Conflictmngt

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  • 1. Nurse-physician Conflict and its management
    Dr. Krupesh Thacker
  • 2. 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)
  • 3. Intro cont…
    • Conflicts occurs in routine life
    • 4. Different person different personality
    • 5. Changing health care system – increased interaction- more chances of conflicts
    • 6. Effects-positive& negative
  • Physician-Nurse conflict
    • Increased education of nurses
    • 7. More rights/responsibilities in patient’s treatment
    • 8. Difficult for physicians to accept such autonomy
    • 9. May find difficulties to trust diagnosis by nurses
    • 10. Nurses feel stress and job dissatisfaction
    • 11. Affect the nurse-physician relationship
    • 12. Conflict may occur
  • Conflict assessment
    Framework for the assessment of conflict
    The components are PEPRS:
    • Parties involved
    • 13. Events/issues (goals, behavior)
    • 14. Power
    • 15. Regulation of conflict(limiting factors, solution used)
    • 16. Style of management
  • Types of conflict
    Forte (1997)
    JEHN (1995)
  • Stage of Conflict
    • Latent conflict : conditions present; but not recognized
    • 23. Perceived conflict : perceive the occurrence
    • 24. Felt conflict : take matter seriously, but will not react openly
    • 25. Manifest conflict : reflects emotions in the behavior
    • 26. Conflict aftermath : solved and a new working relationship is established
  • Causes of Conflict
    • Individual characteristics
    values, education, age, demography
    • Interpersonal factors
    trust, respect, communication
    • Organizational factors
    interdependence
  • 27. Effect of ConflictNegative
  • Effect of ConflictPositive
    “Conflicts are cracks in a broken system, but they can also be source of creativity”
    • Strong relationships
    • 36. New better ways
    • 37. Decrease stress
    • 38. Increase work capacity
    • 39. Increase productivity
  • Conflict Management
    Avoidance
    Frequently used by nurse & physician
  • 40. Managerial Implications
    • Emotional type of conflict
    • 41. Save time and let both of them (physician-nurse) handle the problem
    • 42. Should judge the exact time to interfere in the matter, if required
  • Conflict Management
    Pressing
    • Power difference
    • 43. Overestimate self/other’s power
    • 44. Underestimate self/other’s power
    • 45. Nurses feel insulted, mental stress, job dissatisfaction, negative emotions
  • Managerial Implications
    • To deal with emotional type of conflict
    • 46. Keep a close watch , so whenever required he/she can settle the issue
  • Conflict Management
    Accommodation
    • More importance to other’s wish
    • 47. To avoid unpleasant disputes
    • 48. In past nurses used more frequently
    • 49. Study on 354 professional nurses in
    Thailand in 2000
    41.2% used accommodation
    29.2% used compromising approach
  • 50. Managerial Implications
    • Often uses this method
    • 51. Give physicians what they want
    • 52. Maintain good relations
    • 53. May become avoidance or pressing for the nurses due to accommodation between manager and physicians
  • Conflict Management
    Compromising
    • Both should compromise
    • 54. Good interpersonal relations
    According to the study on 126 nursing
    students, undergraduate and
    graduate students used
    compromising approach followed
    by avoidance
  • 55. Conflict Management
    Collaboration
    “Nurses and physician working together cooperatively to achieve shared problem solving, conflict resolution, decision making, communication and coordination”
  • 56. Conflict Management
    Collaboration
    • New better way
    • 57. No compromise
    • 58. Mutual respect
    • 59. Satisfaction
    • 60. Co-operative attitude
    • 61. Increase work capacity
    • 62. Improve patient’s safety
  • 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.
  • 63. 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
  • 64. Managerial Implications
    • Collaborative approach is beneficial for physicians, nurses as well as patients
    • 65. Manager should try to use this approach to deal with physician-nurse conflict
  • Conclusion
    • Collaborative approach is the best
    • 66. Physician should understand
    & accept the change
    • Attain conflict resolution training program
    • 67. Training improves conflict management skills
    in professional as well as personal life