CC BY
50
UCD 614.253.52. D01:10.24411/2415-7414-2019-10030
CONFLICTS IN THE MEDICAL TEAM: THE ROLE OF NURSES
nZh. Zhalimbetova, 2Hanna Hopia, 1 D. Ospanova
1 Kazakh Mezhitsin University of Continuing Education 2 JAMK University of Applied Sciences, Finland
ANNOTATION
Nursing is a profession in which you need to show communication skills and develop interpersonal relationships. The Mininel et al. study (2011), conducted among nurses and nursing auxiliaries, showed that mental burnout caused by the nature of the work, such as caring for seriously ill people, has less impact on their quality of life than the emotional stress situations and interpersonal relations that are present in the workplace. [1] Organizational conflicts can be positive if they contribute to personal growth and increase productivity. However, in most cases, conflicts have negative consequences and can include irresponsible behavior, unfair treatment, and disagreement in work [2]. As described by Ahmed Higazee Manal [3], among nurses, there are intra-group conflicts that arise between different departments or in one department, a competitive conflict that arises between nurses as a result of injustice of the nurses' managers, and a conflict between a nurse and a doctor, followed by a devastating conflict. Intra-group and competitive conflicts are related to each other as they arise among nurses due to competition, and the unfair attitude of some nursing managers towards all nurses. There are also conflicts with the attending physician because of close interaction between nurses and doctors during care of patients. Such conflicts can be called inter-professional, as they are of great importance for the coordinated work of the team. [2] Improper management of conflicts leads to such negative consequences as the outflow of personnel, the decline in the quality of medical services, and the threat to the safety of the patient [4]. All this will have a significant impact on the reputation of the medical institution.
Key words: conflicts, nursing, conflicts in the workplace.
Introduction. Currently, Kazakhstan is actively reforming the health care system. The transition to the system of compulsory social health insurance since 2017 [5] has led to an increase in the competitiveness of commercial and public health institutions, which has a beneficial effect on the quality of medical services. Therefore, the problem of increasing the effectiveness of professional activities, including nursing personnel, comes to the fore, as the professional team is one of the factors determining the economic situation in medical organizations. For the provision of quality medical services, a favorable social and psychological climate in the team is needed.[6]
The problem of conflicts and stress is a much-discussed topic in all spheres [7]. Medical organizations have many different
professions, and every day there is a close interaction of different views and opinions. Such relationships sometimes generate conflicts, positive or negative, that can affect the entire team. [8]
A conflict is a lack of agreement between two or more parties that may be specific individuals or groups of individuals. In medical institutions, where a large number of nurses work, the emergence of conflicts is inevitable. [9] When people think about a conflict, they most often associate it with aggression, threats, disputes, and hostility [10]. As a result, there is an opinion, especially in our mentality that conflict is always an undesirable phenomenon, that it should be avoided, if possible. But such behavior does not always lead to conflict resolution. Therefore, the inadequate management of conflicts in
>e
О &
a
a
^
a
s t
*zhalimbetova@mail.ru
•c ©
S S
s
3 t
health organizations causes unhealthy working conditions, worsening of working capacity, the dissatisfaction of patients, and a decline in the quality of medical care [11]. The causes of conflicts in most cases are the individual characteristics of each nurse (character, education, disrespect, poor communication skills) and organizational factors [12]. Due to conflicts and the subsequent outflow of personnel, while finding a replacement, there will be an acute shortage of nurses in the workplace, leading to increased levels of stress, stress on other staff, and disagreements with the Matron [13].
The ability to properly exit the conflict provides favorable working conditions for the team. In such an environment, there will be greater labor productivity, reduced outflow of personnel, patient safety is preserved, and the quality of medical services will improve. Not everyone is able to correctly exit conflict situations and as a result, misunderstandings, quarrels and stress arise. And what does conflict mean in the healthcare community where the daily stress of health workers is perceived as a norm of life? A conflict is a disagreement and not always a negative phenomenon. Under the guidance of a competent Head Nurse, a favorable microclimate in the team can be achieved, where everyone respects the leadership and each other. All this prevents the outflow of personnel, and most importantly, it allows new employees to quickly j oin the team. [14] Moreover, if the conflict is not effectively managed, it reduces the level and quality of service, which affects the competitiveness of the organization and affects the prestige of the profession of the nurse in general. [15]
Materials and methods. This article is a review article that includes previous articles on conflicts. Various search engines such as Cinahl (EBSCO), PubMed, Science Direct were used to collect data. Considered articles published over the past 10 years, with the full text available in English. The key word for the search was «nurse conflicts.» The search result gave 136 articles. After reading the titles and abstracts selected 21 articles.
Object of research. The object and purpose of this article is to describe what
conflicts and conflict situations may arise in nursing.
Conclusion. Nursing is a profession in which you need to show communication skills and develop interpersonal relationships. The Mininel et al. study (2011), conducted among nurses and nursing auxiliaries, showed that a mental burnout caused by the nature of the work, such as caring for seriously ill people, has less impact on the nurses' quality of life than the emotional stress situations and interpersonal relations that are present in the workplace. [1] Organizational conflicts can be positive if they contribute to personal growth and increase productivity. However, in most cases conflicts have negative consequences and can include irresponsible behavior, unfair treatment, and disagreement in work [2].
As described by Ahmed Higazee Manal [3], among the nurses, there are intra-group conflicts that arise between different departments or in one department, a competitive conflict that arises between nurses as a result of injustice by the nurses' managers, and a conflict between a nurse and a doctor, followed by a devastating conflict.
Intra-group and competitive conflicts are related to each other as they arise among nurses due to competition, and the unfair attitude of some nursing managers towards all nurses. There are also conflicts with the attending physician because of close interaction between nurses and doctors during care of patients. Such conflicts can be called interprofessional, as they are of great importance for the coordinated work of the team. [2]
Some studies have shown that the prevalence of stress among health workers is high [8].
Medical workers represent a risk group for the development of anxiety and depressive disorders [16], and this affects not only the work, but also their quality of life. Dissatisfied and disinterested in their work, a nurse provides poor quality care [17], and as a result of all this, there may be conflicts. Interest in conflicts is explained by the fact that they are unavoidable, and they play a weighty, complex, and often negative role in the lives of the group and intergroup relations [18].
REFERENCES
1.Mininel V. A., Baptista P. C., Felli V.E. 2011. Psychic loads and wear processes in nursing workers of Brazilian university hospitals. Revista Latino-Americana de Enfermagem, Volume 19 (2), 340-347.
2.Wright R., Mohr D., Sinclair R. 2014. Conflict on the treatment floor: an investigation of interpersonal conflict experienced by nurses. Journal of Research in Nursing, Volume 19 (1), 26-37.
3.Manal Zeinhom A., 2015. Types and Levels of Conflicts Experienced by Nurses in the Hospital Settings. Health Science Journal, Volume 9 (6:7), 2-3.
4.Akpabio I., John M., Akpan M., Akpabio F., Uyanah D. 2016. Work-related conflict and nurses' role performance in a tertiary hospital in South-south Nigeria. Journal of Nursing Education and Practice, Volume 6 (2), 107. Retrieved 25.01.2019 http://dx.doi.org/10.5430/ jnep.v6n2p106.
5.Isimbergenova, G., Gumarova, G. 2017. Introduction of mandatory social medical insurance in the republic of Kazakhstan. Medical Journal of Western Kazakhstan. Volume 1 (53), 13-14. Retrieved 18.01.2019 https://cyberleninka.ru/article/n/vnedrenie-obyazatelnogo-sotsialnogo-meditsinskogo-strahovaniya-v-respublike-kazahstan.
6.Avdeenko, A. S. 2017. Socio-psychological portrait of the labor collective of a medical institution. Vestnik SMUS74, Volume 1 (16), 12-15. Retrieved 18.01.2019 https://cyberleninka. ru/article/n/sotsialno-psihologicheskiy-portret-trudovogo-kollektiva-meditsinskogo-uchrezhdeniya.
7.Rabe M., Giacomuzzi S., Nubling A. 2012. Psychosocial workload and stress in the workers' representative. BMC Public Health. Volume 12, 2-3.
8.Johnston D., Bell C., Jones M., Farquharson B., Allan J., Schofield P., Ricketts I., Johnston M. 2016. Stressors, Appraisal of Stressors, Experienced Stress and Cardiac Response: A Real-Time, Real-Life Investigation of Work Stress in Nurses. Annals of Behavioral Medicine, Volume 50 (2), 187-197. Retrieved 18.01.2019 https://doi.org/10.1007/s12160-015-9746-8.
9.Arveklev S., Berg L., Wigert H., Morrison-Helme M., Lepp M. 2018. Learning About Conflict and Conflict Management Through Drama in Nursing Education. Journal of Nursing Education, Volume 57 (4), 209-216. doi: 10.3928/01484834-20180322-04
10.Maslyakov V.V. 2011. Conflict and stress management in nursing personnel: sociomedical aspects. Modern problems of science and education, Volume 11 (part 2), 333-336.
11.Kantek F., Kavla I. 2007. Nurse manager conflict how do nurse managers manage it? The Health Care Manager, Volume 26 (2), 147-151. Retrieved 18.01.2019. Http://dx.doi. org/10.1097/01.HCM.0000268618.33491.84.
12.Almost J. 2006. Conflict within nursing work environments: concept analysis. Journal of Advanced Nursing, Volume 53, 444-453. doi:10.1111/j.1365-2648.2006.03738.x
13.Ba§ogul C., Gonul O. 2015. Role of Emotional Intelligence in Conflict Management Strategies of Nurses. Asian Nursing Research, Volume 10 (3), 228 - 232. ^
14.Ellis P., Abbott J. 2011. Strategies for managing the conflict within the team. Journal of Renal Nursing, Volume 3 (1), 40-43. Retrieved 26.12.2018 http://dx.doi.org/10.12968/ jorn.2011.3.1.40. £
15.Nursing and Midwifery Council (NMC) 2015. The Code: Professional Standards ¡^ for Practice and Behavior for Nurses and Midwives. Retrieved 12.01.2019 http://tinyurl.com/ zy7syuo. »
16.Romanov S., Niikolaev E., Golenkov A. 2012. Comparative study of personality § adaptive traits in medical students and doctors. Herald of the Chuvash University, Volume 3, 1-3. ^
17.Davey M.M., Cummings G., Newburn-cook C.V. & LO E. A. 2009. Predictors of nurse absenteeism in hospitals: a systematic review. Journal of Nursing Management, Volume § 17, 312-330. Retrieved 26.01.2019 doi:10.1111/j.1365-2834.2008.00958.x g
18.Brown J., Lewis L., Ellis K., Stewart M., Freeman T., & Kasperski M. 2011. Conflict on Interprofessional Primary Healthcare Teams, can it be resolved. Journal of Interprofessional Care, Volume 25, 4-10.
19.Raykova L., Semerjieva A., Yordanov Y., & Cherkezov T. D. (2015). Dysfunctional Effects of a Conflict in a Healthcare Organization. Folia Medica, 57 (2), 133-137. Retrieved 18.01.2019 doi: https://doi.org/10.1515/folmed-2015-0032.
20.Kim W., Nicotera A. M., & McNulty J. 2015. Nurses' perceptions of conflict as constructive or destructive. Journal of Advanced Nursing, Volume 71 (9), 2073-2083. Retrieved 25.01.2019. doi: 10.1111/jan.12672.
21.Leever A., Hulst M., Berendsen A., Boendemaker P., Roodenburg J. & Pols J. 2010. Conflicts and conflict management in the collaboration between nurses and physician - a qualitative study. Journal of interprofessional care, Volume 24 (6), 612 - 624.
TYMIHfll
Мешрбике ici - бул мамандьщта коммуникативтш даFдыларды керсету жэне тYЛFааральщ ;арым-к;атынасты дамыту ;ажет. Эр тYрлi стресспк жаFдайлар, тYЛFааральщ жэне кэаби ;арым-к;атынастар жанжалды жаFдайларFа экелуi mymmh. Мундай жаFдайлардан Ke6ici дурыс шеше алмайды, жэне кдкгъкыстар позитивтi емес терю деп ;абылданады. Бул ма;алада мейiрбикелiк YжымдаFы конфликт дегенiмiз не жэне ;андай салдарлар болуы MYMKrn екенiн тYciнемiз. Кдкгъгеыстарды дурыс жэне табысты бас;ару кадрлардын, кетушщ алдын алуFа, кeрcетiлетiн медициналы; ;ызметтердщ сапасын жа;cартуFа жэне пациенттердщ ;аушаздшн арттыруFа мYмкiндiк бередi.
Ктт свздер: цацтыгыстар, мешрбике, жумыс орнындагы цацтыгыстар.
АННОТАЦИЯ
Сестринское дело-это профессия, в которой нужно проявить коммуникативные навыки и развивать межличностные отношения. Различные стрессовые ситуации, межличностные и межпрофессиональные отношения могут приводить к конфликтным ситуациям. Не все умеют правильно выходить из таких ситуаций, и чаще всего конфликты воспринимаются негативными, нежели позитивным. В этой статье разберем, что значат конфликты в сестринском коллективе и какие последствия могут быть. Правильное и успешное управление конфликтами дает возможность предотвратить отток кадров, улучшить качество оказываемых медицинских услуг и повысить безопасность пациентов.
Ключевые слова: конфликты, уход за больными, конфликты на рабочем месте.
•с «
О &
'в
3
t йз
