Conflict Management among Staff Nurses in Selected Governmental Hospitals in Jeddah

Posted: January 4th, 2023

Conflict Management among Staff Nurses in Selected Governmental Hospitals in Jeddah

Advanced Nursing Research in Health Care-ANUR5603611-3

Due Date: 1/3/1442

Student Name:

Student ID: 44286744

Umm Al-Qura University

Introduction

              The conflict between nurses is considered a significant issue in healthcare environmental over the world (Başoğul & Özgür, 2016). Rahim (2002) defined conflict management as using approaches that limit the negative aspects of conflict, and those that increase the positive aspects of the conflict (Rahim, 2002). Sullivan identified ten conflict management styles: confrontation, negotiation, collaboration, compromise, competing, accommodating, avoiding, withdrawal, smoothing, forcing, and resistance that leaders and nurses can effectively use to handle conflicts (Sullivan, 2013).

Background: Conflict between nurses is considered a critical issue in healthcare environmental over the world. An environment that fosters good nurse-patient relations should be cultivated as it greatly determines a patients wellbeing. (Baddar, Salem, & Villagracia, 2016). However, there is limited literature in areas related to conflict management among nurses in Saudi Arabia. In a cross-sectional quantitative survey of 350 nurse managers in Jordan, by Al-Hamdan, Norrie, and Anthony (2014) using the Rahim Organization Conflict Inventory, the investigators aimed at investigating the conflict management styles used by nurse managers. The study results revealed that the nurses opted for an integrating style while handling conflicts, before opting for compromising, obliging, domineering ad avoidance styles. In the conclusion,  the study suggests a model framework derived from various nursing conflict management styles in use in different Arab countries, pointing to a possibility of better handling of conflicts and stable workplaces (Al-Hamdan, Norrie, & Anthony, 2014). The audience learns that the best approach includes others in selecting appropriate plans, which is also a considerable aspect in this assignment.

Aim:  This study aims to assess the conflict management among staff nurses.

Research Problem: Conflicts adversely affect the individual and organization, and productivity and morale may deteriorate leading to a rapid turnover of employees or dissatisfaction (Baddar, Salem, & Villagracia, 2016).  

Research Question: What are the conflict management styles used by staff nurses in a governmental hospital? 

Significance of the study:

              Most of the research studies on the nursing conflict have been concerned with employee centered research on the managers and doctors in hospitals. Few studies highlight the effective conflict management styles or modes of conflict resolution that can be helpful among nursing staff. To get the real picture of a truly globalized working environment, it’s clear that such insights call for incorporating conflict management study samples from non-western. Al-Hamdan, Norrie, & Anthony, 2014) Within Arab countries, there is minimal studies conducted thus far with only two studies having been published which explores conflict management styles used by nurse managers in Oman and Jordan (Al-Hamdan, Norrie, & Anthony, 2014). Within Arab countries, only two studies have been published which explores conflict management styles used by nurse managers, specifically in the Sultanate of Oman and Jordan (Al-Hamdan, Norrie, & Anthony, 2014). However, it reported that this issue has been rarely investigated in Saudi hospitals, and only one study in Saudi Arabia has explored conflict management styles used by nursing staff from a nurses’ perspective (Baddar, Salem, & Villagracia, 2016). The current study aims to provide useful data on conflict management styles that may help to improve conflict mitigation approaches across the Arab world.

Literature Summary Table

Authors, Title, Publication Date	Problem	Purpose	Data Collection Method	Sample	Major Findings
Al-Hamdan, Z, Norrie, P and Anthony, D. (2014). Conflict management styles used by nurses in Jordan.	Inadequate research explore the styles nurse managers utilize to handle conflicts in Arabian health settings.	To examine conflict resolution techniques used by nurse leaders in Jordan.	Data was collected using the Rahim Organization Conflict Inventory (ROCI II) questionnaire.	350 nurse managers took part in the study.	Nurse leaders employ the integrating approach of conflict management, followed by other techniques such as comprising, obliging, dominating and avoiding.
Al-Hamdan, Z., Masa’Deh, R., & Nussera, H. (2015). Conflict management style of Jordanian managers and its relationship to staff nurses’ intent to stay.	Shortages of nurses require health leaders to develop more effective ways of boosting retention.	The purpose of the study is to examine the connection between conflict management and approaches utilized by nurse leaders and intent to stay of members.	The researchers performed a cross-sectional descriptive quantitative study. Data was collected using and the intent to stay scale and the Rahim organization conflict inventory II.	320 staff nurses and 42 nurse managers from four health facilities in Jordan.	The conclusions of the survey support the argument that leadership conflict management techniques impact staff nurses’ intention to stay and the eminent of care.
Alshammari, H., & Dayrit, R. (2017). Conflict and conflict resolution among the medical and nursing personnel of selected hospitals in Hail City.	It is possible to experience considerable conflicts among health practitioners, which requires proper conflict resolution techniques.	To examine the diverse forms of conflict encountered by medical and nursing practitioners.	The conflict self-assessment test and a researcher-made tool were used to gather data.	Medical practitioners from Maternity and Children’s Hospital, Hail General Hospital, and King Khaled Hospital took part in the study.	The facilities tend to adopt diverse approaches to mitigate the emerging conflicts.
Baddar, F., Salem, O., & Villagracia, H. (2016). Conflict resolution strategies of nurses in a selected government tertiary hospital in the Kingdom of Saudi Arabia.	Conflict is inevitable and it is possible to witness considerable misunderstanding among health care practitioners.	The research aims at determining the conflict resolution techniques of health practitioners (nurses) in particular government hospitals in KSA.	The researchers performed a descriptive correlational research design and data collected using questionnaires.	78 nurses took part in the study.	It is possible to solve conflicts using various approaches.
Basogul, C., & Ozgur, G. (2016). Role of emotional intelligence in conflict management strategies of nurses.	Today’s rivalries in the workplace and individual variances progressively escalate conflict among nurses.	The research examines the level of emotional intelligence (EI) and conflict management techniques of nurses and the link between them.	The researchers performed a cross-sectional, descriptive study, and gathered data using Bar-On’s Emotional Quotient Inventory and Rahim Organizational Conflict Inventory-II.	277 nurses.	The researchers found that nurses’ EI affects conflict management approaches.
Bou-Karroum, L., et al. (2020). Health care workers in conflict and post-conflict settings: Systematic mapping of the evidence.	Nurses are important for the provision of health care services in conflict prone areas and in reestablishing stable health.	To identify and recognize the published evidence on health workers in conflict and post-conflict settings	Systematic mapping of secondary literature.	474 literacy works were included in the study.	Nurses are likely to achieve impressive outcomes when handling patients who come from conflict-prone areas when they understand the concepts of conflict management.
Ibrahim, S., & Emad, H. (2018). The effect of conflict-management enhancing strategy for head nurses on the quality of vertical dyad linkage with nurses.	The article acknowledges that it is possible to experience conflicts between nurses, thus making it necessary to develop effective remedy plans.	The purpose of the study is to determine the possible impact of conflict-management enhancing technique for nurses.	The researchers adopt a pre-experimental research design.	The study incorporated 203 staff nurses and 31 head nurses serving at the Port Said Hospitals.	The more effective the nurse leaders develop appropriate conflict management strategies the easier it becomes to address conflicts among the team members.
Tosanloo, M., Adham, D., Ahmadi, B., & Pourreza, A. (2019). Causes of conflict between clinical and administrative staff in hospitals.	It is difficult to provide quality care without settling conflicts within team members.	To recognize the origins of battles encountered by clinical and managerial staff in infirmaries.	A cross-sectional study where data collection happened using self-administered questionnaires.	320 administrative and clinical employees from six health facilities attached to Ardabil University of Medical Sciences took part in the study.	It is easier to handle conflicts between members of staff by developing appropriate techniques to reduce nurses’ encounter of conflicts.
Zeinhom, M., & Higazee, A. (2015). Types and levels of conflicts experienced by nurses in the hospital settings.	It is possible to experience conflicts as nurses interact during their daily operations, which makes it necessary to identify the possible effects of such disagreements.	Identify types of conflicts witnessed by nurses and find out the level of conflict among this population.	A quantitative descriptive research design. Data collection happened using Nursing conflict scale (NCS).	128 nurses from five private and governmental hospitals.	Intra-team conflicts and disruption from physicians are rampant and nurses experience moderate level of misunderstanding.
Young, S., et al. (2016). Conflict and care: Israeli healthcare providers and Syrian patients and caregivers in Israel.	Patients sometimes relate with patients who experience conflicts and have to identify effective ways of relating with them.	To find out how social and geopolitical history of Syria and Israel impacts nurses and Syrian patient caregivers in Israel.	Mixed-methods phenomenological study and interviews.	Two hospitals in Israel and patient family members in Syria.	The research shows that nurses may have to employ conflict resolution techniques to handle patients coming from areas with high rates of conflicts.

Problem and Purpose

The similar and common problem in all the articles is to show how conflicts are likely to interfere with nursing practice in situations where proper mitigating mechanisms lack. For example, Zeinhom, and Higazee (2015) and Tosanloo, Adham, Ahmadi and Pourreza (2019) share the same view that it is not uncommon to experience conflicts among nurses, and nurse leaders should develop proper mitigation techniques to avoid blunders that could affect the entire process. The purpose of most authors is to sensitize nurses and their managers on the benefits of dealing with emerging issues without causing any form of apprehension and destructive anxiety. Al-Hamdan, Masa’Deh, and Nussera (2015) write that the decreasing number of fully competent caregivers require managers to embrace more enticing ways of retaining their workforce, including devising appealing frameworks for dealing with emerging disagreements. Young et al. (2016) elaborates how it may sometimes be difficult to offer services to patients who experience considerable conflict when they lack enough knowledge on conflict management.

Research Methods

The authors use different research methods to express their views and findings. For example, Tosanloo, Adham, Ahmadi and Pourreza (2019), Baddar, Salem, and Villagracia (2016), and Basogull, and Ozgur (2016) perform a cross-sectional study, which entails comparing variables gathered at a particular time on a given population or sample, and they all use questionnaires to gather data. Young et al. (2016) use a mixed-method approach, which entails exploring both the qualitative and quantitative techniques, and gathers data using interviews. Zeinhom and Higazee (2015) and Al-Hamdan, Masa’Deh, Nussera (2015) employ quantitative techniques to perform their research, and use statistical data to represent their findings. Al-Hamdan, Norrie, and Anthony (2014) use ROCI II to gather information, same to who use ROCI II and the intent to stay scale. Zeinhom, and Higazee (2015) acquires information using the NCS. Ibrahim and Emad (2018) conduct a pre-experimental, which entails examining a single group and reporting about relevant issues. Bou-Karroum et al. (2020) perform a systematic literature review of the relevant sources to acquire the necessary data. Ibrahim and Emad (2018) conduct a pre-experimental research design, which entails applying some basic, but not all experimental practices.  Even though these approaches differ, they all contribute towards responding to the research questions.

Major Findings and Conclusions

Most of the papers express the view that nurses are likely to conduct their operations more effectively in circumstances where it is easier to handle emerging conflicts. However, it emerges that health leaders intervene by offering guidance on what to do to achieve the desired outcome in such a way that people do not differ in their views and ways of looking at things. The work by Young et al. (2016) affirms that having adequate knowledge on conflict management and resolution may be helpful in fostering relationship with some patients, especially those who come from areas or families that witness considerable conflicts. The results indicate that health facilities require guidelines to help them deal with conflicts because Zeinhom and Higazee (2015) clarify that disagreement is inevitable and still expanding in healthcare. Nurses and their leaders should acknowledge the significance of identifying the conflict mitigation techniques being applied by nurses when they relate with their doctors and patients (Tosanloo, Adham, Ahmadi & Pourreza, 2019). Nurses and all those who relate to them should borrow from Ibrahim and Emad (2018) who discover from their research that it is easier to handle conflicts when the facility has already-established intervention mechanisms. Some nurse managers may employ an integrating approach that Al-Hamdan, Masa’Deh, and Nussera (2015) find to be effective, or apply avoiding, dominating, compromising, and obliging that Basogull, and Ozgur (2016) identify as possible remedies. It is important to come up with an effective plan because Al-Hamdan, Masa’Deh, and Nussera (2015) identify that the more effective nurse leaders develop conflict mitigation mechanisms, the easier it becomes to retain workers for long.

Strengths and Weaknesses of the Research Methods

The research methods that the various researchers use to explore their research questions exhibit some strengths and limitations. For example, the descriptive correlational research is advantageous because it provides researchers with the chance to describe the different variables and the connections that exist between them. The other merit is that the approach permits investigators to determine the strengths and directions of a connection so that later researches can narrow the results down, and if possible, identify the cause experimentally. However, the correlational research is disadvantageous because it does not offer a conclusive explanation for why that link exists in the first instance. The other limitation of the approach is that it cannot give information on which variable influences the other. The mixed method, on the other hand, are advantageous in knowing the differences between qualitative and quantitative findings. The demerit with the approach that Young et al. (2016) uses is that it may require time to transform the data in certain ways so that both forms of data can be utilized during the examination. The quantitative descriptive research design that Zeinhom and Higazee (2015) use in their study is advantageous because it is possible to incorporate more subjects and allowing more generalization of outcomes. Nevertheless, the approach is disadvantageous because the process mainly deals with numbers, which could result in considerable errors. In addition, it may be difficult to comprehend a context of a concept, especially if it entails intricate statistical data. The primary advantages with the pre-experimental research design that Ibrahim and Emad (2018) deploy are, ease in collecting data, and ease in presenting in tables and graphs, and efficiency in interpreting information. The limitations with the technique is that the data collection techniques may change over time, and it may be hard to express more than a single variable each time. Finally, the systematic literature review is beneficial because it offer substantial summary of the identified studies, while its limitation is that some works may not give adequate information on the research question.

Similarities and Differences

The studies present some similar and different features, which may be important to highlight during their analysis. One of the evident similarities is that they acknowledge the importance of adopting effective conflict mitigating styles in a clinical setting, especially where nurses offer their services. They share the impression that health facilities that do not pay much attention to conflict resolution techniques decrease their chances of achieving cohesion in the way people address contradicting views and opinions. The other similarity between the various articles is that the composers perform some form of study by gathering necessary information to prove their hypothesis or answer their research questions. The findings from all the studies concur that it is easier for nurses to handle conflicts when they receive support from their leaders, and when the facility where they serve appreciate the importance of conflict management. The other similarity is that all the authors use other works to support their research and findings. Using additional evidence also allows readers to perform further analysis of the subject, which provide them with more information about the subject under investigation. Also, the articles are similar in the way they all focus on handling conflicts in clinical settings in the Arab world. They all add onto the scare information regarding the methods that nurses and their leaders in the region use to address workplace conflicts. The main difference that distinguishes the papers is they use different methodologies to express their views and findings. The diversity in the way of presentation expose readers to a wide range of research techniques, and provides them with the chance to know their strengths and weaknesses. Despite these differences, they all contribute towards developing the impression that conflict management is important in nursing practice.

Answer to the PICOT Question

The PICOT Question: What are the conflict management styles used by staff nurses in a governmental hospital? 

Answers to the question: It is evident from the examination of the various works that taking adequate measures in good time may help to address conflicts effectively as opposed to waiting until it is too late. The study reveals that enacting plans to deal with emerging conflicts without creating further tension and in a way that makes everyone view such disagreement as part of the workplace increase the desire to serve, and provides room for increased communication. It is easier for nurse leaders to regulate the rate of employee turnover when they have better ways to handle conflicts than when they rely on less effective styles or take no measures at all. Leaders need to compare the available mitigating techniques and identify the one that mostly suit the team and nature of conflict before proceeding with implementation. Taking time to compare the different designs makes it possible to avoid errors that could result in wasteful use of resources and time in an approach that is less likely to give the best results. Besides, the intervening team should identify a suitable timeframe for achieving the desired goals and enact the desired plans within the specified time. Even though it might be necessary to expand the timeframe beyond the required time in some cases that should not be the priority. Above all, leaders and nurses should try confrontation, negotiation, collaboration, compromise, competing, accommodating, avoiding, withdrawal, smoothing, forcing, and resistance that are equally effective in mitigating conflicts.

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