will not react openlyManifest conflict : reflects emotions in the behaviorConflict aftermath : solved and a new working relationship is established
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CAUSES OF CONFLICT
Individual characteristics
values, education, age, demography Interpersonal factors
trust, respect, communication Organizational factors
interdependence
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EFFECT OF CONFLICTNEGATIVE
Job stress Negative EmotionsAbsenteeism Intent to leaveMedical Errors Reduced productivityPatient’s safety AvoidanceJob dissatisfaction
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EFFECT OF CONFLICTPOSITIVE
“Conflicts are cracks in a broken system, but they can also be source of creativity”
Strong relationships New better ways Decrease stress Increase work capacity Increase productivity
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CONFLICT MANAGEMENT
AvoidanceFrequently used by nurse & physician
Positive Negative
Postpone the matter
Delayed decision
Save time Patient’s safety
To withdraw Interpersonal relations
Diplomatic Communication lack
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Managerial Implications
Emotional type of conflict Save time and let both of them
(physician-nurse) handle the problem Should judge the exact time to interfere
in the matter, if required
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CONFLICT MANAGEMENT
Pressing
Power difference Overestimate self/other’s power Underestimate self/other’s powerNurses feel insulted, mental stress, job dissatisfaction, negative emotions
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Managerial Implications
To deal with emotional type of conflict Keep a close watch , so whenever
required he/she can settle the issue
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CONFLICT MANAGEMENT
AccommodationMore importance to other’s wish To avoid unpleasant disputesIn past nurses used more frequently Study on 354 professional nurses in
Thailand in 2000
41.2% used accommodation
29.2% used compromising approach
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Managerial Implications
Often uses this method Give physicians what they want Maintain good relations May become avoidance or pressing for
the nurses due to accommodation between manager and physicians
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CONFLICT MANAGEMENT
Compromising Both should compromise Good interpersonal relations
According to the study on 126 nursing students, undergraduate and graduate students used compromising approach followed by avoidance
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CONFLICT MANAGEMENT
Collaboration
“Nurses and physician working together cooperatively to achieve shared problem solving, conflict resolution, decision making, communication and coordination”
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CONFLICT MANAGEMENT
Collaboration
New better wayNo compromiseMutual respect SatisfactionCo-operative attitude Increase work capacityImprove patient’s safety
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CONT…
Study : in 5 hospitals on 75 physician & 54 head nurses; collaborating method is
chosen more frequently by nurses & least frequently by physicians
Improving collaborative communication has benefits of increasing patient
survival, shortening length of hospital stay, enhancing professional
relationships, staff satisfaction.
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CONT…Patient’s safety is directly proportional to the physician-nurse communication that decreases medical errors
Must understand the severity of the effect of their conflict on patient’s life as well as hospital’s productivity
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Managerial Implications
Collaborative approach is beneficial for physicians, nurses as well as patients
Manager should try to use this approach to deal with physician-nurse conflict
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CONCLUSION
Collaborative approach is the best Physician should understand
& accept the changeAttain conflict resolution training program Training improves conflict management skills
in professional as well as personal life