Nursing Concepts and Tools for Conflict Management

This essay will discuss on the thesis statement: Nurse-patients and Nurse-nurse conflicts in critical healthcare situations can be managed through the adequate nursing conductance of nursing concepts, communication frameworks and nursing tools such as, patient centered care, conflict management framework and AIDET nursing tools.

This essay will demonstrate Scenario 2 which reflects a critical clinical situation and prevalence of ineffective communication which has resulted in conflict between the nursing student and the patient and Assistant in Nursing (AIN). The first section of the essay will focus upon patient centered care, the conflict management framework and nursing AIDET tool. The second section will highlight the key areas reflecting communication ineffectiveness. The third section will then focus on applying these chosen concepts. Lastly, the essay will conclude with an overview of the key issues addressed.

The nursing concept of patient centered care, the communication framework of conflict management and the nursing tool of AIDET will be considered. Patient centered care encompasses direct involvement of the patient in the decision-making framework of their care plan process where the nurse must notify herself with the needs, opinions, preferences and consent from the patient. It is of relevance to this scenario since obtaining consent from the patient would have prevented the conflicts with the nursing student (Liberati et al., 2015). The conflict management framework encompasses the use of 5 Ps of perceptions, people, practices, policies and preferences during a challenging scenario and is of relevance since its utilization would have resulted in a win-win situation where both the nursing student and AIN would have been satisfied with each other and the patient (Johansen & Cadmus, 2016). The nursing AIDET tool is essential for ensuring positive therapeutic relationships with the patient and is of relevance since adherence to ‘Acknowledge, Introduce, Duration, Explanation and Thank You’ principles would have enlightened the nurse on client needs and also comforted the patient (Allen, Rieck & Salsbury, 2016).

The suitability of patient centered care lies in its ability to ensure fulfillment of patient needs and perception of security. It maybe disadvantageous considering that it hinders nursing autonomy and may not be suitable for comprehension for all patients (Håkansson Eklund et al., 2019). A conflict management framework is beneficial since it results in healthy nurse-patient and nurse-nurse collaboration during critical situations. However, a ‘win-win’ may always not be possible due to nursing competition, misperceptions or lateral bullying (Ibrahim, Mohamed & EL-Gazar, 2018). The AIDET tool is advantageous in strengthening patient satisfaction but again may not always be acknowledged by a patient (Varghese, 2017).

Communication Ineffectiveness in the Chosen Scenario

The communication in this scenario is not effective due to an absence in the usage of patient centered care by the nursing student and the lack of adequate conflict management and interpersonal communication between the nursing student and the AIN during the situation of patient distress while showering. It can be observed that the nursing student engaged in showering with the patient without obtaining her consent or enquiring about her needs from the previously allocated AIN. This is an example of ineffective communication since practicing patient centered care by the nursing student would have enlightened her on the patient’s needs and permission and hence, avoided in a stressful situation for the patient (Mohammed et al., 2016). Further, enquiring about the patient’s needs from the AIN would have enlightened the nursing student on the require techniques for showering the patient and would have ensured patient feelings of comfort and security instead of the distress observed in the scenario (Nowaski et al., 2018). Another key example of ineffective nursing communication is the lack of adequate interpersonal communication between the nursing student and the AIN. Interpersonal communication is essential in the prevention of conflicts as well as in the maintenance of healthy relationships in professional as well as non-professional environments since it removes communication barriers such as judgment and misperceptions (MacLean et al., 2017). Hence, instead of judging the nursing student as incompetent and leaving her on her own with the distressed patient the AIN should have at least empathized with her novel experience in nursing professionalism and assisted the nursing student in teaching the correct methods of showering. This would have prevented the ineffective communication conflict between the AIN and nursing student and resulted in achievement of positive patient health outcomes and healthy inter-professional relationships (Folse, 2018).

Patient centered care encompasses the nursing responsibility of directly involving the patient in their respective care plan by enquiring actively about the patient’s needs, opinions and preferences and his/her consent (Feo & Kitson, 2016). Hence, to improve effectiveness in communication and prevent the patient feeling distressed and scared during showering, the nursing student should have applied principles of patient centered care which would necessitate asking the patient for her consent during showering, communicating with her empathy and enquiring about her comfort (Ross, Todd & Clarke, 2015).

Interpersonal communication, empathy and patient listening are some of the key prerequisites in ensuring healthy relationships and prevention of conflict even in the clinical scenario (Gausvik et al, 2015). For managing a conflict situation of stressed, fearful and aggressive patient during showering, the nursing student and the AIN could have applied a conflict management framework of five 5, that is, perceptions, people, practices, policies and persistence (Ba?o?ul & Özgür, 2016). Firstly, the nursing student and AIN must first work on their misperceptions about their individual competencies and engage in interpersonal communication and empathy to understand each other’s views without judgment and work collectively towards patient treatment. Secondly, both of them should have considered the characteristics of the ‘people’ or patient’s age and disease condition and question and work collaboratively considering the cognitive inabilities of the patient. Thirdly, the conflict was required to be managed by ‘practicing’ patient centered care and gentle persuasion to calm the patient. Fourthly, establishment and adherence to a conflict management framework or policy is essential to standardize and redirect nursing practice and could have avoided the observed communication conflict. Lastly, both the nursing student and the AIN should have focused on the immediate intervention of patient comfort assurance instead of highlighting differences in competencies. An application of such a conflict management framework would have resulted in a ‘win-win’ situation where the patient and the nursing parties would have been satisfied in the deliverance of care (Baddar, Salem & Villagracia, 2016).

Application of Nursing Concepts and Tools in the Chosen Scenario

The maintenance of satisfactory nurse-patient relationships and the fulfillment of patient satisfaction, are the hallmarks of effective clinical communication (Alasad, Tabar & AbuRuz, 2015). Hence, to ensure long term patient satisfaction and comfort, the nursing student should have adhered to the AIDET nursing tool. This would include: acknowledging and greeting the aged patient by her name when entering, the nursing student introducing herself, providing duration details and explaining the showering process and importance followed by obtaining consent and thanking the patient and her family. This would have made the patient in question feel dignified, respected, secured and comforted prior to showering (Barber, 2018).

Conclusion

To conclude, this essay proves the thesis statement that adherence to key nursing concepts, tools and communication frameworks will aid in resolution of conflict and improvement of professional and patient relationships. The chosen scenario of patient distress and hindered nursing partnerships concerning patient hygiene can be managed through nursing student’s usage of patient centered approach for obtaining consent, adherence to a 5 P conflict management framework to prevent AIN-student conflicts and performance of the AIDET tool to ensure patient satisfaction. To conclude, this essay provided key insights on learning essential communication framework and tool usage in critical healthcare scenarios.

References

Alasad, J., Tabar, N. A., & AbuRuz, M. E. (2015). Patient satisfaction with nursing care: measuring outcomes in an international setting. Journal of Nursing Administration, 45(11), 563-568. doi: 10.1097/NNA.0000000000000264. 

Allen, T., Rieck, T., & Salsbury, S. (2016). Patient perceptions of an AIDET and hourly rounding program in a community hospital: Results of a qualitative study. Patient Experience Journal, 3(1), 42-49. Retrieved from: https://pxjournal.org/journal/vol3/iss1/7. 

Baddar, F., Salem, O. A., & Villagracia, H. N. (2016). Conflict resolution strategies of nurses in a selected government tertiary hospital in the Kingdom of Saudi Arabia. Journal of Nursing Education and Practice, 6(5), 91-9. Retrieved from: https://www.researchgate.net/profile/Fatma_Baddar/publication/290649621_Conflict_resolution_strategies_of_nurses_in_a_selected_government_tertiary_hospital_in_the_Kingdom_of_Saudi_Arabia/links/56a666e708ae6c437c1aed92/Conflict-resolution-strategies-of-nurses-in-a-selected-government-tertiary-hospital-in-the-Kingdom-of-Saudi-Arabia.pdf. 

Barber, S. (2018). Patient Care in Decline: AIDET As a Tool for Improvement. Radiologic technology, 89(4), 419-421. Retrieved from: https://www.radiologictechnology.org/content/89/4/419.full. 

Ba?o?ul, C., & Özgür, G. (2016). Role of emotional intelligence in conflict management strategies of nurses. Asian nursing research, 10(3), 228-233. doi: https://doi.org/10.1016/j.anr.2016.07.002. 

Feo, R., & Kitson, A. (2016). Promoting patient-centred fundamental care in acute healthcare systems. International Journal of Nursing Studies, 57, 1-11. doi: https://doi.org/10.1016/j.ijnurstu.2016.01.006. 

Folse, V. N. (2018). Communication and conflict. Leading and Managing in Nursing-E-Book, 123. Retrieved from: https://books.google.co.in/books?hl=en&lr=&id=XdB5DwAAQBAJ&oi=fnd&pg=PA123&dq=Folse,+V.+N.+(2018).+Communication+and+conflict.+Leading+and+Managing+in+Nursing-E-Book,+123.&ots=vd1ZJmtY9N&sig=OECCid-Z7o2WeTOuKMStrHu3vo4#v=onepage&q&f=false. 

Gausvik, C., Lautar, A., Miller, L., Pallerla, H., & Schlaudecker, J. (2015). Structured nursing communication on interdisciplinary acute care teams improves perceptions of safety, efficiency, understanding of care plan and teamwork as well as job satisfaction. Journal of multidisciplinary healthcare, 8, 33. doi: https://dx.doi.org/10.2147%2FJMDH.S72623. 

Håkansson Eklund, J., Holmström, I. K., Kumlin, T., Kaminsky, E., Skoglund, K., Höglander, J., … & Summer Meranius, M. (2019). ” Same same or different?” A review of reviews of person-centered and patient-centered care. Patient Education and Counseling, 102(1), 3-11. doi: https://doi.org/10.1016/j.pec.2018.08.029. 

Ibrahim, S. A., Mohamed, H. A., & EL-Gazar, H. E. (2018). The Effect of Conflict-Management Enhancing Strategy for Head Nurses on the Quality of Vertical Dyad Linkage with Nurses. International journal of Nursing Didactics, 8(04), 25-34. doi: https://doi.org/10.15520/ijnd.v8i04.2128. 

Johansen, M. L., & Cadmus, E. (2016). Conflict management style, supportive work environments and the experience of work stress in emergency nurses. Journal of nursing management, 24(2), 211-218. doi: https://doi.org/10.1111/jonm.12302. 

Liberati, E. G., Gorli, M., Moja, L., Galuppo, L., Ripamonti, S., & Scaratti, G. (2015). Exploring the practice of patient centered care: The role of ethnography and reflexivity. Social Science & Medicine, 133, 45-52. doi: https://doi.org/10.1016/j.socscimed.2015.03.050. 

MacLean, S., Kelly, M., Geddes, F., & Della, P. (2017). Use of simulated patients to develop communication skills in nursing education: An integrative review. Nurse education today, 48, 90-98. doi: https://doi.org/10.1016/j.nedt.2016.09.018. 

Mohammed, K., Nolan, M. B., Rajjo, T., Shah, N. D., Prokop, L. J., Varkey, P., & Murad, M. H. (2016). Creating a patient-centered health care delivery system: a systematic review of health care quality from the patient perspective. American Journal of Medical Quality, 31(1), 12-21. doi: https://doi.org/10.1177%2F1062860614545124. 

Nowaskie, D., Carvell, C. A., Alder, C. A., LaMantia, M. A., Gao, S., Brown, S., … & Austrom, M. G. (2018). Care coordinator assistants: Job satisfaction and the importance of teamwork in delivering person-centered dementia care. Dementia, 1471301218802739. doi: https://doi.org/10.1177%2F1471301218802739. 

Ross, H., Tod, A. M., & Clarke, A. (2015). Understanding and achieving person?centred care: the nurse perspective. Journal of Clinical Nursing, 24(9-10), 1223-1233. doi: https://doi.org/10.1111/jocn.12662. 

Varghese, A. S. (2017). Improving patient satisfaction through implementing AIDET. doi: https://sigma.nursingrepository.org/handle/10755/621589.