NR 283 Quiz 2
Name
Chamberlain University
NR-447: RN Collaborative Healthcare
Prof. Name
Date
In a state-wide survey of South Carolina nurses regarding horizontal violence, more than 85% of respondents reported being victims, with experienced nurses frequently identified as the perpetrators (Dulaney & Zager, 2010). Wilson and colleagues (2011) similarly found that 85% of nurses had experienced horizontal or lateral violence (Lachman, 2015, p. 39). Nursing, particularly for new nurses, can be a highly stressful field. These professionals enter the workforce with aspirations to make meaningful contributions to patient care. However, upon entering the real world, many nurses encounter a cutthroat environment, with fellow nurses showing reluctance to mentor or support them. This issue is not exclusive to new nurses but also affects those transferring between units or organizations, where they are met with colleagues who are either unwilling or unable to provide necessary support.
In my unit, this challenging dynamic is all too common. Veteran nurses create an uncomfortable atmosphere, making it clear that they do not get along. This tension is palpable, particularly for new staff who struggle to determine whom they can trust. This issue is part of a larger phenomenon where “nurses eat their young,” a term used to describe senior nurses’ mistreatment of their less experienced colleagues.
A frequent conflict I have observed involves nurses talking behind each other’s backs, criticizing how others perform their duties. Our unit fails to operate as a team, hindering patient care. Nurses refuse to assist each other with minor tasks, such as monitoring vital signs so a colleague can take a break or address another issue. Although everyone feels overwhelmed, no one is willing to extend help, leading to a lack of collaboration, which ultimately compromises patient care.
This hostile environment is not conducive to providing quality patient care. For patients to feel secure and trust the facility, the staff must work together harmoniously. When patients sense discord among the staff, they may feel unsafe and be reluctant to seek care. Patients can observe when a healthcare team is functioning well, which assures them they are receiving the best care. Conversely, when patients witness nurses arguing about their responsibilities or hear them dismissing each other’s concerns, it undermines their confidence in the care they are receiving. Patients want to believe that all nurses have their best interests at heart.
One incident I witnessed involved two nurses arguing at the nurses’ station, where patients could hear and see the disagreement. One nurse, feeling that her patient load was heavier, demanded that the other nurse take on more patients, despite the latter being relatively new. The argument escalated, with the senior nurse belittling the newer one, accusing her of not working hard enough, and insisting that she “act like a nurse.” The newer nurse tried to explain that she was still acclimating to the unit and the computer system, but her efforts were dismissed. Patients were visibly upset by the veteran nurse’s behavior and sympathized with the new nurse, recognizing the tension between the staff.
As a new nurse myself, still in orientation with a lighter patient load, I empathized with my colleague, worrying that I might soon face similar treatment. This unit has a reputation for senior nurses “eating their young,” contributing to high turnover rates as nurses either resign or request transfers to other units. Lachman (2015) points out that incivility, bullying, and lateral violence negatively impact job satisfaction and retention, creating an environment where learning and professional growth are stifled (p. 41).
This conflict remains unresolved and will likely continue unless it is addressed in a structured, non-threatening manner. A mandatory meeting is needed to discuss the behavior and treatment of new staff. During this meeting, nurses should be encouraged to voice their concerns and collaborate on strategies to foster teamwork and improve communication. As Felblinger (2009) notes, creating a civil workplace benefits both patients and staff, promoting a more positive and productive work environment (p. 20).
Latent Conflict:
Latent conflict arises when there is an awareness that problems may develop, based on past experiences or observations. In my unit, this is evident at the start of each shift when certain nurses express a reluctance to work with particular colleagues due to personal or professional differences.
Perceived Conflict:
In this stage, individuals recognize that a conflict exists, but no action has been taken to address it. In my unit, we have moved beyond this stage, as the ongoing issues between staff are widely known, yet remain unresolved, with management and staff avoiding the problem.
Felt Conflict:
This stage is characterized by emotions such as anger, stress, and anxiety. Although the conflict has not been directly addressed, the tension is palpable, creating a stressful and hostile work environment. Nurses are avoiding direct confrontations, leading to heightened stress and a chaotic atmosphere.
Manifest Conflict:
At this stage, the conflict either reaches a resolution or continues to escalate. In my unit, nurses avoid collaborating, leading to arguments in front of patients and behind-the-back gossip, all of which negatively impact patient care. This behavior is destructive and undermines the unit’s overall functionality.
To resolve this conflict, I would collaborate with the nurse leader to implement a combination of accommodation and collaboration strategies. Reducing the patient load for precepting nurses would help alleviate their stress and allow them to be more patient with new staff. Monthly team-building exercises and meetings would provide a platform for open discussions, fostering better communication and cooperation among nurses. Additionally, recognizing staff members for their teamwork efforts could boost morale and further encourage collaboration. Improving team morale would enhance patient care by ensuring that nurses feel supported and are more willing to assist each other.
Using a combination of accommodation and collaboration is more effective than relying on either strategy alone. By addressing individual concerns and working towards a collective goal, such as improving patient care through teamwork, the unit can foster a more positive and productive environment. As Finkelman (2016) states, conflict is inevitable in any organization, but it can be managed effectively through open communication and collaboration (p. 324). Implementing teambuilding strategies and establishing a formal mentorship program for new nurses would help create a more supportive environment, reducing turnover and improving patient care.
Felblinger, D. M. (2009). Bullying incivility, and disruptive behaviors in the healthcare setting: Identification, impact, and intervention. Frontiers of Health Services Management, 25(4), 13-23.
Finkelman, A. (2016). Leadership and management for nurses: Core competencies for quality care (3rd ed.). Pearson.
Lachman, V. D. (2015). Ethical issues in disruptive behaviors of incivility, bullying, and horizontal/lateral violence. Urologic Nursing, 35(1), 39-42.
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