THE EFFECT OF LEADERSHIP ON INTER-PROFESSIONAL CONFLICTS AMONG HEALTH WORKERS (A CASE STUDY OF UNIVERSITY OF PORT HARCOURT TEACHING HOSPITAL, RIVERS STATE)

CHAPTER ONE

INTRODUCTION

1. 1. BACKGROUND OF THE STUDY

Conflict in inter-professional teams is not a new phenomenon. Over the last 30 years there have been numerous publications describing conflict between professional dyads such as physicians and nurses, social workers and nurses, family therapists and family doctors, and social workers and physicians (Abramson & Mizrahi, 2011; Hendel, Fish, & Berger, 2007; Kriesel & Rosenthal, 2014). Conflict is one of the countless challenges common to many organizations, the health sector inclusive. The potential for conflict or conflict to arise in this setting is significantly higher because of multifaceted and regular interactions among health workers. The World Health Organization described health workers as all people engaged in actions whose primary intent is to enhance health; they include doctors, nurses, pharmacists, laboratory technician, laboratory scientists, community health workers, management, and support workers. Health-care workers are primarily concerned with the well-being of the patient, but organizational hierarchy, specialization, and multiplicity of skills have created conflict and power struggle among various groups of health professionals over the control and leadership of the work process. To worsen the situation, different health-professional associations act as interest groups to influence government policy in favour of their members, not minding the implication to other professional groups and the health sector in general. Inter-professional conflict (IPC) is hazardous to patients, health workers themselves, and the health system in general. Several studies have shown that conflict or conflict in the health sector disrupts intra- and intersectorial collaboration, and causes or aggravates stress including emotional exhaustion for workers. In addition, it reduces the commitment of workers to the health service and encourages selfish behaviour which ultimately results in mistreatment or non- treatment of patients. This is the ultimate adverse effect of inter professional conflict. Incessant strike actions arising from inter professional conflict is currently the order of the day in Nigeria’s health sector and this is unacceptable and unethical as it comes with a lot of negative effects to the general populace. According to one particular study, Nigeria experienced minimum of eight major industrial actions orchestrated by health workers between the years 2013 and 2015. Inter Professional Conflict among health workers has been very intense, deep rooted, and unparalleled with quality of health-care delivery adversely affected. The Presidential Committee of Experts on Inter-Professional Relationships in the public health sector identified approximately 50 contentious issues dividing health-sector workers, and a considerable number of them were explored in this study. The most profound conflict appears to be between doctors on one hand and other health workers on the other hand. There are many contentious issues between them; paramount is the leadership in the health sector. The effect of this conflict may not be immediately apparent to the health-care workers themselves. From available literature, inter-professional conflict is not limited to any of the three levels of health care. However, as the secondary care level occupies the midpoint between the highly specialized or highly skilled sets of workers in tertiary health settings and the much less skilled workers at primary settings, the authors elected to compare the opinions of doctors and other workers at a secondary health-care setting. This study seeks to determine the effect of leadership on inter-professional conflicts among health workers in Rivers state.

1. 1. STATEMENT OF THE PROBLEM

Recently health care organizations have become complex due to recruitment, lack of resources, communication skills, and work overload. These are subjected to complex interpersonal dynamics among colleagues, and if policies are exist to identify and resolve these, then out come in terms of job satisfaction by employees, and patient satisfaction through standard care will be improved. The Center for American Nurses conducted a survey in 2009, to recognize challenges related to conflict encountered by the professional registered nurse, that interpersonal conflict is the most frequent and problematic type of conflict experiencing in work place. No one denies this fact but usually the manager pays less attention due to busy schedule and adopts avoidance style which result in poor work related attitudes and psychological states, such as job dissatisfaction, organizational commitment, turnover intensions, negative emotions, and emotional exhaustion. Hence, it is important for the nurse leaders to identify the source of conflict which may terrible impact on patient care, and to manage conflict by understanding the strategies for the effectiveness of health care setting. Hence, managerial style plays a vital role when conflict is arising either within group or with manager. However, stressful environment, difficulty in achieving the goal and misperceptions lead to conflict. In this regard lack of job satisfaction and staff turnover will result low work outcome and have direct effect on patient care and professional image. There are many skills, those we should learn and practice to work together in a specific way, which may acceptable to all.

1. 1. AIMS OF THE STUDY

The major purpose of this study is to examine the effect leadership on inter professional conflicts among health workers. Other general objectives of the study are:

1. To examine the sources of conflict among health care workers in Rivers state.

2. To examine the types of leadership styles used in conflict management among health workers.

3. To examine the effect of leadership on inter professional conflicts among health workers.

4. To examine conflict management strategies among health care workers in Rivers state.

5. To examine the relationship between leadership and conflict management among health workers.

6. To examine ways for improvement of leadership style for conflict management in the hospital.

1.4 RESEARCH QUESTIONS

1. What are the sources of conflict among health care workers in Rivers state?

2. What are the types of leadership styles used in conflict management among health workers?

3. What are the effects of leadership on inter-professional conflicts among health workers?

4. What are the conflict management strategies among health care workers in Rivers state?

5. What is the relationship between leadership and conflict management among health workers?

6. What are the ways for improvement of leadership style for conflict management in the hospital?

1.5 RESEARCH HYPOTHESES

H01: There is no significant effect of leadership on inter-professional conflicts among health workers.

H02: There is no significant relationship betweenleadership and conflict management among health workers.

1.6 SIGNIFICANCE OF THE STUDY

This study will be of great significance to the health care personnel, nurse managers, nurse administrators, patients and the hospital. The finding from this study will provide a basis for the determination of appropriate leadership style(s) to be used by nurse managers, capable of enhancing managing conflict in the workplace. Findings from this study can be utilized to educate nurse managers on effective leadership styles and how these styles affect inter professional conflicts of health care workers. By implementing preferred leadership styles, conflict among health workers will decrease. For health care administrators, the results of this study have numerous implications for conflict management practice.

1.7    SCOPE OF THE STUDY 

The study is based on the effect of leadership on inter professional conflicts among health workers in rivers state.

1.8 LIMITATION OF STUDY

Financial constraint- Insufficient fund tends to impede the efficiency of the researcher in sourcing for the relevant materials, literature or information and in the process of data collection (internet, questionnaire and interview).

Time constraint- The researcher will simultaneously engage in this study with other academic work. This consequently will cut down on the time devoted for the research work.

1.8 DEFINITION OF TERMS

Leadership:The individuals who are the leaders in an organization, regarded collectively or the activity of leading a group of people or an organization or the ability to do this and the act of inspiring subordinates to perform and engage in achieving a goal.

Conflict: Conflict refers to some form of friction, or discord arising within a group when the beliefs or actions of one or more members of the group are either resisted by or unacceptable to one or more members of another group.

Health workers:Health workers are people whose job it is to protect and improve the health of their com- munities. Together these health workers, in all their diversity, make up the global health workforce.