Managing Organizational Conflicts: A Phenomenological Study of Nurse/ Physician Conflicts in Nigerian Hospitals and their Impact on Managed Care Delivery

Okhakhu Al,Okhakhu Joo

doi:10.4172/2169-026x.1000115

Abstract

This study builds on and analyzes the conclusions examined the relationships in how nurses resolve their conflicts with doctors. They conclude that “dominance approaches to conflict resolution are associated with low occupational stress levels, whereas the obliging and avoidance approaches are linked to higher stress” and that “seniority and status of nurses affect both their choice of conflict-resolution tactics and the associated stress and job satisfaction levels”. This research furthers the investigation by sieving through the lived experiences of nurses and physicians in Nigeria to ascertain if cultural socializations complicate conflict resolution between nurses and physicians, and if it further adversely affects patient care delivery. This phenomenological study used five thematic questions to interview 100 nurses from five major healthcare facilities across the country, seeking their experience of inter-professional, personal, and ethical conflict in-care of patients. The findings suggest that in Nigeria, cultural socialization weigh heavily on how conflicts are handed, and have a negative impact on healthcare management/delivery. The perceived dominance or professional superiority of physicians over nurses has adverse effect on nursing. The research shows value for collegiality in patient care, and points to new direction in the understanding collaboration.

Highlights

Tabak et al [1] study outlined the following as sources of conflicts between nurses and physicians: “gender differences; gaps in education and socio-economic status; lack of understanding and sympathy; and, of late, the clash when nurses try to take on more professional responsibility”
Verbal abuse has been shown to negatively impact patient care, work satisfaction and turnover rates [41] as well as morale, productivity and error rates [42]. It seems that directly addressing these important issues may be beneficial to nursing and physician practice, besides finding out how cultural socializations complicate the resolution of these conflicts
In Kilmann and Thomas’ [45] model for conflict resolution, nurses in conflict with other staffers were found to lean towards the tactics of avoidance and compromise, the senior nurses tending to compromise while rank-and-file nurses chose avoidance [46]

Summary

Introduction

Tabak et al [1] study outlined the following as sources of conflicts between nurses and physicians: “gender differences; gaps in education and socio-economic status; lack of understanding and sympathy; and, of late, the clash when nurses try to take on more professional responsibility”. Workplace characteristics included employment status at the hospital (full time or part time), facility, type of unit (by medical specialty), average number of hours worked, average number of patients cared for, perceived quality of care provided, and inability to meet patient care needs resulting nursephysician conflicts This purposive research selected nurses, aged 23–53 years, who are information-rich key informants, knowledgeable in the issues explored in order to enter the world of their experience [8]. Verbal abuse has been shown to negatively impact patient care, work satisfaction and turnover rates [41] as well as morale, productivity and error rates [42] It seems that directly addressing these important issues may be beneficial to nursing and physician practice, besides finding out how cultural socializations complicate the resolution of these conflicts. They add that role separations and clear definitions of competence may facilitate nurse/physician collaboration

Findings

Discussion

Conclusions