Conflict Challenges for the healthcare professional.

Please add your input and learn from your colleagues recommendations.

  1. The provider arrives on the floor to find that her orders were not carried out to the letter and explodes in a tirade in front of the patient and their family.
  2. There is a fundamental disagree on relevance of information regarding care management in this case. Nursing believes certain issues are relevant, but the physician disregards the concerns without any specific explanation.  Animosity develops between nursing staff and the physician.
  3. There are multiple physicians not integrating care in an ICU patient. At various times the physician’s frustration is vented onto the nurse treating the patient who becomes angered and confused as to what is appropriate care and annoyed over the derogatory comments about other physicians with whom she maintains a respectful professional relationship. This miscommunication threatens quality of care.
  4. Two nurses disagreeing over the timing, documentation and relevance of the information about a common patient such as change in shift and the derogatory conversations that occur from both sides afterward with other staff members.
  5. Patient/family don’t like the way the nurse/the therapist is treating them and complains to their Nurse Practitioner, making accusations about quality, trying to enlist the NP to their bias, as they perceive the NP will condemn the nurse/therapist.
    1. There is an element of dark satisfaction on the part of the patient when they create conflict and use the senior person in the traditional hierarchy as their advocate/ surrogate to criticize someone perceived as lower on the hierarchical chain.
    2. How does this impact long term distrust between care givers? Does the provider recognize the patients manipulative behavior?
  1. Demanding providers who complain about administrative processes, quality of other department’s care, demands in the operating room, and believes the loud squeaky wheel will reward their demands.
  2. ERROR management – communication, disclosure, what the patient and family wants – what happens when this is ignored, and a plaintiff’s attorney begins to coach the adversarial patient.
    1. How should the ADR address medical mistakes?
  3. Dispute over modification of a long-standing care plan policy or procedure.
  4. Anger and hostility that fracture relationships when providers disagree on care management decisions.
  5. A provider is reported by an anonymous communication to the ADR office as possibly being impaired. Alcohol is detectable on the provider’s breathe.  What steps does the ADR take to intervene for patient safety?
  6. Conflict between two radiology technicians from an outside dispute is carried over to hostile behavior in the outpatient clinic. The disruptive behavior affect several other people in the outpatient work environment.
  7. Several younger nurses are posting Facebook comments that target one older nurse they have a tense and acrimonious relationship with.
    1. How can the ADR influence behavior outside of the workplace? Does the ADR have the right or authority to do so?
  8. Surgeons are complaining that the O.R. staff are all visiting techs who are not qualified to participate in their cases. This has caused escalating anger and dysfunctional relationship between the operating room nurse manager, several surgeons and the few nurses that are full time staff.  Initial inquiry discovers a much larger problem set with complaints including timing, turn over and even PACU quality of care initiatives.
      1. Who are the stakeholders and how will the ADR bring the large group of surgeons together with administration? Is it necessary to have all of the surgeons at every meeting?
  9. The provider is a significant contributor to the hospitals bottom line and her patients love her but nursing staff, technicians and even ward clerks find the provider demanding, aloof and discourteous.  The administration does not want to upset the provider because of their financial contribution and the provider’s public image is quite important to the hospital’s board members.