Case Study Analysis: Emotional Intelligence and Conflict Resolution in Healthcare

Case Study Analysis: Emotional Intelligence and Conflict Resolution in Healthcare

The healthcare setting in the contemporary age is inherent of many challenges that are experienced by health workers at both the managerial, education and point-of-care level. Healthcare costs are either too high, rising too fast or disproportionate to quality of outcomes, posing a challenge (Hall, 2015). In the same way, emerging technologies in healthcare come with both advantages and challenges to the workforce and the management. Elsewhere, an equally scalar number of challenges arise from population health, including aging of baby boomers and increased incidence of chronic diseases (Macri, 2016). This is besides issues of shortage of healthcare workforce and other resources to meet the needs of the clientele. This implies high possibility of conflicts emerging between workers and the management, patient population and other stakeholders. The resolution of these conflicts must proceed in a manner that appreciates the importance of working together as a team and seeking sustainable solutions to the various healthcare challenges. In dealing with such conflicts, nurses need to employ concepts of emotional intelligence and management both at a tactical or strategic level (Adolphs, 2010). In this paper, a case study of a dispute at the workplace is presented and analyzed in line with the ability model of artificial intelligence, among other things, considering the need to foster a team climate, conflict resolution skills and evaluating solutions.

Case Scenario

There has been an acute shortage of nurses in the institution. Almost every department lacks the required threshold, with the critical care and the obstetrics ward the worst hit. Given the complexity of the care aspects involved in the affected wards, nurses have been forced to work overtime to cover for the shortage and in most instances end up extremely overworked. The administration in the past offered to pay some per diems for the additional work but have so far failed to keep their promise, resulting in endless conflicts with the nurses. In one particular case, I worked for 14 hours non-stop in a ward that I had only come as a stand in for another nurse that had been taken ill. Despite the working environment appearing quite new, I worked for excess hours with no compensatory allowance and with a number of students that were on placement. Upon bringing the matter to the attention of the nurse manager, she was adamant that the situation, though bad, had little cure. There was need to exercise patience and empathy to the patients in the ward, the payment and working hours notwithstanding.

The shortage of nursing staff in the facility has been a long standing problem in the institution. My experience only awakened me to the fact that many nurses had gone through the same and I was likely to go through it again. By observation, one could clearly notice that the nursing staff often appeared exhausted and overworked within a few hours of reporting. The issue was exacerbated by various factors. First, most Australians prefer to use the public health system due to the incentives provided by Medicare (Macri, 2016). This has increased the pressure on public health facilities more so in offering services like maternal care for the lower and middle class in the society. It is therefore almost impossible to balance the healthcare resources with the demand. Elsewhere, training of nurses, recruitment and retention remains problematic. Despite communicating the need to hire more nurses in the facility, the management has reiterated their commitment to the same albeit with no substantive success. There were simply no enough nurses to deal with the healthcare situation. On compensating nurses for overtime, the administration on its part has appeared dishonest, fueling distrust with the nursing staff. There has been no clear plan to pay nurses for additional work and any compensation of such nature has only been sporadic.

In the end, the conflict remains on course. Nurses demand to work for only eight hours as required in practice and get ample compensation for any extra hours of work. In addition, they demand that other nurses are employed to ease the burden they carry on a daily basis. It is unfortunate that within the struggle of meeting the excess workload in their hands, they also have to supervise and work with nursing students on placement from various Nursing Schools in Australia. In the past, the management has attempted to refer to placement nurses as the additional staff needed to ease shortage. In the view of the nursing staff, such was a callous suggestion that failed to acknowledge the additional burden imposed by learners. There is thus need to hire qualified registered nurses, offer proportionate compensation and apportion the working hours in a fair manner. The height of the conflict has been several strike notices within the institution, which have normally been prevented by a swift move towards dialogue. However, as it stands, the demands remain unmet and another strike may be on the horizon.

Theoretical Framework

The above case study shall be analyzed using the ability model of artificial intelligence. The model was updated by Mayer, Caruso & Salovey (2016) introducing a number of new postulates above the initial fundamental assertion that some individuals have higher ability to manage emotions than others. This model maintains the four facets earlier stated, from perception of emotions, use of emotions to facilitate thought, understanding emotions and managing them. However, there are additional ideas posted in each of the four abilities in the model. For instance, perceiving emotions entails identifying dishonest/deceptive emotions, expressing emotions accurately when desired, contextualizing emotions within occupation and culture, reading emotions in other people’s language, facial expression and verbal cues among others. On its part, using emotions to facilitate thought includes generating emotions that aid judgment and thought, coming up with emotions that help to understand the experiences of another person, selecting issues to address based on one’s emotional state and many others. Understanding emotions on the other hand includes among others understanding cultural differences and their relations in expression of emotions, differentiating moods from emotions, breaking down complex emotions, understanding the antecedents, causes and consequences of different emotions, labeling of emotions and apportioning their respective differences among other things. Managing emotion in the end entails using one’s own emotion to generate desired outcomes, leveraging on other’s emotions to get desired outcomes and engaging and disengaging with emotions depending on their usefulness among other abilities. Generally, the ability model highlights various actions that one should be able to do with respect to emotions.

Assessment

It is important to understand the different stakeholders in the impasse and their relative importance in order to picture how they could be engaged. There were nurses as the main stakeholders, making demands on pay, working conditions and recruitment of other nurses. The hospital administration beginning with the nurse managers were also important stakeholders as the complaints of the nurses were directed towards them. They were the ones to effect any changes if such was to be decided as the course of action. Also important were the territory, national and state governments that offer funding, policy and oversight to public health facilities in Australia. They were important for the long term implementation of nursing reform to ensure that there were enough nurses, compensation for practice was appropriate and the working conditions favorable. They also offered oversight over the hospital administration in the boiling conflict with the nursing staff. Not any less important were the patient population who caused lots of pressure on public healthcare resources, leading to the need to expand the healthcare resources to match the overwhelming demand. In accordance with Fig. 1 below, there was need to meet the interests of the nurses, show consideration to patients and recognize the role of key players like the government and the hospital administration in the resolution of the conflict.

Fig 1: Stakeholder Analysis

There was also need to review the broader scales of the issues leading to the emergence of the conflict. The shortage of nurses in the institution was not an isolated problem that could be entirely blamed on the management. According to Macri (2016), there was a worldwide crisis of nursing and other healthcare professionals with majority of the health systems around the globe unable to attain self-sufficiency. The reasons for a shortage of nurses are quite a number. First, the training of nurses is quite rigorous and demanding both intellectually and financially and as it is at the moment, there is yet to be adequate support that shall ensure a higher output of nurses. There are limited nursing educators and resources to train nurses leading to the shortage globally. Elsewhere, the pressure brought about by external forces of population health has been overwhelming for existing nursing resources. There is a growing population of the aged who have multiple health needs that the nursing workforce is unable to satisfy. In addition, the burden of chronic diseases has advanced the demand for critical and long term care. All these factors put together lead to overwhelming of the healthcare system and a heavy burden for the nursing workforce to carry. 

In seeking resolutions, it was important to consider the various provisions of the ability model of emotional intelligence (E1). The first stage would be to correctly perceive the emotions of each party embroiled in the dispute. Perception of emotion must entail discerning deceptive and genuine emotions from various cues as presented by stakeholders. As argued by Adolphs (2010), emotions have both sensory and motor features.  This makes it possible to read them and understand how the various stakeholders feel about the situation. It was apparent that the nurses were angry and dissatisfied with their work due to the long working hours, lack of proper compensation and excessive workload. Perceiving of emotions was needed to determine whether the hospital administration was truly empathetic towards the situation of nurses or were simply negligent and uncanny. More importantly, there was need to manage emotions in the entire situation. This was more so in relation to understanding our own emotions as nurses and how they can be leveraged for the desired outcome, better working conditions. It also entails the leveraging of emotions of the administration, the patient population and other stakeholders for the desired outcome. The management of emotions in this case shall be the route to solution as well as ensuring that medical errors do not suffice out of the situation. Such were likely to be costly for the patient population and needed to be avoided at all costs. Managing emotions in this case shall ensure that patient life is safeguarded even as the agitation for better working conditions ensues. The main conflict resolution styles that are emergent from an emotional intelligence approach are accommodating and compromising (Adolphs, 2010). Accommodating entails each parties yielding to the demands of the other out of acknowledgement of their feelings. Nurses can be accommodative of the challenges and shortcomings of the healthcare system as long term solutions are sought. In compromising, less than ideal solutions are accepted. This requires good bargaining skills and managing emotions at a personal level as well as those of others carefully to bring them into negotiations (Sportsman & Hamilton, 2007). Instead of giving ultimatums and irreducible minimums, the nurses can accept some less attractive solutions from the management in dealing with the scenario. For instance, they may accept to work for longer hours as long as they are compensated for additional time.

In the end, a project planning approach must be adopted in raising the issues affecting nurses in the institution. This involves being strategic and coming up with a clear list of issues, grievances and misdemeanors that need to be addressed (Codier & Codier, 2015). The nurses must be organized, not necessarily in the framework of unionization but rather in an ad hoc manner with respect to the specific conflict that was ensuing. In this case, the nurses shall have a unified voice and raise their issues as a block with unitary leadership. The leadership shall engage the hospital administration, government agencies and other stakeholders in the issues facing them and together seek solutions. There is need to therefore build collaborative networks and a team climate among the nurses for them to clearly articulate their issues and gain the attention of the various stakeholders. The collation of issues and collaborative effort will also help to establish clear communication channels with all stakeholders (Codier & Codier, 2015). The present fragmentation and distrust may be due to lack of proper communication between the hospital administration and the nursing workforce. Therefore, organizing the issues and teaming up as nurses under a single leader can be of great use as they advocate for better working conditions. The main conflict resolution mechanism that shall emerge from a project planning approach is collaboration between different stakeholders in addressing the problems facing the nurses. Collaboration involves high levels of communication and consultation between parties in seeking resolutions to the challenges both on the short term and the long term (Sportsman & Hamilton, 2007). Without proper organization and leadership as suggested, it would be impossible to engage each other constructively and resolve the ensuing conflict.

Implications on Client Safety and Fostering a Team Climate

The ensuing conflict has several implications on client safety. From an emotional perspective, negative valence is likely to increase the incidence of medical errors and absence of care. As Codier & Codier (2015) note, a large amount of morbidity and mortality in the healthcare system is caused by medical errors that undermine patient safety. These errors may arise from institutional failures, human and administrative lapses and so forth. However, it is apparent that in the presence of negative valence as in the case scenario, the likelihood of errors increases. Nurses are overworked and de-motivated by lack of due compensation, which undermines their focus and efficiency. They also lack commitment due to the loss of intrinsic motivation and therefore perform poorly with a possibility of many errors. The nurses may also withdraw care completely exposing patients to a wide range of medical problems. This underlines the need for understanding and managing emotions in the situation in order to guarantee patient safety. For instance, if the conflict was to culminate into a strike, lots of patients in the wards requiring urgent and critical care would be in jeopardy. There will not only be problems due to medical errors but also lack of care. 

On a positive note, the situation facing the nurses may help them cohere and work as a team to both advocate for their rights as well as operate in the extremely wanting conditions. First, the problems facing them from payment to overwhelming workloads can only gain the interest of stakeholders if they are raised in a unified voice. Thus, the workforce will be forced to work together in order to draw the attention of the government and the hospital administration towards their challenges (Adolphs, 2010). They need to be a team in order to point out their issues clearly and build a strong case for change. The current situation requires them to be advocates in the healthcare environment which can only be achieved through a system of working together. On the other hand, it must be noted that the current situation calls for a team effort if the minimum level of service is to be rendered. This is because resources are scare and need to be shared, collaboration is needed in offering care in the absence of enough personnel among other factors. Therefore, there shall be a team climate automatically created by the need to overcome the challenges posed by long working hours, huge workloads and lack of proportionate compensation.

Proposed Solution & Evaluation

To bring the problems faced in the healthcare setting to an end, there is need for advocacy by the nursing workforce. Advocacy in this case covers both aspects of the profession as well as the specific healthcare setting. Notably, the issues of scanty nursing workforce are global and deeply entrenched systemically beginning with the training of nurses and the lack of enough nursing educators (Hall, 2015). Therefore, addressing such issues requires a systematic approach that brings together all the stakeholders and seeks sustainable solutions. In addressing the compensatory issues, the same systemic pattern emerges, with the financing of healthcare in public hospitals fragmented between state, territory and national governments. Therefore, there is yet again need to build stakeholder support in seeking solutions due to their multifaceted nature. This means that the advocacy efforts must be well planned and directed in a purposeful manner. Strategies of advocacy to be used include raising the issues through seminars, forums and inter-stakeholder group meetings as well as impromptu engagements with the management. The nurses must come together under a single leader, deliberate on the issues affecting them and engage in advocacy.  

From the outset, the above solution represents the best practice of emotional intelligence. It involves perceiving and understanding the emotions of each other as affected nurses, the emotions of the management as those supposed to offer reactionary solutions as well as the emotions of the patient population who urgently need care. By coming up with inter-stakeholder consultations, there is emotion management on the part of the nurses as well as the managers in order to come up with a fitting bipartisan solution. The decision to form a unified voice, with a clear leader and a purposeful engagement is tantamount to proper emotional management that takes into account the needs of the patients as well as other stakeholders. In the end, the success of the advocacy efforts shall also rely on the emotional intelligence of all parties in the midst of the engagements as given in the ability model.

Conclusion

The case study presented in this paper precipitates the various facets of conflict resolution at the workplace as well as how emotional intelligence models can be applied appropriately in remedial. The ability model of emotional intelligence offers a good basis for finding solutions albeit a project management approach is also needed to bring order, purpose, leadership and a team climate in seeking solutions. It was apparent that advocacy was the way to going the scenario, though it could not be achieved without the nurses coming together and systematically engaging the stakeholders of the issue. The case shows a prima facie case of employing social and emotional competence at the workplace. 

References

Adolphs, R. (2010). Emotion. Current Biology, 20(13), R549-R552.

Codier, E., & Codier, D. (2015). A model for the role of emotional intelligence in patient safety. Asia-Pacific journal of oncology nursing, 2(2), 112.

Hall, J. (2015). Australian health care—The challenge of reform in a fragmented system. New England Journal of Medicine, 373(6), 493-497. 

Macri, J. (2016). Australia’s Health System: Some Issues and Challenges. Journal of Health & Medical Economics.

Mayer, J. D., Caruso, D. R., & Salovey, P. (2016). The ability model of emotional intelligence: Principles and updates. Emotion Review, 8(4), 290-300.

Sportsman, S., & Hamilton, P. (2007). Conflict management styles in the health professions. Journal of professional nursing, 23(3), 157-166.