The demand for full time nurses is continuing to boom in the global market. However, the unfortunate shortage of nurses in the global scenario is undeniable (Hunt, 2009). The rate at which nurses are graduating from universities today does not sufficiently quench the ever growing demand for nursing professionals. The issue of providing an active replacement for the nurses who have left their respective organization continues to be a source of main concern for health care institutions.
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The rising rates of seasoned nurses have resulted in replacing the more experienced and skilled professionals by infusing fresh graduates who lack the required skill and experience needed to effectively adapt to a clinical environment. This is coupled by the booming level of workload witnessed by these graduates who many are unable to cope with. Adding fuel to fire the initial work experience is discouraging for many graduates who hence are exhausted .This results in numerous fresh graduates completely burning out in just 18 months of their introduction to professional medical environment (World Health Organization, 2006).
This exposure of the nursing graduates to the professional environment is not alienated from the concepts of socialization and professionalization. However the issues differ in this context on the pretext of the resulting personal, emotive and intellectual ride that he/she may have to witness due to role changes .These are aroused by the experiences and expectations associated with this change.
Hence conflict in the workplace for new nursing graduates is the topic which will be dealt during the course of this essay. Transitions are described as a movement from one state to another. The initial 12 months of transition to a clinical environment leads to a number of conflicts. This initial experience of fresh graduates mostly is with relevance to the setting of that particular health organization. The performance of these graduates in these clinical settings is suggestive of how these institutions act as breeding grounds for these nurses by providing them with the needed educational preparation (Clark, 2009).
Within this clinical setting new graduates are exposed to many formal protocols, norms, regulations, rules and expectations. In this environment of array and despair the support provided to theses nurses by the organizational inhabitants is also insufficient. The beginning year for these graduates is hence regarded by many as an obstacle year since it results to the arousal of many conflicts within the organizations. The pressure to abide by contemporary practiced is outlined by stringent ward routines which nurses may regard as ineffective but are even then forced to follow by senior nurses. Hence a resultant conflict with senior nurses may arise. Patients may too have expectations regarding how they want to be dealt with and hence taken care off. This leads to a significant in congruency in perceptions pertinent to patient-care issue and results in conflicts with patients their families and visitors (Joint Commission on Accredition of Healthcare Organizations, 2010). It also takes time and skill to attain respect and work as a team with fellow physicians. This may surface conflicts with physicians. These conflicts hamper patient care.
Conflict with Senior Nurses
A good senior nurse would be an individual who can efficiently run in a health institution and can organize communicate and understand the fresh nurse graduates who are relatively new and in experienced. If a senior nurse involves their subordinates in the decision making process, shows appreciation for hard work and responds by giving their juniors more power and responsibility, things may go well. However, a difficult relationship with a senior nurse is a common cause of an in favorable position adopted by senior nurses (Brown, 1992).
There are hence in broad terms two main sources of conflict between the senior and fresh lot— when people’s perceptions, power or actions relating directly to the job are challenged; or when two people just don’t fond of each other. The latter often called ‘a personality clash’ is very common in health institutions. It can be arduous however to distinguish between the two sources of conflict (Clark, 2009).
Hunt (2009) says that for many years the professional practices of nurses have been restricted by inflexible bureaucratic practices with solid structures and organizational designs. Today structures of many organizations continue to change and hence adopt a mode that is more flexible in its approach and less rigid. These structures are not only less bureaucratic but also increase a nurse’s role in decision making process.
However many organizations still continue following traditional and inflexible structures which leave little or no room for new graduate nurses to exercise their respective decision making abilities .This not only makes the new graduate less autonomous but also undermines their creative potential. They hence have to reach out to their senior nurses for most issues. This not only inhibits their learning potential but also leads to numerous conflicts regarding difference in perception regarding how an issues needs to addressed and hence sorted out.
The senior nurses may enrich the fresh graduates or may diminish it. Many senior nurses may even be insecure about their positions and hence in order to protect their own position may look to misguide the new graduates. They may even constantly pester them and look to undermine their services and ideas. This may lead them to constantly ignite disagreements with fresh agreements and stem feelings of resentment. Bullying and an over aggressive attitude can make the situation potentially worse.
Further fresh graduates may too in their attempt to improve their own position and prove themselves disrespect their seniors. Over confidence may make them undermine the authority of seniors by going about their own respective way of doing and running things. Neeraja (2003) further adds that fresh graduates may also be unaware of how to work as a team. This may lead to further enmity of senior nurses towards them. They do not realize that their seniors may be a source of learning for them if considered so.
Conflict also may simply arouse due to the senior and junior just not liking each other. Such personal disliking can hence hinder performance and job and arouse major conflicts.
Conflicts with Patients
The work place setting of a health institution is never void of conflict. A patient interaction with a nurse is often not in the best of circumstances. It often happens when a patient is sick and hence emotionally distressed. In such a time a fresh graduate nurse may seem the easiest and the most convenient way to vent out (Andersen, Fagerhaug, & Beltz, 2010).
In addition a patient nurse interaction is never black and white. Each patient has their own behavior and distinct habits .It hence may be difficult for a fresh graduate to properly reach out the patient in this time of stress and ordeal which may bring out arguments and release of pent up stress.
Care of a patient demands customer service. This can be made difficult by the lack of control and alternative options experienced by patients and their families. They may be customers but they are not so by their will or their own choice. Even the calmest people can become aggressive and angry in sickness and injury. This can trigger difficult emotions. Hence nurses are handling people with extremely tense emotion and anger (Andersen, Fagerhaug, & Beltz, 2010). Since the nurses are fresh they may not be skilled enough to handle such difficult people. They themselves may not be emotionally strong enough to with stand the pressure. To make matters worse nurses often look to work with families and friends who are disturbed seeing their loved ones in trouble. They themselves may have questions along with the patient with which may need to be handled with proper tact. They also may require the nurse to provide them with reassurances. If not handled in a proper manner, the nurses may find themselves on the brink of a major conflict (World Health Organization, 2006).
Collectively, the hospital workplace of the nurse is a breeding ground for intense emotion and distress. Patients and their families is each coping with ambiguity and the potential or real effects of life-altering medical conditions. They become frustrated. They are confused. They are upset. The fresh nurses may not have the tact to decide the way information is to be conveyed to the patient and their families.
With a press of a button a nurse is available. They are hence assumed to be like robots and key to all their questions. They are seen as a source of comfort and information. If they fall short of this a patient may not care how new or in experienced the nurses are and hence they may be targeted.
The possible conflict scenarios involving patients and/or their families are too numerous to imagine. And hence are to some extent unavoidable.
Conflict between Physician and Nurse
Reports of physician nurse conflict are widespread. Power imbalance between physician and nurse, differing goals of practicing medicine and gender conflict between physicians (mostly males) and nurse (mostly females) may stem conflicts between the two parties (Kathleen & McGhee, 2008).
Power imbalance between physician and nurse
In most societies physicians are often associated with respect and an elevated financial standing. Medical schools are virtually one of the most difficult schools to get in to and their studies too are equally exhausting requiring the brightest minds. Nurses though are not looked down upon but are obviously not given the importance and standing given to that of a physician. They are relatively paid less too. Their authority and power is hence also typically lesser than that of a proper physician. Officially the physicians are not the bosses of nurses. However because of more expertise and knowledge physicians do wind up telling the nurses what to do and what not to do. Nurses are somewhat hence seen subservient to physicians (Coombs, 2004). New graduates may not adapt to this relationship equation and may consider it as an ego blow. The nurse may feel that she/he deserves more responsibility and credit than that is given to them and hence may make them frustrated and agitated towards the physician forcing them to react in a way that may not be accepted by the physician. This hence may fuel a conflict.
Differing goals of practicing medicine
One core difference between the responsibilities of the physician and nurse is that a physician focuses on diagnosing and treating the disease of a patient while a nurse is focused on taking care of the patient. This may be a source of conflict between the two parties. The nurse may work more towards taking care of the patient rather than working to diagnose the disease and treat it. Hence this may upset the physicians who may undermine the nurse further and regard him/her as an obstacle in their own practice (Kathleen & McGhee, 2008).
Gender Conflict
Though today there are many male nurses. Yet the profession is still dominated by females. Physicians on the other hand are predominantly males. Hence the conflict may result due to the prevailing conflict of the two genders in the society. Theory hence suggests that the physician may look down upon nurses solely because in some societies women are not given the standing men are. Hence fresh graduates may feel less empowered which may force them to suppress their questions and ultimately perform poorly (Kathleen & McGhee, 2008).
Resolving conflict
As seen above the conflicts in work place may hamper patient care. Hence it is paramount for us to find effective solutions to these conflicts.
One common recommendation is to improve communication between newly graduated nurses and senior nurses. Same should also be applied for the interaction between physicians and nurses and also that of patient and nurses (Huston & Marquis, 2008). Inefficient communication can produce unmet expectations and lead to pent up anger and misunderstandings. This can stain relationships.
But while better communication would help, it solely cannot assist filling in the power gap between a new nurse and a senior one. Same is true between the equation shared by a physician and fresh nurse graduate. Hence elevation of the status of fresh nurse graduates may help stop the power struggles. Also this will force patients to not to take the nurses for granted and to treat them with respect and gratitude rather than punching bags.
Optimal method of conflict resolution provides another important solution. This fosters collaboration, harmony and cooperation which may appease the tensions that a new nurse may face with the physicians and senior nurses (Ellis & Hartley, 2003).
5 steps to ensure effective conflict resolution
Open. The staff should ensure that the discussion has a fruitful function and a clear goal that is understood by everyone including nurses.
Clarify. This fact finding step will help one indulge deeply in all the aspects of the issue.
Develop. At this point it is discussed how to effectively resolve the conflict and inhibit it from reoccurring.
Agree. This will enable everyone to agree on a particular action.
Close. Outline the plan for resolving the conflict and see to it that everyone including the nurses are in agreement to it.
However the physicians may not be keen to take part in this medium of resolution since they may be very happy with their own status.
The question hence to be addressed is that how can freshly graduate nurses be given power when their seniors and physicians are not willing to relinquish it?
The solution could perhaps lie in how the hospital head deals with these new nurses. He can act as a role model for others to follow and look up to. He should convey to all the disciplines and contributions that the nurses may make. They should also develop an organizational vision of how patients and staff members should interact with the new nurses. The vision should produce the equations expected to be shared by all with these parties with nurses. These should then be translated into a set of standards, norms and rules. Inappropriate behavior will not change unless it results in consequences for the perpetrator. Hence punishments should be outlined for those not abiding by with the rules (Coombs, 2004).
The physician and nursing heads need the support of hospital management in this endeavor. Hence the management should be keen to take active part in the endeavor.
It should however be understood that it should not solely be the staff’s and patients responsibility to make required changes but also the responsibility of the fresh nurses. They should be more aware of their responsibilities and incorporate with in them more patience. Preferably orientations should be given to these nurses for a couple weeks to help them assimilate with the environment (Joint Commission on Accredition of Healthcare Organizations, 2010). Also they should be encouraged with the help of compensations and bonuses. They should be encouraged to asked questions and have diversity in their tasks to break their monotonous routine.
Conclusion
An important point to note is that conflict of any genre is not conducive for a work place setting. It affects ones performance by aggravating the mental and emotional state of the person at hand.
A nurse has a very important role in a health institution. The nurse helps take care of the patient. A nurse who has just joined the hospital environment may not be that confident and hence may be more prone to pressure. This is likely to impact the optimal functioning of the team since the attention may be diverted from the most important matter at hand-customer care .Poor patient care and low quality health care may be a result of the conflicts.
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Hence without doubt the issue of the work place conflicts of the fresh nurses needs to be addressed by individual clinicians and the overall health care staff. Even though the administrators and managers may initially opt to avoid dealing with issue and try to sweep it under the rug, it is important for them to be cognizant of the sensitivity of the situation and hence take appropriate measures to suppress these conflicts by promoting a healthy organizational culture
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