The nurse manager support process in the work-family conflict of clinical nurses: a qualitative study

Background

Nurses are exposed to work-family conflict because of the high expectations associated with the workplace and family demands. Nurse managers' support for work-family conflict requires theoretical principles.

Aims

The current study explores managers' experiences of work-life conflict and how they manage this.

Methods

Grounded theory is used to explain the theoretical principles of nursing managers' support to clinical nurses. Participants included 20 managers and 2 clinical nurses working in one hospital. The data collection method used unstructured interviews. Sampling was first purposive and then theoretical, and data analysis was carried out using Corbin and Strauss's approach.

Results

Participants' primary concern was the threat to their organisational position, and they used a functional-exchangeable conservation strategy to consolidate their own positions. The strategy resulted in the consolidation of managers' and nurses' positions. Two factors were identified as influencing nurse managers' strategies, namely 'the sense of insecurity in the functional position' with a deterrent effect, and 'cooperative atmosphere' as a facilitator with a positive effect.

Conclusion

The most important supportive strategy used by nurse managers in the work-family conflict of clinical nurses was based on 'functional-exchangeable conservation' between themselves and the nursing staff. Functional- exchangeable protection is a type of protection of human resources by the manager. In this exchange, to solve the conflict between work and family for the nurse, the nursing manager wants to maintain their managerial position by solving the nurse's problem. Both of them benefit from this exchange. The theory of functional-exchangeable protection may provide the necessary background for the development of a prescriptive theory to minimise nurses' worries about family matters. Flexible work schedules may help nurses resolve work-family conflict and so provide better care and reduce work errors. The concept of functional-exchangeable protection and its subclasses may be helpful in preparing policies to support clinical nurses through implementing flexible work schedules, increasing nurses' motivation and fulfilling the family role of nurses.

The relationship between nurse managers' personality traits and their conflict management strategy preferences

AIM

To investigate the relationship between nurse managers' personality traits and conflict management strategies.

BACKGROUND

Despite the important role of personality traits in conflict management strategy preferences, no study to date has addressed the relationship between personality traits and conflict management in nurse managers.

METHODS

A descriptive and cross-sectional design was applied. The study sample consisted of 114 nurse managers from six hospitals, and 111 participants completed forms for a total response rate of 97.36%.

RESULTS

The main findings revealed that the conflict management strategies used by nurse managers participating were as follows: integrating (39.21, range = 29-45), avoiding (38.39, range = 23-65), compromising (31.51, range = 24-40), dominating (20.05, range = 12-28 ) and obliging (19.42, range = 14-25). It was seen that managers whose personality traits were extraverted, agreeable or conscientious chose the integration strategy to manage conflict, whereas managers with emotional inconsistency in personality traits preferred the avoiding strategy.

CONCLUSIONS

Nurse managers are important to effectively managing conflicts in the clinical environment. Personality trait may be linked to the successful management of conflict.

IMPLICATIONS FOR NURSING MANAGEMENT

Revealing the relationship between nurse managers' personality traits and associated conflict management strategies can help senior management organise useful training programmes to improve the conflict management capabilities.

Exploring biopsychosocial correlates of pain, pain management strategies, and risk for opioid misuse among home care workers in Washington State

Home care workers (HCWs) are at high risk for musculoskeletal pain and injury, and they are an important population for pain management research and intervention. The purpose of this study was to gather novel data on HCWs' work characteristics, pain experiences, pain management strategies, and risk for opioid misuse. A survey invitation was e-mailed to a random sub-sample of HCWs in Washington State, and 421 responded. Over half (54.2%) reported chronic or currently elevated pain. Pharmacological pain management strategies were used by 67.3% of all respondents with 4.8% reporting prescription opioid use. Biopsychosocial factors like injuries, interpersonal conflict, financial strain, and anxiety were associated with increased opioid misuse risk. Multimodal primary and secondary interventions are recommended to improve HCWs' pain management.

Is Commitment to One’s Profession Always a Good Thing? Exploring the Moderating Role of Occupational Commitment in the Association Between Work Events and Occupational Health

Using a 12-week experience sampling design, this study examined the interaction between negative and positive events in predicting work engagement and burnout in a sample of nurses. Additionally, this study explored the moderating effect of affective occupational commitment as a moderator of work events and work engagement/burnout relation. Results indicated that positive and negative events, as well as their interactive effects significantly predicted both work engagement and burnout. In addition, occupational commitment moderated the association between negative events and burnout. Specifically, the association between negative events and burnout was stronger for nurses who reported high occupational commitment. Positive events did not interact with occupational commitment to predict work engagement or burnout. Similarly, occupational commitment did not moderate the link between negative events and work engagement. Implications for research and practice are discussed.

Breaking the health-care workplace conflict perpetuation cycle

Purpose

The purpose of this study is to describe and interpret the interpersonal and intragroup conflict experiences of staff-level employees and leaders in the medical imaging technology field, working in US tertiary care centers to extract mitigation and management strategies.

Design/methodology/approach

A total of 13 medical imaging technologists, who were employed in leadership and staff positions throughout the USA, offered their in-depth accounts of workplace conflict in this interpretive phenomenological investigation.

Findings

Conflict avoidance was a predominant conflict management style. This style did little to effectively manage workplace conflict. In some cases, it led to deleterious effects on individuals and organizations and created conflict perpetuation. With proper conflict mitigation and management, the conflict perpetuation cycle can be broken.

Research limitations/implications

Generalization beyond the group being studied is not applicable, as it is not the intent of phenomenological research. Four leaders participated in the research study. To examine this population more completely, a greater sample size is required. This recommendation also applies to the staff technologist roles. Another limitation involved the leader/staff-level representation inequality, as well as the male–female representation. These imbalances made it difficult to effectively make comparisons of the experiences of leaders with staff-level technologists, and males with females.

Practical implications

Offering the medical imaging workforce emotional intelligence training, health-care administrators can invest in their leaders and staff technologists. Medical imaging schools can incorporate emotional intelligence training into their curricula. Clear policies may decrease the ill effects of change when unforeseeable occurrences result in schedule modifications. Making technologists fully aware of who is responsible for shift coverage when these events occur may reduce negative impact. Trainings in organizational change, collaboration or positivity may be warranted, depending on findings of cultural assessments. Team-building events and opportunities for employees to intermingle may also be used to improve a departmental or organizational culture.

Social implications

Mitigating and managing health-care workplace conflict more effectively may prevent patient harm, thus improving the health of members of society.

Originality/value

According to recent studies, conflict, and the incivility that often accompanies it, has been on the increase in US organizations overall, and in health care specifically. Conflict that perpetuates can adversely affect health-care organizations and its employees. This paper offers mitigation and management strategies to prevent such consequences.

Learning About Conflict and Conflict Management Through Drama in Nursing Education

BACKGROUND

In the health care settings in which nurses work, involvement in some form of conflict is inevitable. The ability to manage conflicts is therefore necessary for nursing students to learn during their education.

METHOD

A qualitative analysis of 43 written group assignments was undertaken using a content analysis approach.

RESULTS

Three main categories emerged in the analysis-to approach and integrate with the theoretical content, to step back and get an overview, and to concretize and practice-together with the overall theme, to learn by oscillating between closeness and distance.

CONCLUSION

Learning about conflict and conflict management through drama enables nursing students to form new knowledge by oscillating between closeness and distance, to engage in both the fictional world and the real world at the same time. This helps students to form a personal understanding of theoretical concepts and a readiness about how to manage future conflicts. [J Nurs Educ. 2018;57(4):209-216.].

The Reciprocal Effect of Psychosocial Aspects on Nurses' Working Conditions

Objectives: Psychosocial work risks are most often considered in the context of occupational stress. The aim of this article is to evaluate the correlations between different aspects of nurses' psychosocial working conditions.

Materials and Methods: The study was conducted using the questionnaire: Psychosocial aspects of work. A total of 789 nurses working in inpatient health care facilities in Bialystok were included in the study. Correlation analysis was performed by determining Spearman's correlation coefficient.

Results: Correlations between the primary scales, such as job demands, control, social support, well-being, and expectations of changes, were evaluated. The weakest correlation was shown between the assessment of job demands and other work aspects. The strongest correlation was found between the ability to control and social support. Perception of the need for changes was influenced by the assessment of job demands, components of the control scale and, most of all, the scale of social support. A strong correlation was found between physical and psychological well-being and support from superiors and coworkers.

Conclusions:

The state of well-being had no effects on nurses' assessment of the demands they were faced with. Nurses' well-being depended only on social support provided by their superiors and colleagues, the sense of being able to have an effect on the performed work, minimal conflicts, and absence of overload.

Management should enable adequate working conditions in order to ensure nurses' physical and psychological well-being, as both these aspects were closely correlated.

Poor social support, lack of a sense of control over one's work, conflicts, and work overload were factors that promoted nurses' expectations of changes.

Nursing and pharmacy students' use of emotionally intelligent behaviours to manage challenging interpersonal situations with staff during clinical placement: A qualitative study

AIMS AND OBJECTIVES

To identify challenging interpersonal interactions experienced by nursing and pharmacy students during clinical placement, and strategies used to manage those situations.

BACKGROUND

Healthcare students and staff experience elevated stress when exposed to dynamic clinical environments, complex care and challenging professional relationships. Emotionally intelligent behaviours are associated with appropriate recognition and management of emotions evoked by stressful experiences and development of effective relationships. Nursing and pharmacy students' use of emotionally intelligent behaviours to manage challenging interpersonal situations is not well known.

DESIGN

A qualitative design, using semi-structured interviews to explore experiences of challenging interpersonal situations during clinical placement (Phase two of a larger mixed-methods study). Final-year Australian university nursing and pharmacy students (n = 20) were purposefully recruited using a range of Emotional Intelligence scores (derived in Phase one), measured using the GENOS Emotional intelligence Inventory (concise version).

RESULTS

Challenging interpersonal situations involving student-staff and intrastaff conflict, discourteous behaviour and criticism occurred during clinical placement. Students used personal and relational strategies, incorporating emotionally intelligent behaviours, to manage these encounters. Strategies included reflecting and reframing, being calm, controlling discomfort and expressing emotions appropriately.

CONCLUSIONS

Emotionally intelligent behaviours are effective to manage stressful interpersonal interactions. Methods for strengthening these behaviours should be integrated into education of nursing and pharmacy students and qualified professionals. Education within the clinical/workplace environment can incorporate key interpersonal skills of collaboration, social interaction and reflection, while also attending to sociocultural contexts of the healthcare setting.

RELEVANCE TO CLINICAL PRACTICE

Students and staff are frequently exposed to stressful clinical environments and challenging interpersonal encounters within healthcare settings. Use of emotionally intelligent behaviours to recognise and effectively manage these encounters may contribute to greater stress tolerance and enhanced professional relationships. Nursing and pharmacy students, and their qualified counterparts, need to be educated to strengthen their emotional intelligence skills.

Grin and Bear It?: Employees' Use of Surface Acting During Co-worker Conflict

Using survey data from 459 employed individuals, the conditional indirect effects of three types of interpersonal conflict at work on strains and performance through surface acting were tested. Results indicated that task, relationship and non-task organizational conflict were positively related to depressive and physical symptoms and negatively related to performance. Task conflict had a significantly weaker association with employee outcomes than either relationship or non-task organizational conflict. Surface acting negatively related to all types of conflict, although it had a weaker association with relationship conflict than task or non-task organizational conflict. Support was found for moderated mediation relationships whereby surface acting mediated the associations between all types of conflict with depressive symptoms, as well as the association between relationship and non-task organizational conflict with physical symptoms, when conflict was infrequent. Surface acting also mediated the associations between all types of conflict and performance when conflict was frequent. Future research directions are discussed that can advance our theoretical understanding of how emotional labour and interpersonal conflict interact to affect employees, as well as further our ability to improve employee well-being and organizational functioning. Copyright © 2016 John Wiley & Sons, Ltd.

Safety and Health Support for Home Care Workers: The COMPASS Randomized Controlled Trial

OBJECTIVES

To determine the effectiveness of the COMmunity of Practice And Safety Support (COMPASS) Total Worker Health intervention for home care workers.

METHODS

We randomized 16 clusters of workers (n = 149) to intervention or usual-practice control conditions. The 12-month intervention was scripted and peer-led, and involved education on safety, health, and well-being; goal setting and self-monitoring; and structured social support. We collected measures at baseline, 6 months, and 12 months, which included workers' experienced community of practice (i.e., people engaged in a common activity who interact regularly for shared learning and improvement). Implementation occurred during 2013 and 2014 in Oregon.

RESULTS

In an intent-to-treat analysis, relative to control, the intervention produced significant and sustained improvements in workers' experienced community of practice. Additional significant improvements included the use of ergonomic tools or techniques for physical work, safety communication with consumer-employers, hazard correction in homes, fruit and vegetable consumption, lost work days because of injury, high-density lipoprotein cholesterol, and grip strength. Consumer-employers' reports of caregiver safety behaviors also significantly improved.

CONCLUSIONS

COMPASS was effective for improving home care workers' social resources and simultaneously impacted both safety and health factors.

The COMPASS pilot study: a total worker Health™ intervention for home care workers

OBJECTIVE

To develop a team-based Total Worker Health™ (injury prevention + health promotion) intervention for home care workers and estimate intervention effects on workers' well-being and health and safety behaviors.

METHODS

Home care workers (n = 16) met monthly in teams for education and social support using a scripted, peer-led approach. Meeting process measures and pre-/postintervention outcome measures were collected.

RESULTS

Knowledge gains averaged 18.7% (standard deviation = 0.04), and 62.0% (standard deviation = 0.13) of participants reported making safety or health changes between meetings. Workers' well-being improved significantly (life satisfaction, d = 0.65, P < 0.05; negative affect, d = 0.64, P < 0.05), and the majority of other safety and health outcomes changed in expected directions.

CONCLUSIONS

COMPASS is a feasible intervention model for simultaneously preventing injuries and promoting health among home care workers.

The COMmunity of Practice And Safety Support (COMPASS) Total Worker Health™ study among home care workers: study protocol for a randomized controlled trial

BACKGROUND

Home care workers are a high-risk group for injury and illness. Their unique work structure presents challenges to delivering a program to enhance their health and safety. No randomized controlled trials have assessed the impact of a Total Worker Health™ program designed for their needs.

METHODS/DESIGN

The COMPASS (COMmunity of Practice And Safety Support) study is a cluster randomized trial being implemented among Oregon's unionized home care workers. Partnering with the Oregon Home Care Commission allowed recruiting 10 pairs of home care worker groups with 8 participants per group (n = 160) for balanced randomization of groups to intervention and control conditions. Physiologic and survey evaluation of all participants will be at enrollment, 6 months and 12 months. Primary outcomes are to increase health promoting (for example, healthy nutrition and regular physical activity) and health protecting (that is, safety) behaviors. In addition to assessing outcomes adjusted for the hierarchical design, mediation analyses will be used to deconstruct and confirm the program's theoretical underpinnings and intervention processes. Intervention groups will participate in a series of monthly 2-hour meetings designed as ritualized, scripted peer-led sessions to increase knowledge, practice skills and build support for healthy actions. Self-monitoring and individual and team level goals are included to augment change. Because generalizability, reach and achieving dissemination are priorities, following initial wave findings, a second wave of COMPASS groups will be recruited and enrolled with tailoring of the program to align with existing Home Care Commission educational offerings. Outcomes, process and mediation of those tailored groups will be compared with the original wave's findings.

DISCUSSION

The COMPASS trial will assess a novel program to enhance the safety and health of a vulnerable, rapidly expanding group of isolated caregivers, whose critical work allows independent living of frail seniors and the disabled.

TRIAL REGISTRATION

ClinicalTrials.gov identifier: NCT02113371, first registered 11 March 2014.