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Reflective Journal on a Conflict Issue of Registered Nurse

SNPG902 School of Nursing

Task Description 

Select incidents from the present or the past and ‘journal’ these incidents fully in a diary. You may journal one (1) important incident that has made an impact on you personally, or you may journal an ongoing process at work as it unfolds. Analysis of Journal The analysis of the journal involves identifying the major and minor themes that can be identified within the journal. For example, you may identify a personality clash as a major theme and then identify anger and anxiety as minor themes. Reflection The journal is a record of your reflections. As such it should include your thoughts on the incidents, your feelings and your insights through the analysis of the incidents. Linking to Theory When the themes have been uncovered and you have discussed these in relation to your thoughts and feelings you should try to locate these themes in the literature of theorists – publications from texts and journals. Does the theoretical information support your feelings about the incidents? Suggestion The Journal ideally should be formatted at the beginning of the semester and then make your entries each week. Your entries should include incidents you have encountered that have good, neutral or bad outcomes together with a critical discussion of the entry. Each student will design their own Management Journal. The student is expected to record evidence of their learning. This evidence may include critical management incidents, a brief case study, research of a particular practice issue, meaning of new management techniques, and/or professional development. The evidence provided by the student within this section should be that they have implemented a critical thinking approach to their nursing management, and can demonstrate their decision making (recognising and defining a problem, gathering relevant information, generating possible conclusions, testing possible conclusions, and reaching appropriate decisions). The student should reflect upon their experience within this study management theory and practice, and provide a statement in regard to what personal attributes they have gained during study. A reference list shall be submitted at the end of the Management Journal.

Answer

The reflective journal centres around my own experience at work. Being a healthcare worker in a nursing home, I have been facing a conflict situation in my workplace that has been bothering me on a personal level. The conflict situation has been ongoing for the past three weeks and has been mostly due to a personality clash with one of my co-workers. As a result of this, I have been occasionally feeling angry and anxious, which is affecting my daily work schedule and productivity. However, from a personal point of view, I feel that this issue could have been easily avoided with some intervention of our nursing management and good situational leadership qualities from my part. The details of the conflict issue over the past three weeks have been jotted down as individual weekly entries in my diary for further analysis and personal insight on the incidents.

Journal Entries

As a registered nurse in a local nursing home, it is the duty of my team to provide health and social care to the people and patients who visit our nursing home for personal medical care and treatment. I am in charge of my team of six members, and as their head, I guide my other staff members provide the appropriate care to the patients. However, recently, after one of my staff members shifted to another city, her job was vacant and replaced by a migrant healthcare worker from China. The nursing management of our organization appointed her on my team so that I can train her on the basic duties and protocols we follow in our nursing home. However, this team member, being from a completely different cultural background, speaks very little English, and communication has been a significant problem from the very first day. Not only me, but my other team members are also unable to interact and communicate with her properly, and this has made them frustrated about the situation.

Here I used Rolfe’s model of reflection focused on three elements “what’, ‘So what’ and ‘Now what’. Here, in the initial stage the practitioner reflects upon the issues and experiences while describing the situation. In the second phase the focus is on building the theory and knowledge where practitioner gets an opportunity to learn from the experiences. Third phase is related to reflection of practitioner on actions considered and identifying the route to improve the situation while final stage is reflected upon the noteworthy contribution to practice (Rolfe, Freshwater & Jasper, 2001, 2010). The reflection model guides me through the process of self-awareness and development in a particular situation making it possible to identify the consequences of my actions and steps required to facilitation of personal and professional growth. 

16th April 2019:The new employee, Cho, is from China and speaks very little English, which makes conversation with her very difficult. My other five team members and I have been facing an issue to talk with her and discuss our medical treatment plans for our patients. As we all work as a team, we make specific plans for each of our patients based on their illness and requirements. Communication is essential among the health workers as everybody should have shared knowledge about the health progress of our patient and also take shifts on giving them medicines and other treatments. At the end of every day, each member report me on their daily work and how much the progress is made on the patient’s health. However, due to the language barrier, we were unable to get any proper details from our new team member, Cho and even she was unable to follow our daily routine properly.

Further, a new conflict situation arrived when Cho was losing motivation due to lack of communication and was lagging behind her prescribed duty. This made the other team members compensate for her work and work extra hours at the nursing home. As their in-charge, it was my duty to guide them swiftly on the healthcare processes, and even I was struggling to manage the team and distribute the work equally for everyone. The other team members getting frustrated by this reported me on the progress, and I was informed that some of our patients were not getting the right treatment and care due to the lack of work from Cho. As their team leader, I had to come up with a time management solution so that each of our patients can get the necessary care they deserve. 

23 April 2019: In the third week, the major conflict was created when a new patient was appointed to us by the nursing management and special intensive care was necessary for him. As per our nursing guidelines, we must never be emotionally attached to our patients as that might hamper the prescribed treatment. The new patient was suffering from an allergic reaction, and we were informed by the doctor to provide him with a specific diet plan accompanied by medicines that would help him get better. However, due to a different cultural background, Cho was very much emotionally attached with the patient, and despite being told to strictly follow the diet plan, Cho was offering the patient foods that might be harmful to him. As the patient was suffering from a severe allergic reaction, he was in a lot of pain and asked Cho to provide some prohibited delicious food to ease her pain. Instead of following the prescribed plan, Cho felt bad for the patient and gave him food outside of the diet plan. This made me immensely frustrated and irritated at the same time, and Cho and I were having a conflict situation due to our difference in viewpoint on how the patient should be treated. Despite my repeated warnings, Cho kept on giving the food to the patient outside the planned diet chart. I had to take the issue to the nursing management of our organization for further intervention of higher authority for handling the situation.

When I approached the nursing management, I was suggested that as Cho is my team member, I should be the one to deal with her, and they would not intervene in this situation. I was further informed that as their team leader, I should develop personal leadership skills more so that I can organize and manage my team and get the job done. As their team leader, I was willing to motivate my team members and also guide Cho on our protocols that we follow in our organization. However, due to the language barrier, I was not able to get to her, and this further increased my anxiety, as I was unable to mitigate the situation.

30 April 2019: In the third week, situations took a new turn as one of my team members got in a situation of disagreement with Cho. As the two were arguing about their shifts for taking care of a patient, I had to step in to handle the situation. Although I was able to clam down my other team member, I was unable to handle Cho who kept on saying things in her native language and unable to interpret them I was frustrated. Later, when she finally calmed down, I talked to her and convinced her to adjust her time slot so that all our team members had equal job schedule. However, Cho replied that she is unwilling to compromise for her, and I had to remind her they did the same for her when she first joined our team. Despite this effort, Cho was unwilling to compromise and clearly stated that she would not rearrange her working schedule. I also stated that it is in the best interest of the team, patient and organization if we work collaboratively towards a common goal, which is the welfare of our patients. Despite repeated attempts, when I was unable to convince her, I was fiercely angered and thought of complaining to the organization management to shift Cho to some other team under other registered nurses who would able to handle her. 

Then, the organization management asked me whether the organization needs any new management techniques or professional development that would help to handle such situations. I was also given full authority to identify and analyse any personal changes in the health care settings and also ways to respond to those changes. Even changing the management goals would be a viable option if it would help to handle such a conflict situation in the future.

Reflective Analysis of Journal

I have developed a reflective analysis of the incidents of the three weeks to provide my feelings and insights on them. The major and minor themes of the journal entries have also been discussed for further analysis and link them with theoretical evidence.

Week 1:As it is evident from the incidents of the first week, the multi-cultural work environment is quite common in the health care sector, and it is the duty of the team leader to manage all his team members who might belong from the different cultural background. People from different countries value different things and prioritize the various aspects of works based on their bringing up. Although language barrier is a major issue, instead of getting irritated and frustrated about it, the leader should always try to motivate his team to work collaboratively and work in harmony for a higher productive output (Callara, 2008).

Further, it is evident from the journal entry that due to lack of interaction and communication between Cho and the other team members, Cho was slowly losing motivation to work and this impacted the care process for the patients. In the health care sector, workers must always feel motivated to work to provide the best treatment and care for the patients. As a leader, I should have stepped in and used better leadership skills to encourage my other team members to support Cho in spite of the language barrier and also keep Cho motivated by giving some motivational speech and encourage her by constant support till she gets accustomed to the ways and processes of our organization. 

Week 2: In the second week, when the major conflict situation occurred, as a team leader I should have kept my cool on the way I handled Cho for offering food outside the prescribed plan to our patient. Instead of complaining about Cho to our organization management, I should have been more respectful to the different cultures and had to understand that some people are more sensitive and compassionate to other people suffering from the ailment. Although it is best not to get attached emotionally with our patients, however, when Cho was doing the same due to different cultural background, instead of getting angry and frustrated about it, I should have personally talked to her in private on how we handle our patients here and how that helps to provide the best care for them. This would have also built a strong between us and I would have been able to convince her why it is necessary to work in collaboration with the other team members and how to treat patients for a more productive and efficient outcome.

Also, when I was asked by the organization management to handle and manage my team, instead of getting angry and frustrated, I should have stepped in as a true leader and develop my leadership skills to get a better hold of the entire situation. Also, I should have focused more on my communication, negotiation and convincing skills to either convince the management to shift Cho to a different team or should have directly communicated with Cho on a personal level so that she is willing to comply by the rules and work as a team. 

Week 3: In the third week, the incidents are more focused on my conflict resolution skill as a leader and also time management skills to help my team organize our work schedule. As a part of the team, all members should help out others when needed and compromise and readjust their working schedule as required by the other members. By implementing a proper time management schedule, I could have organized the working schedule of my team members and also stepped in as soon as the conflict took place between Cho and my other team member. Workplace conflict is never good, especially in the healthcare sector as it would impact the quality of medical care received by the patients and also deteriorate the capabilities of my team members.

In the final week regarding the incidents, as I was asked by the organization management to make all the necessary management changes and goals that would help to avoid such a situation in the future, I should implement a positive and optimistic approach in the workplace to help team members work in harmony in a positive work environment. Also, we need to implement certain multi-cultural work ethics in our organization to deal with people from different cultural background and also help and support them get accustomed to their new surroundings and work policies for the better quality of work and high productive outcome (Shin and Zhou, 2003).

Literature Review

In this section, some of the literary theories have been discussed in support of the reflective analysis of the journal entries. This literature of theorists from the publication of texts and journals further helps to evaluate and analyse my role as a team leader, team management, time management and motivational concepts for the benefit of the team members.

Of the various leadership theories related to management in the workplace, the ideal theory for the healthcare sector is the transformational leadership style. According to this leadership theory, as stated in Dugan (2017), a transformational leader must always empower his employees on finding their internal motivation and succeed at what they do. As mentioned by Antonakis& Day, (2017), acting as not a micro-manager of the team, and working more like a team member and a part of the community, this helps leaders to encourage their team members to transcend their self-interests and join in the collective goal of the organization which to provide medical care to patients in this context. A transformational leader is also effective in developing new ideas for the company and maintain a positive work culture and employees love working in such an environment. According to Cherry & Jacob, (2016), with a good transformational leader, they appeal to the employees as they follow his ideals, values and morals in the workplace, essential in the health care sector. This theory of leadership is extremely helpful in the incidents of the first and third week where my transformational leadership skills would be useful in managing my team members and communicate better with Cho. As stated by Urden, Stacy & Lough, (2017), this is useful in resolving the conflict situation in the third week and make transformational changes in the organization management for future development and growth. This leadership theory can be further enhanced with behavioural theories of leaders and based on the type of situation, autocratic leadership, democratic leadership and Laissez-faire leadership can be implemented (Reynolds and Vince, 2004).

There are multiple journal sources on the management theories and concepts at the workplace. Although all management theories revolve around similar concepts, leaders and managers need to handle people, processes and information based on the situation and necessity. It has been discussed in Rosenberg Hansen & Ferlie, (2016), management theories can be broadly classified into classical management theory, behavioural management theory and modern management theory. The classical management theory is focused on the execution of tasks and maximum production output from the employees. According to Berry, Broadbent & Otley, (2016), the behavioural management theory treats the workplace as a social environment and focuses mostly on the human elements. The modern management theories are based on the previous two theories while also utilising scientific methods and systems thinking. As stated by Hochet al., (2018), all these three types of management theories can be used in the healthcare sector based on the requirements and the incidents that occurred. Behavioural management theory can be applied for week 1 and week 2 to understand the multi-cultural ethics in the workplace and cultural background of Cho and help her get used to the new work environment. Modern management theory can be used for week 3 to establish new changes in the management for avoiding future situations and conflicts (Vince, 2002).

Apart from this, Maslow’s hierarchy of needs theory can be used for the incidents of the second week where motivating Cho and the other team members is essential for bringing out the maximum potential from them and also keep them focused on the goals of the organization that is serving the patients. According to Fallatah& Syed, (2018), Maslow's hierarchy of need consists of a pyramid that helps to understand and meet the needs of the employees. The bottom level of the pyramid consists of the basic needs with safety and belongings in the second and third level. This theory is exceptionally helpful in handling the certain sensitive situation in the workplace and helps to tie together a team for working collaboratively towards a common goal (Yukl, 2009).

Suggestions

A proper evaluation and analysis of the incidents of the three weeks clearly reveal the problems with Cho and other additional problems in the workplace of the health care sector. As a team leader, I should have clearly consulted the various leadership and management theories for a better understanding of the situation and handling them with minimal effort and maximum output. Maintaining multicultural workplace ethics in the organization would have helped to deal with Cho in a much swifter manner and deal with her problems due to her cultural differences than the rest of us. Also, maintaining a motivational leadership skill is useful to resolve a conflict situation between the team members and manage them with a positive attitude. Developing more personal leadership skill and also changing the organizational management rules is essential for avoiding future incidents of a similar kind. Conflict among team members is never good in the healthcare sector and might have a negative outcome and impact on the patients. However, Cho's emotional bonding with the patients can also have some positive impacts as well, however, instead of conflicting with the prescribed plans, this can be utilised in other areas like a patient feeling depressed and helping him relax and feel happy can be done only by connecting with him on a personal level. As a leader, it is my duty to check the process of interaction between my team members and patients and also among themselves to gain the maximum productive output.

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