Physician-Nurse Conflict

As a family nurse practitioner (FNP), we have the responsibility to provide the best care we can with the patient’s best interest at heart. On a daily basis we deal with the needs and wants of our patients, this alone provides an ethical dilemma. What we think is best and what our patients want could in fact create an ethical dilemma, however, when we have an ethical dilemma, it is our responsibility to get to a decision with caring, respect, an open mind and honesty to our patients (Parker, 2007). In making a decision regarding an ethical dilemma it is our responsibility to use a framework model to guide us in making an informed decision that is best for our patients. It may not always be the most popular decision but if it is in our patient’s best interest, then you are practicing as a good and prudent, NP.

A conflict can be described as an interpersonal disagreement between two or more parties having a difference in opinion, controversy, negative understanding or insufficient communication (McKibben, 2017). Within the healthcare arena, conflict cannot be avoided. It can have the ability to have a negative impact on the function of the team and result in inadequate patient care. When poor patient care is provided, the integrity of the nurse, the nursing profession, and healthcare as a whole is endangered (McKibben, 2017). As a result, conflict management is the process of recognizing and dealing with conflict in a realistic, fair, and competent fashion. Productive communication, problem solving, and discussing with a focus on the issues are required skills needed for conflict management (Saeed, Almas, Anis-ul-Haq, & Niazi, 2014).

One of the conflicts that arise in health-care from a conflict perspective is the focus of the provider and is the provider functioning as a scientist or a care giver. Are there objective versus subjective concerns for the patient and is the health care provider treating the disease or is the provider treating the person? The conflict that arises between health-care provider and patient is vastly influenced by the patient’s cultural and social beliefs.

Political Activity is alive and well in organisations – one of the biggest killers of productivity is not a lack of innovation, productive systems or visionary thinking, its politics (Fraser, 2013, p. 1). It is a major issue in organisations as the individual who controls their working relationship consumes time and resources for their own gain at the company’s expense. In this

What is conflict? Even something as basic as a universal definition for the word conflict seems to vary from source to source. A literature review focusing on conflict defined it as “the interaction of interdependent people who perceive incompatibility and the possibility of interference from others as a result of this incompatibility” (Brinkert 2010). Often times the disagreement results not from a concrete difference, but rather a difference in perception (Ellis & Abbott 2012). One of the most important factors effecting conflict management is the resolution style used. The most often used tool for classifying how conflict is managed is the Thomas-Kilmann Conflict Mode Instrument (Iglesias & Vallejo 2012).

Within the practice of nursing, situations often arise where nurses are forced to make decisions regardless of their level of experience in the profession. Providing care and following the physician’s orders historically were the nurse’s sole responsibilities. However, social change, changes in health care finances, increasing international perspectives, and demographic population changes, have resulted in a significant evolution of the roles and responsibilities emplaced on today’s nurses (The National Association of Clinical Nurse Specialists (NACNS), 2007). Kelly and Crawford (2013) believe budget cuts, higher client acuity and clients with complex needs, mergers of hospital corporations as well as a general shortage of qualified nurses has made it necessary for nurses to play a role in decision making. Decision making is defined as “cognitive process leading to the selection of a course of action among alternatives” (Kelly & Crawford, 2013, p. 352).

|Give at least two examples of how other people/team’s political behaviour in the organisation could impact on the | |

The human resource officer and hospital administrator must revisit the code of conduct in the institution and redevelop it to address issues between nurses and physicians.

The mid-level practitioner thought there was a delay in the patient’s endotracheal tube not extubated in a specified time frame. The attended nurse was dismayed that the midlevel practitioner chose to escalate the issue with management; instead, of communicating with the nurse to find out why the endotracheal tube was not removed as per the policy. One may contemplate which method to use to resolve this issue without disrupting the care of the patients. At the same time, one may also try to rationalize the issue and avoid confrontation, reasoning that it was a minor issue. Simply not resolving a conflict can have more negative consequences; also, it can send the message that the behavior is acceptable. As the authors simply stated in the journal, not resolving a dysfunctional conflict can spread in a manner similar to a contagious disease in the organization. Nevertheless, fear of a superior should not stop a nurse from speaking his/her

The three governing entities for hospitals-- the medical staff, the administration and the board of trustees—seemingly have the same goals of providing safe, quality patient care and to do so at a reasonable cost. Tension between the three often exists, however, despite the common goals. I believe there are three main reasons for this tension: Mistrust, unclear expectations and lack of communication. These three concepts are intertwined, with each one affecting the other two, so it generates a cycle that is difficult to break.

Overlooking my journal entries, I found that conflict is a prominent theme. This is because of differences between people and usually it ends up as a conflict that needs to be resolved. With this I want to understand if I am capable of handling conflict in both my career and life. Conflict is common to everyday life. There are different interpretations, but I view conflict as a clash due to different interest or values. Although conflict usually between two or more people, I have also noticed that in my daily life, I encounter conflict within myself and trying to balance this has proved a great challenge. As a person, I think that conflict has both its positive and negative aspects but the most common areas noted not only in the clinical placement, while performing as a student nurse, but also in everyday life while interacting with people. The idea of living in a different country, as an immigrant especially Canada, has opened my eyes to many values. The fact that we are all different, from varying backgrounds, multiple cultures and extraordinary heritage all makes us unique. But this uniqueness ought to pull everyone together but at the same time, it separates people. Everyone is now placed in groups causing difficulty in interaction.

Mild office politics motivates employees to work harder and compete to achieve a common goal. High office politics make simple tasks complex, organizations are ineffective, employees are burned out from work-related stress, talented but not politically savvy employees leave the firm.

Conflict or disagreement over the range of issues has become inherent aspect of modern organisational life. People from different cultural and education background work in an organisation. People working in an organisation may possess different goal and interest. People working in organisation may tend to different over a range of issues including organisational politics, organisational procedure, personal preference or political preference. It is also argued that conflict is essential characteristics of organisational life. Role of manager is paramount with regard to negotiating the conflict that arises in organisational life (http://www.sagepub.com/). Often lack of

After further review of the case study, conflict management among team members needs to be addressed. Resolving conflict can often be like a constant balancing act among the opposing needs and interests; conflict can be unpleasant and stressful (Haraway & Haraway III, 2005). Conflict manage is essential for the success of healthcare organizations. Learning, as an organization, to constructively manage and succeed in conflict situations is a foundational construct of leadership and management (Ledlow, 2009). There are six different conflict styles: (1) accommodating, (2) avoiding, (3) collaborating, (4) competing, (5) compromising and (6) problem solving. After reading the case study, the surgical team is displaying conflict style of avoiding “potential disruption outweighs the benefits of resolution, gathering information supersedes immediate decision making, others can resolve the conflict more effectively and issues seem a result of other issues,” (Ledlow, 2009). Instead of going to the Physician Assistant, Nurse B should feel comfortable speaking to the surgeon with her questions and concerns.

Have you ever wondered what role politics and power play in organizations? When used effectively they can be compatible in reaching the organizations goals. Power is defined as the ability to get someone to do something you want done or the ability to make things happen in the way you want them. (Schermerhorn, Hunt, and Osborn, Chap. 15). Power is important within organizations because it is the way in which management influences individuals to make things happen. When power and influence combine, most of the time 'politics' become involved in some manner which may pose some problems. Organizational politics is best described as management influenced by self-interest through the use