Managing Conflict for Nurses, One

¶ … Managing Conflict

For nurses, one of the biggest challenges that they must deal with is a variety of conflicts on a regular basis. In some cases, this can occur from other staff members who are unwilling to work together. While at other times, caregivers can be a major obstacle which is creating new challenges for the entire health care team. This is the situation, I experienced after 25 years of serving in numerous health care environments. (Medina, 2006) (Leddy, 1998)

To fully understand how to assess and manage the conflict requires carefully analyzing the situation. This will be accomplished by examining the parties involved, events / issues, power, regulation / conflict and the style of conflict (i.e. PEPRS). These elements will provide specific insights as to the challenges facing the staff and the assessment of the conflict. (Medina, 2006) (Leddy, 1998)

Parties Involved

The parties that are involved are the doctors, nurses, case manager and social workers. They are providing support to the caregiver and his mother (the patient). He is her son and has become very irate. This is because he believes that a different course of action needs to be taken to save her life. At the same time, he has brought in the patient's grandson from the belligerence and tension he is showing towards staff. The defining variables for this component are the challenges various professionals are having in dealing with the patient's son. This has caused everybody to become concerned about what will happen next and it has increased the overall amounts of tension at the unit. (Medina, 2006) (Leddy, 1998)

Events / Issues

The main event is the patient's condition is continually becoming worse. This is because her son is questioning the diagnosis of health care professionals and has sought out a second opinion. During this process, he has taken her out of the hospital in order to utilize other treatment options that will help (most notably: a radical form of chemotherapy).

This based upon the fact that her condition is related to metastatic cancer involving: her liver, lungs and brain. At the same time, she has a bowel obstruction, which is causing abdominal pain, nausea and bleeding. The son has taken her out of the hospital and readmitted her a few days later. This has made her condition worse. She was sent to the ICU and the bowel obstruction was treated. This has stabilized her to the point, that she can be transferred out of the unit. (Medina, 2006) (Leddy, 1998)

The problem is; with her son refusing to believe anything the health care team is telling him and he is making everyone's job more difficult. This is taking place with him having a belligerent and confrontational attitude towards the staff members. We have tried to place a nasogastric tube inside her, in order to decompress the belly and alleviate her vomiting and stomach distention. However, he is refusing this treatment option and will not sign a DNR. (Medina, 2006) (Leddy, 1998)

To make matters worse, he is constantly arguing with the staff and has created a situation where the police / hospital security had to become involved. He was told by law enforcement that if there are any more incidents, he will be banned from the facility and face the possibility of arrest. To keep an eye on his mother, he has sent her 23-year-old grandson to sit by her side from 10:00 AM until 10:00 PM. The problem is becoming worse, because the patient's condition is not steadily improving. as, her son is not seeking out any kind of effective treatment options. This means that it is only a matter of time until she will face the possibility of death. When this happens, everyone is fearful of another incident occurring (which will create chaos at the unit). (Medina, 2006) (Leddy, 1998)

In this component, the defining variables are how the staff will deal with the issues from the family. That is refusing to listen to what they have to say and is continually creating a hostile environment for everyone. The big challenge will be how to handle these issues and maintain a stable atmosphere when this happens. (Medina, 2006) (Leddy, 1998)

Power

The health care staff has the power to restrict the son from the facility. This is provided that he continues to have similar outbursts and harasses the staff. The problem is he can help to alleviate suffering, if he was to take a more open attitude about what is happening and offer insights about possible issues she had in the past. This could make it easier for everyone to deal with critical challenges and prevent the situation from becoming worse. (Medina, 2006) (Leddy, 1998)

However, because the son is engaging a confrontational attitude, means that these issues are becoming very complicated based upon the way he is acting. These elements are showing how new tactics must be utilized that will exercise health care professionals' power and control over the situation. The defining variables for this component are the primary caregiver does not want to cooperate and understand what is happening. This supports the answer to the assessment question by illustrating what options they have available, in dealing with these kinds of challenges over the long-term. (Medina, 2006) (Leddy, 1998)

Regulation and Conflict

The basic regulations allow the caregiver to make decision concerning the treatment options the patient is receiving. According to the AAPS, the patient and the caregiver have a number of freedoms available to them. The most notable include:

To seek consultation with the physician(s) of their choice.

To contract with their physician(s) on mutually agreeable terms.

To be treated confidentially, with access to their records limited to those involved in their care or designated by the patient.

To use their own resources to purchase the care of their choice.

To refuse medical treatment even if it is recommended by their physician(s).

To be informed about their medical condition, the risks and benefits of treatment and appropriate alternatives.

To refuse third-party interference in their medical care, and to be confident that their actions in seeking or declining medical care will not result in third-party-imposed penalties for patients or physicians. ("Patient's Bill of Rights," 2013) (Cohen, 2005)

These different elements are showing how the son has the right to refuse treatment options. However, given the fact that he is unsatisfied with what is occurring, means he should seek out assistance elsewhere. ("Patient's Bill of Rights," 2013) (Cohen, 2005)

As a result, the defining variables are: what measures can be taken to either encourage him to find services from another provider or begin working with health care professionals. This is creating a conflict, as the son is not satisfied as to what is happening. Yet, he continually returns to the hospital for treatment after trying alternative therapies. This answers the questions, by showing other options for dealing with these challenges.

Style of the Conflict

The style of the conflict is based upon an adversarial relationship the son has with health care professionals. This is when he wants to help his mother. Yet, he is unable to do so by following their advice and seeking out more radical forms of therapy. Then, a few days later, he goes back to the original facility and wants assistance from the staff he alienated. (Levine, 2004) (Cohen, 2005)