CONFLICT RESOLUTION STRATEGIES USED BY NURSE MANAGERS IN TEACHING HOSPITALS IN ANAMBRA STATE

CHAPTER ONE
INTRODUCTION
Background to the Study
Conflict is a normal part of any healthy relationship (George, 2011). After all, two people cannot be expected to agree on everything, all the time. Although there is no universal definition of conflict (Kelly, 2006; Patton, 2014), it can be described as a process in which one party perceives that its interest are being opposed or negatively affected by another party (Kreitner & Kinick, 2010). It can be competitive or opposing action of incompatibles. Which triggers strong emotions and can lead to hurt feelings, disappointment and discomfort. Learning how to deal with conflict rather than avoiding it is crucial. when conflict is mismanaged or handled in an unhealthy manner, it can cause great harm to a relationship, cause irreparable rifte, resentments and break ups, but when handled in a respectful, positive way, it increases the understanding of one another, builds trust and strengthens the relationship bonds that exists between people in the workplace (Introduction to Conflict Resolution, Concepts and Definition, 2011).
 
In health care industry managing conflict is a difficult task as the health care institutions is composed of individuals, professionals and clients with different ethical and cultural background. Health care is delivered by people who walk in organizations, large and small Successful health outcomes depend on the effort of many people within the organization, including clinicians, supports staff and managers, each organization, in turn depends on many other organizations, such as insurance companies, vendors and other health organization. Each individual is part of many groups both formal and informal. Nurses see themselves as members of the health care team on their shifts and their clinical units, as members of the nursing department, and as employees of their health care organizations. An environment characterized by interactions among many people within a defined setting is conducive to conflict (Krogerus & Tschappler, 2012).
 
Today’s health care environment provides a ‘’perfect storm’’ of opportunities for conflict. Buckley (2008) described health care in the midst of many changes which bring forth misunderstanding, hard feelings and definitely conflict. The hospital in particular is an arena with many diverse players with diverse interests, goals, personalities and levels of achievement. All of this provides the atmospheric conditions for the growth of conflict.
There are five styles of handling conflict, according to the Rahim and Bonoma model: avoidance, compromise, obliging, dominating, and integrating (Kreitner and Kinicki, 2010; Leever et al., 2010). Avoidance and compromise are common styles used among physicians and nurses (Leever, 2010; Tabak & Koprak 2007). ). According to Kreitner and Kinicki, these two choices are temporary fixes. In certain circumstances, however, they may be useful (Rahim, 2002). Nonetheless, when dealing with complex issues, the preferred style of conflict handling is integrating (Kreitner & Kinicki, 2010; Rahim, 2002). Kelly (2006) reported that a study of intensive care nurses revealed that they tended to use avoidance in order to protect relationships, prevent open arguments, act as proper role models in the presence of students and so they are not “branded [as] emotional or unfeminine women. Those who avoid conflict “neglect their own needs, goals, and concerns” in order to satisfy others. This self-sacrificial approach may be considered an expectation in a career that ascribes to the philosophy of altruism. However, compromise was found to be the most prominent style of choice among doctors and nurses working in five Israeli hospitals, whereas a qualitative study done in a Norwegian hospital determined that physicians and nurses used avoidance, compromise, and dominating styles depending on the contextual factors of perceived interrelationship between the members, and the urgency of taking action regarding the situation (Leever et al., 2010.) Shin (2008) suggests that by increasing awareness about health care conflict may catalyze more useful approaches in conflict resolution within the industry. She continues that by addressing negative conflict early on, workplace relations are strengthened and a healthier environment is developed. Kelly (2006) concurs; she asserts that when conflict management is ignored, the team can dismantle and human potential is wasted.
Unresolved conflict among nurses and other health care provider’s also interferes with the achievement of successful clinical outcomes as well as with personal and professional satisfaction. Therefore since conflict is inevitable in any environment of human interaction the unit heads are faced with the task of resolving conflict both among nurses and between nurses and other health care team members, effective conflict resolution will help to prevent deadlock and recrimination and restore stability as well as to foster wholesome and functional communication within the clinical team, improve  job cooperation ,help foster teamwork which lead to good patient outcome ,satisfaction and high  turnover,
 
Since all these are benefits of conflict resolution the researcher therefore want to find out the strategies the unit heads apply in resolving conflicts as it will help to study how they resolve conflict resolution.
 
Statement of the Problem
In all places where there are interactions between people there is bound to be misunderstand resulting from differences in perception, behavior and approach of life issues. The researcher observed during her practice as a nurse at Nnamdi Azikiwe University Teaching Hospital Nnewi, that there are sometimes cases of conflict among the nurses, nurses and patients, or other health professionals and even within the nurse himself. This poses problem to collaboration in client care to the detriment of the patients. The researcher observed that despite the available rules and regulations guiding practice as well as professional ethics, conflict still exists. Does it mean that the nurse managers do not know what to do or that they do not apply the best strategy in conflict resolution? This prompted the researcher to conduct this study in other to ascertain the various conflicts resolution strategies adopted by heads of nursing units in Teaching Hospitals in Anambra State, to manage and reduce conflict to the barest minimum.
 Purpose of Study
The purpose of the study is to determine the conflict resolution strategies used by heads of nursing units in Federal and State Teaching Hospitals in Anambra State.
Objectives of the Study
The specific objectives of the study are:

1. To identify the sources of conflicts experienced by Nurse Managers in Federal and State Teaching Hospitals in Anambra State.
2. To assess the ways the nurse managers handle these conflicts in their units.
3. To identify the challenges encountered by the Nurse Managers in implementing these conflict resolution strategies in the units.

Hypothesis

1. There is no significant difference between the conflict resolution strategies used by nurse managers in Federal and in State Teaching Hospitals in Anambra State.

 
Significance of the Study
Findings from the study will help to identify ineffective strategies applied by nurse managers in conflict resolution on the basis of which appropriate recommendation can be made to the nurse managers and managers in health care system generally on better approaches to unavoidable but unhealthy conflicts that may arise among staff. Findings will also help to address the best way forward in coexistence among health providers within a unit to enable good patient turnover through good conflict resolution practice.
 
Findings from the study will assist policy makers in understanding the best approach in dealing with conflicts among staff members. The result of this study will provide basis for further studies and local literature for references.
 
Research Question

1. What are the sources/causes of conflict encountered as nurse managers by Nurse Managers in Federal and State Teaching Hospitals in Anambra State?
2. What are the strategies the unit heads apply in resolving conflicts?
3. What are the challenges encountered by the Nurse Managers in implementing these conflict resolution strategies?

 
Scope of the Study
The work is delimited to the identification of sources of conflict experienced, the strategies applied in resolving conflict and the challenges the nurse managers in Federal and State Teaching Hospitals in Anambra State encounter in application of conflict resolution strategies.
 
Operational Definition
Conflict Resolution Strategies: This means what the nurse managers do when they experience any conflict as a unit head in their units to see that the conflict is controlled and does not continue example compromising avoiding accommodating competing and collaborating
Nurse Managers: They are individuals registered by Nursing and midwifery council of Nigeria to practice as nurses, who are in the rank of Principal Nursing Officer and above who are in charge/leaders of their ward/units/clinics.