Principles of Health Care Management

Patient care in our hospitals is heavily dependent on collaborations between physicians and nurses. These are professionals who are highly trained in their own right and their services are indispensable. However, for them to be effective, they need not only to work together but respect each others’ expertise since their services are interdependent. Each health care profession has information that the other needs to posses in order to practice successfully. However, be it as it may, there are areas of both conflict and professional cooperation that are witnessed in our hospitals.

Collaboration is a desired virtue but it is a hard thing to achieve especially due to the nature of working relationships. For collaboration to be acquired a lot of effort is demanded from both sides, this is because it involves a joint responsibility for patient care. It is important to note here that for a high level of collaboration to occur, time is needed to allow the concerned parties to establish and develop relationships; relationships can take long to establish especially due to the working hours nature of the involved parties, both physicians and nurses no longer spend time in hospitals as there before.

Discussion There are characteristics of conflict in any organizational structure. These include; where two or more parties are involved in one activity. This is the scenario with the physicians and nurses where they common ground is the patient. Though they both claim to have shared responsibility there is tendency for one party to oppress the other and make them be seen by the management as the ones failing. This kind of scenario happens when different parties are especially required to report differently about the same responsibility.

For the case of physicians and nurses, it is difficult for one party to accept responsibility in case there is a problem with the patient. The two parties seek to exonerate themselves and blame each other. Areas of conflict Level of education is a major concern in the medical field. Physicians are obviously highly educated than nurses and this becomes an issue especially where the former want to diminish the efforts of the other. Nurses, especially those who have not at least attained a university degree feel intimidated by physicians.

However this does not have to happen because where there is cooperation between physicians and nurses, the not so learned nurses are able to contribute to the task at hand and feel satisfied despite their level of education. It is also important to note here that levels of education can be improved and most of the nurses are always looking forward to professional growth so it would be unwise for physicians to look down upon nurses. Another area of conflict is that of income generation.

Physicians have always been viewed as major income generators in many hospitals. However, if we are saying that there cannot be success without collaborations between the two parties then it would be unfair to for hospital organization to view physicians as the only income generators since they efforts alone are not enough. Nurses are also a substantial source of income though not as much as that of physicians and their efforts should equally be acknowledged. The other area that may cause conflict between nurses and physicians is the nature of their training.

Nurses are trained to be social and have an aspect of sourcing for confirmation while doctors are trained to be focused on justice issues and are therefore able to make decisions much faster. This kind of training background makes it difficult for the two parties to collaborate since one particularly the physician might feel lagged behind by their counterparts especially when it comes to making decision. Also, the nurse might feel like their reasoning is not considered and this make it difficult to cooperate with their colleagues.

It would be possible to socialize the two parties but unfortunately due to the economic demands, there may not be enough time for the both parties to reestablish their relationships. Both nurses and physicians have become money minded and they would rather go it alone and make more money than make time to socialize. However, all is not lost since there is interdisciplinary service learning opportunities that have proven to be successful by training on collaborative skills in medical schools. There is also another way of socializing the two parties.

This is the Registered Nurse-Resident Physicians Preceptorship Program that is making time for the both parties to work together and by doing so both the nurses and physicians can learn and appreciate each others efforts and importance. It is during such programs that it is hoped that both parties will not only acknowledge each other’s importance but also change their perspective towards each other. Once this has been accomplished, more collaboration in sharing responsibility is achieved. (John et al 2007) Another area of conflict between the nurses and physicians is exposure to compassion fatigue.

Compassion fatigue affects hospital professionals since they are exposed to human sufferings on a daily basis. The viewing of human painful procedures and the emotional suffering they go through especially during demise can cause the two parties to not cooperate. Compassion fatigue and burn outs mostly cause a great challenge to communication without which there can’t be collaboration the result of which is substandard patient care. This problem can be dealt with more efficiently by the management of the health facilities.

The management is expected to ensure that professionals are provided with workable shifts and self renewal programs that can aid relieve some of the fatigue experienced by both parties. It is also the responsibility of the professionals to take care of themselves they are expected to come up with ways of protecting and reducing effects of compassion fatigue and seek help when need be. Personal care will go a long way in enhancing team work and subsequently improve patient’s care. (John et al 2007) Another issue that causes conflict between nurses and physicians is negotiation.

It is important to note that how negotiation are done will determine the kind of relationship the two parties are going to have. A negotiation table should always be leveled, title should be dropped and hierarchy removed so that everyone can feel equally important. Senior professionals should learn to have the accurate way of presenting themselves and how to do away with intimidating phrases and attitudes. Nurses should also learn to present themselves accurately without feeling intimidated and at the same time maintaining respect for their seniors.

When negotiations are done with respect, collaborations in professionals’ respective departments runs smoothly. Conflict management should also be dealt with wisely. No matter what measures are put there is likely hood of conflicts but how these conflicts are dealt with determines how well or bad the parties will continue to collaborate. It is important to note here that some conflicts are beneficial since they bring out the other side of an issue to light. As a matter of fact lack of conflict could be lead to a group think which is not necessarily very helpful to a developing organization.

Having mentioned all those sources of conflicts it is obvious that physicians and nurses do not cooperate a lot. This paper will therefore look into measures that will be taken to resolve this conflict. First there must be definition of shared authority and accountability. It is clear from the above discussion that it is not possible for physicians and nurses to be work separately and therefore there must be same language, same policies and same ethical principles for the both parties.

Again, since we learnt earlier in this paper that there some of the conflicts are as result of training, there must be strategies put in place to ensure that upcoming generation must be taught collaborative skills. This will enhance collaboration in future health care professionals. There must be joint assessment and planning. This will not only make the two parties work together but it will save hospital running costs since they minimize double ordering of resources. (John et al 2007) Areas of cooperation

It is clear from the above discussion that due to the numerous areas of conflict, there is not so many areas of cooperation. However it is important to note here that improved cooperation between the physicians and nurses will only result to improved patient care which is a generally shared objective by all health organizations. In his book “How Doctors Think”, Jerome Groopman points out different areas where doctors fail. It is interesting to note from the book that he does acknowledge that doctors also make mistakes and especially points out the communication problems they the doctors encounter with their patients.

This is a very good scenario where the need for nurses comes in. It is clear that doctors would have done a better job if they made use of a nurse as opposed to going it alone. Dr Groopman shows clearly here that despite doctor’s brilliance and experience they are still capable of making mistakes and that them too need assistance both from the patients and the nurses. As a matter of fact Groopman says that even a combination of five doctors can still fail to diagnose a problem and this shows that doctors just like nurses are not perfect.

He acknowledges that the difficulty in communication between the doctor and the patient is basically because the doctor is stereotyping the situation and instead of him looking for confirmation where he is not sure like his nurse counterpart would do, he goes ahead and makes a wrong decision. Dr Groopman goes ahead and shows us how doctors miss something even in the theatre. One is tempted to think that, that would have been avoided if he was collaborating with a nurse the both of them would not have missed it!!!

Finally Groopman says that a good doctor is one who is ready to accept that him too can sometimes make very silly mistakes. He however goes ahead and says that there are doctors like him who are willing to reexamine their mistakes since they have realized it is different to read from the book than from seeing it in the body. Though I agree with the doctor, the silly mistake in my view can be reduced if not avoided if the doctors would let a nurse despite less educated or experienced to help him. (Jerome Groopman 2007) Conclusion

From the above discussion we have learnt that there are many sources and causes of conflicts between physicians and nurses. These include education level where physicians who are more educated than nurses tend to think that nurses may not be of much help. The solution for this is as have seen earlier in the paper is for physicians to acknowledge that despite their education level they can’t do it without nurses. Also the physicians should be well aware that education is acquired and that the less educated nurse today will be the most educated nurse tomorrow and so there is need to respect her and collaborate with her.

At the same time gender has also come up as an issue where female nurses as seen as less capable as compared to their male physicians counterpart. This as we have seen has nothing to do with gender but credibility and that to overcome this let honor be given to whom it deserves. This paper has also shown that money has been source of conflict between physicians and nurses since physicians are viewed to be more productive in terms of money than their nurse counterparts and though this is true it should be noted that the two work together and so nurses are also contributors.

The paper has also dealt with intra personal conflict avoidance where one can guard h/herself from compassion fatigue and also interpersonal conflict where respect for each others’ perspective will resolve conflict wisely without damaging group cohesiveness. Once the above and many more measures have been implemented then there can be a discussion about areas of physician and nurses’ cooperation. References John R. Griffith et al (2007), The Well Managed Health Care Organization (6th edition) (Chicago: Health Administration Press, 2007) Jerome Groopman (2007), How Doctors Think (New York: Houghton-Mifflin, 2007) ISBN 0-618-61003-0

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