Why Nurse-Physician Conflict Happens and to Resolve It

Why Nurse-Physician Conflict Happens and to Resolve It

This is part three of a four-part series on conflict in the workplace. Part one dealt with bullying and part two covered intergenerational conflicts among nurses.

Updated Sept 01, 2020

Forty years ago, nurses were completely subordinate to doctors and treated more as assistants or caregivers than peers in patient care. But in today’s landscape, the role of the nurse is considered vitally important in healthcare, and in fact, Registered Nurses are one of the largest occupations in the United States. There’s also a much greater emphasis today on interdisciplinary collaboration, which brings doctors and nurses closer together in the hospital hierarchy.

Despite this evolution of the perceived importance of nurses as an integral part of the healthcare delivery system, there is still a perception that the nurse-physician relationship is often strained.

  • A 2013 survey found that only three percent of survey respondents rated that relationship as strong, or characterized by a climate of mutual respect.
  • A 2015 study found that doctors and nurses don’t always agree on whether conflict exists. It reported that physicians rated their relationships with nurses significantly better than the nurses did. 

Why Do Nurses and Doctors Clash?

The reasons for conflict between nurses and doctors are complex and varied.

First, conflict can arise from fundamental disparities in knowledge and power. Despite efforts to make medicine less paternalistic, there is still a general perception that doctors are in charge, giving orders that both nurses and patients must follow.

Of course, this hierarchy can endanger patients by making it more difficult for nurses to speak up when they see a potential error or a better course of action in treating a patient. There is often the expectation that nurses will defer to physicians, and when they do not, it can cause conflict.

Second, there is an essential difference in perspective between nurses and doctors. Nurses are trained to view the patient holistically, while physicians have been taught to focus on “the case” and strategize treatments and cures, without necessarily considering the emotional, social, or cultural factors that affect the patient.

How Nurse-Physician Conflict Harms Patients

Hostile or adversarial roles at best do not improve patient care, and at worst, can threaten patient safety. When physicians and nurses disagree over issues related (or even unrelated) to patient care, it can lead to a lack of focus on what really matters: improving the health and safety of a patient.

Conflict between nurses and physicians can also lead to nurse burnout, which translates into high turnover and a difficult work environment. Learn more about how strong nursing leadership can reduce conflict in the workplace.

Resolving Conflict Between Roles

There are several strategies for minimizing interdisciplinary conflict.

  • Interpersonal strategies often focus on making nurses feel more empowered. An effort to level the playing field can go a long way toward making nurses feel involved and comfortable working with physicians.
  • Organizational culture is an important determining factor in nurse-physician relationships. Hospitals should consider a shared governance model that gives nurses a voice, and should have policies in place that make it clear the organization will not tolerate verbal abuse or disruptive behavior from physicians.
  • The most promising approach to reducing interdisciplinary conflict is for doctors and nurses to train together. New models of team-based care are taking collaboration to a much higher level than typically seen in the past, and it makes sense that this collaboration should start while doctors and nurses are still in training. This helps both sides to move away from an adversarial mindset and toward understanding each other’s roles better—which in turn promises to improve patient care and enhance job satisfaction for both nurses and doctors.

An American Journal of Nursing article (June 2009) titled “Conflict in the Workplace” states that:

…experts agree that unresolved workplace conflict contributes to occupational stress, poor morale, job dissatisfaction, and turnover. This is especially so when conflict is managed by confrontation, avoidance, or withdrawal. Burnout is reduced when workers are able to resolve conflicts through collaboration. Collaboration is generally regarded as the best way to resolve conflict because it reduces competition and avoidance without excessive accommodation or collaboration.

How Education Can Help

Nurses have the ability to further their education in order to feel confident “sitting at the table” with doctors. To participate fully in interdisciplinary teams, they need to demonstrate greater leadership abilities, which is possible when they earn graduate-level education.

Nurses who advance themselves by attaining an MSN or Doctor of Nursing Practice are more likely to stand out as respected members of multi-disciplinary teams and capable leaders. Discover American Sentinel University’s online MSN programs (with five different specializations, including Nursing Management and Organizational Leadership) and Doctor of Nursing Practice (four tracks, including Executive Leadership). Earning one of these degrees will help you as a nurse earn a level of distinction and respect among your peers and achieve your short- and long-term career goals.

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