Dr.

Krupesh Thacker

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)

Conflicts

occurs in routine life Different person different personality Changing health care system increased interaction- more chances of conflicts Effects-positive& negative

Increased

education of nurses More rights/responsibilities in patients treatment Difficult for physicians to accept such autonomy May find difficulties to trust diagnosis by nurses Nurses feel stress and job dissatisfaction Affect the nurse-physician relationship Conflict may occur

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

FORTE (1997)

JEHN (1995)

Interpersonal

Task content

Intrapersonal
Inter group Intra group

Emotional
Administrative

Latent

conflict : conditions present; but not recognized Perceived conflict : perceive the occurrence Felt conflict : take matter seriously, but will not react openly Manifest conflict : reflects emotions in the behavior Conflict aftermath : solved and a new working relationship is established

 Individual characteristics

values, education, age, demography Interpersonal factors trust, respect, communication Organizational factors interdependence

Job

stress Negative Emotions Absenteeism Intent to leave Medical Errors Reduced productivity Patients safety Avoidance Job dissatisfaction

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

Avoidance
Frequently used by nurse & physician Positive Postpone the matter Save time To withdraw Diplomatic Negative Delayed decision Patients safety Interpersonal relations Communication lack

Emotional type of conflict Save time and let both of them (physiciannurse) handle the problem Should judge the exact time to interfere in the matter, if required

Pressing
Power

difference Overestimate self/others power Underestimate self/others power Nurses feel insulted, mental stress, job dissatisfaction, negative emotions

To deal with emotional type of conflict Keep a close watch , so whenever required he/she can settle the issue

Accommodation
More

importance to others wish To avoid unpleasant disputes In past nurses used more frequently Study on 354 professional nurses in Thailand in 2000 41.2% used accommodation 29.2% used compromising approach

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

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

Collaboration

Nurses

and physician working together cooperatively to achieve shared problem solving, conflict resolution, decision making, communication and coordination

Collaboration
New

better way No compromise Mutual respect Satisfaction Co-operative attitude Increase work capacity Improve patients safety

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.

Patients

safety is directly proportional to the physician-nurse communication that decreases medical errors
understand the severity of the effect of their conflict on patients life as well as hospitals productivity

Must

Collaborative approach is beneficial for physicians, nurses as well as patients Manager should try to use this approach to deal with physician-nurse conflict

Collaborative

approach is the best Physician should understand & accept the change Attain conflict resolution training program Training improves conflict management skills in professional as well as personal life