The leadership approach adopted by nurses significantly influences the quality of care and patient outcomes

The leadership approach adopted by nurses significantly influences the quality of care and patient outcomes

The leadership approach adopted by nurses significantly influences the quality of care and patient outcomes. Conflicts often arise in healthcare organizations due to interactions with people from diverse backgrounds. In nursing practice, the major types of conflict include intrapersonal, interpersonal, intragroup, intergroup, and disruptive (Dahshan & Moussa, 2019; Higazee, 2015). Intrapersonal conflicts arise when nurses are assigned tasks that are not commensurate with their expertise. For this reason, they may feel inept to handle the task and subsequently consider leaving the job. Interpersonal conflicts may be triggered by miscommunication between nurse and other healthcare personnel, differences in attitude, an unclear chain of authority, diversity of perception, a chaotic work environment, wrongful assignment of tasks, and various interactions at work (El- Dahshan & Moussa, 2019). Notably, more than 60% of the nurse population currently working in Saudi Arabia comprises expatriates (Alshammari & Dayrit, 2017). Foreign nurses’ minimal understanding of the local culture can trigger interpersonal conflicts with Saudi-born healthcare personnel and patients. The study by Alshammari and Dayrit (2017) among Saudi hospitals revealed the existence of intragroup disagreements between nurses and other healthcare professionals, especially physicians. Therefore, intrapersonal and interpersonal conflicts have the potential to undermine nursing practice.

By contrast, intragroup conflicts arise due to rivalry over opportunities for growth and development, selective abuse by leaders, and the lack of professional support. Low motivation among nurses results in reduced quality of patient care and outcomes. Intergroup conflicts are associated with different goals and opinions among groups (Higazee, 2015). Group relations are vital in realizing the vision of an organization. However, competition between groups impacts the decision-making process, thus undermining the quality of patient care. Lastly, disruptive or inter-professional conflicts arise due to differences between nurses and physicians. As noted by El- Dahshan and Moussa (2019), the scope of practice and role accountability are primarily responsible for disruptive conflicts. Reduced confidence among nurses arising from disruptive disputes hampers the quality of patient care and outcomes. Addressing varied types of conflicts in nursing contexts is crucial in enhancing healthcare delivery.

Nurses also experience various levels of conflict in their practice. In a study conducted among nurses working in private and public hospitals in Amman, Jordan, Higazee (2015) identified three levels of conflicts: low, moderate, and high. 37.5% of the participants experienced moderate-level conflicts, 19% low-level, and 54.2% high-level conflict as measured using the nursing conflict scale (NCS). In a recent study, Dahshan and Moussa (2019) compared the levels and types of conflicts experienced by nurses in Saudi Arabia and Egypt. Saudi nurses reported moderate to low levels of conflict while their Egyptian counterparts experienced moderate to high levels of conflict (Dahshan and Moussa (2019). These findings underscore the need for Saudi nurse heads to devise efficient strategies for resolving disputes to minimize disagreements and to foster a productive workplace for improved nursing care.

Leadership style influences the management of conflicts in nursing circles. Transformational leaders stress the need for interpersonal relationships; thus, they foster concessions regarding shared values and goals, priorities, and meaningful purposes (Shah, 2017). Additionally, transformational leaders frequently emphasize team goals, thus ensuring the proper utilization of rewards for professional collaboration. In handling conflicts, these leaders encourage team members to consider and integrate divergent opinions and adopt the best alternatives (Shah, 2017). For these reasons, nurse heads who adopt transformational leadership are likely to manage various types of conflicts effectively. Nurse leaders apply the democratic approach in managing conflicts among nurses. In the study conducted by Hassanian et al. (2019), democratic leadership was found to be highly useful in conflict resolution in nursing contexts. Particularly, democratic nurse leaders were found to favor nonintervention and solution-oriented strategies in handling disagreements in their organizations (Hassanian et al., 2019). As further observed by Black (2019), the participatory leadership style is useful in managing interpersonal conflicts. Therefore, nurses and physicians nurture mutual respect and work professionally towards realizing the vision of the organization. Overall, nurse leadership styles significantly affect the success of conflict management in healthcare settings.

Different nurse leaders use various conflict management strategies. A study conducted by Baddar et al. (2016) in a Saudi-based hospital revealed that nurses use several conflict management approaches in their respective work stations, including accommodation, competition compromise, avoidance, and collaboration (p. 96). Accommodation, which emphasizes concern for others, was the most popular conflict resolution strategy reported by the participants at 61.5%. Collaboration, which involves exchanging information and exploring alternatives was utilized by 60.3% of the nurses, while compromise (ceding ground to find an amicable answer to disagreements) and avoidance (the tendency to suppress or withdrawal) were reported by 57.7% and 56.4%, respectively. Competition, which entails prioritizing one’s concerns over those of others, was the least used at 42.3% (Baddar et al., 2016). Similar findings are reported by Alshammari and Dayrit (2017), who found that Saudi nurses working in maternity and children’s hospitals preferred collaboration while those in other facilities mostly used avoidance. Transformational nurse heads are likely to use accommodation, compromise collaboration. Notably, they can use collaboration in creating linkages between nurses and physicians, thus promoting harmonious and productive work contexts that augment the health care provision.