Interpersonal conflicts in nursing through the lens of senior nursing students: a qualitative study

NURSE EDUCATION TODAY Volume 144, January 2025, 106398 https://doi.org/10.1016/j.nedt.2024.106398Get rights and content HIGHLIGHTS * • The study provides a unique perspective by exploring

interpersonal conflicts through the lens of nursing students. * • Nursing students know the significant role of nurses/nurse managers in conflict management within healthcare institutions. *

• Alternative teaching methods should be employed to prepare nursing students for situations of interpersonal conflict. ABSTRACT BACKGROUND Unmanaged interpersonal conflicts emerge as

significant obstacles for the nursing team during daily duties. Observations and discussions with nursing undergraduate students determined the need to explore their perspectives on conflict

management in greater depth. OBJECTIVE To investigate the perspectives of senior undergraduate nursing students on conflicts experienced by nurses during clinical practice, as well as the

strategies employed to manage these conflicts. DESIGN This is a qualitative descriptive study. PARTICIPANTS The study involved written interviews with 31 senior undergraduate nursing

students from a university in Istanbul, Türkiye. METHODS Data were collected between November 23, 2023, and December 4, 2023. Thematic analysis was used. RESULTS Four themes emerged: (1)

Causes of conflicts, (2) Methods for resolving conflicts, (3) Nurse managers' approaches, and (4) Student learning through observation. The themes were organized under 13 sub-themes:

ineffective communication, absence of a singular goal, misunderstanding in role boundaries, and lack of professionalism (first theme); transparent communication, absolute loss, integration,

and softening (second theme); autonomy in conflict resolution and seeking other professionals to manage conflicts (third theme); positive side of the conflict, negative side of the conflict,

and how I would act if I were the nurse manager (fourth theme). CONCLUSIONS Nursing students know that staff nurses and nurse managers play crucial roles in conflict management.

Communication issues were identified as significant causes of conflicts. Open communication and the active involvement of nurse managers were determined as essential for effective conflict

resolution. Positive outcomes of conflicts included changes in attitudes; however, conflicts were also acknowledged as contributors to workplace stress. The study underscores the importance

of equipping nurses with conflict resolution skills through practical educational approaches. INTRODUCTION Interpersonal conflicts are significant challenges for the nursing team during

daily duties (Alan et al., 2022; Aseery et al., 2023). These conflicts can arise from factors such as personality differences, unclear role definitions, hierarchical issues, and excessive

workloads, all of which negatively impact professional dedication and job satisfaction, as well as increase stress. This situation highlights the need for effective conflict management

strategies to promote a healthy work environment and maintain the quality of patient care (Özlük et al., 2022). While conflicts experienced by nursing team members may involve various

individuals or groups, one of the most frequently discussed conflicts in the scientific literature includes staff nurses and their managers (Başoğul, 2021; Labrague et al., 2020).

Interpersonal conflict is defined as a “disagreement or incompatibility” between individuals, groups, or parties, which may exist within the same or different hierarchies (Calha et al.,

2018; McKibben, 2017). Interpersonal conflicts occur when there are differences in interests, goals, values, or opinions between two or more parties, leading to disagreement, tension, or

confrontation (Özlük et al., 2022). The healthcare field includes professionals from various disciplines, where extensive verbal, non-verbal, and written communication creates a fertile

ground for interpersonal conflicts. Interpersonal conflicts are inevitable and normal in such environments where professional groups focused on human interaction converge (Gokoglan and Ozen

Bekar, 2021; Grubaugh and Flynn, 2018). Conflicts do not always lead to negative outcomes. Conflict is a bidirectional concept with both negative and positive effects (Almost et al., 2016).

When managed appropriately, conflict encourages critical thinking and generates new ideas (McKibben, 2017; Oliveira et al., 2010; Silva et al., 2018). However, unmanaged conflicts can impair

communication, damage long-term professional relationships, and undermine the concept of teamwork. Healthcare professionals with impaired teamwork spirit will be unable to provide quality

care (Grubaugh and Flynn, 2018; Labrague et al., 2018; McKibben, 2017). Evidence shows that when conflicts involving nurses are poorly managed—such as when they are repetitive or when

satisfactory solutions are not reached—issues like low productivity, negative work environments, increased stress and anxiety, poor patient care, higher absenteeism and turnover,

deteriorating teamwork, job dissatisfaction, and damage to the institution's reputation can arise (Gokoglan and Ozen Bekar, 2021; Özkan Tuncay et al., 2018). Ignoring conflicts, which

is an example of poor management, can escalate tensions between the involved parties (Gokoglan and Ozen Bekar, 2021). Interpersonal conflicts are inevitable aspects of human interactions and

can be opportunities for growth and change if managed effectively and constructively (Oliveira et al., 2010; Silva et al., 2018). Thus, rather than being avoided, conflicts should be

managed properly to recognize their potential for development and transformation (Özlük et al., 2022; Silva et al., 2018). The attitudes of nursing team members significantly impact conflict

management, but nurse managers must have specific skills—such as leadership, empathy, emotional intelligence, and problem-solving abilities—to manage conflicts effectively (Kim et al.,

2015; Koesnell et al., 2019; Özkan Tuncay et al., 2018). Conflict management involves understanding the different types of conflicts, their causes, dynamics, and effective management

strategies. As the origins of conflicts vary, so do the methods used to manage them. Effective communication, mediation, negotiation, problem-solving, training and development, establishment

of policies and protocols, constructive feedback, and promotion of a collaborative environment are important approaches to conflict management (Özlük et al., 2022). Five conflict management

methods are identified in the literature: integrating, compromising, dominating, obliging, and avoiding (Rahim, 2011; Thomas and Kilmann, 1974). When nurse managers employ the integrating

strategy, the focus is on achieving mutual satisfaction through cooperation and seeking solutions that meet the needs of all parties involved. In contrast, avoidance involves bypassing or

postponing the conflict, either due to a lack of interest, fear of repercussions, or the hope that tensions will decrease over time (Özkan Tuncay et al., 2018; Thomas and Kilmann, 1974).

According to the scientific literature, nurse managers more frequently use the integrating strategy and less regularly use the avoiding strategy for managing interpersonal conflicts

(Al-Hamdan et al., 2019; Labrague et al., 2018). Although nurse managers can choose different approaches to managing interpersonal conflicts, open dialogue is often a key component of the

strategies that achieve the most success (Pereira et al., 2019). Since conflict situations involving nurses are common, nursing students often witness and, at times, experience such

conflicts during their clinical placements (Labrague and McEnroe-Petitte, 2017). In this context, nursing students play crucial roles, as their perspectives on conflicts in nursing can

provide valuable insights into both education and healthcare fields. Conflicts experienced during clinical practice, whether among peers or observed among professionals, can negatively

influence nursing students' perceptions of the profession, especially when these interpersonal conflicts are not properly managed (Bayar et al., 2009; Kurt and Öztürk, 2019). Although

interpersonal conflicts and their management in the nursing field are widely addressed in the scientific literature (Labrague et al., 2018), including studies conducted with nursing students

(Choi and Ahn, 2021; Labrague and McEnroe-Petitte, 2017), there is a gap regarding nursing students' understanding of conflicts and their perspectives on the management strategies

adopted by nurse managers. Based on observations and discussions with nursing undergraduate students, a need was identified to deepen their perspectives on conflict management and, if

necessary, enhance the curriculum to better prepare them for the interpersonal challenges that may arise during clinical practice. When training in conflict resolution is provided during

clinical practice, nurses can learn by observing and evaluating both the positive and negative outcomes of these conflicts (Kim et al., 2015). It is believed that by analyzing the work of

other professionals dealing with conflicts, nursing students can develop an appreciation grounded in observation for the positive outcomes of efficient conflict management. This type of

practical activity allows students to be more comprehensively prepared for the challenges of clinical practice, as it offers a valuable opportunity for them to learn from real-world

examples, strengthening their conflict resolution skills. Additionally, as they are not directly immersed in the context, students may offer unique insights on the subject. Activities aimed

at preparing nurses to resolve conflicts efficiently and providing relevant insights for those seeking leadership or management positions in nursing should be developed. Thus, the present

study can benefit both nurses in their clinical practice and those aspiring to leadership or management positions. Based on the above, this study aimed to contribute to the literature by

investigating the perspectives of senior undergraduate nursing students on the conflicts experienced by nurses during clinical practice, as well as the strategies employed to manage these

conflicts. SECTION SNIPPETS DESIGN AND SAMPLE This descriptive-qualitative study was reported according to the COREQ (Consolidated Criteria for Reporting Qualitative Research) checklist

(Tong et al., 2007). This design was chosen due to the exploratory nature of the study. The qualitative approach analyzes participants' experiences and opinions, providing a rich

understanding of the topic (Creswell and Creswell, 2018). The study included fourth-year undergraduate nursing students from a foundation university located in Istanbul, Türkiye. FINDINGS

Participants had an average age of 22.35 years. Of the 31 students, 18 were female and 13 were male. Only one student reported being married, while the others were single. Thirteen students

were born in Istanbul, with the other 18 born in other provinces of Türkiye. Nursing students shared their reflections on various conflicts observed in the workplace during their clinical

placements in Nursing Management. Although the conflicts involved different individuals and groups, those among nursing DISCUSSION The objective of this study was to contribute to the

literature by investigating the perspectives of senior undergraduate nursing students on conflicts experienced by nurses during clinical practice, as well as the strategies employed to

manage these conflicts. Interpersonal conflicts among nurses often occur due to the constant interaction of these professionals with patients, patients' families, and other members of

the multidisciplinary team during daily activities. Nurses often serve as CONCLUSION This study offers a unique view by examining interpersonal conflicts in nursing from the perspective of

nursing students. One of the key findings was that, despite students completing a clinical placement of only seven days, they observed various conflicts among nursing team members. Conflicts

involving nurses were attributed to ineffective communication, unclear boundaries regarding roles and hierarchies, a lack of common goals, and unprofessional behavior. Various methods were

chosen to FUNDING This research received no specific grant from any funding agency in the public commercial, or not-for-profit sector. CREDIT AUTHORSHIP CONTRIBUTION STATEMENT ANA LUIZA

FERREIRA AYDOGDU: Writing – review & editing, Writing – original draft, Supervision, Resources, Project administration, Methodology, Investigation, Formal analysis, Conceptualization.

BUSRA DISBUDAK: Writing – review & editing, Writing – original draft, Resources, Investigation, Formal analysis, Data curation. DECLARATION OF COMPETING INTEREST The authors declare no

conflicts of interest. ACKNOWLEDGMENTS The authors would like to thank the nursing students from Istanbul Health and Technology University for their participation in the study, and to the

university's Rectorate for their support. ANA LUIZA FERREIRA AYDOGDU, Nurse. Post Graduation degree in Public Health Nursing. Master in Hospitals and Health Institutions Administration.

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STRESS AND BURNOUT IN NURSES USING ML CLASSIFICATION 2025, Proceedings of 2025 3rd International Conference on Intelligent Systems, Advanced Computing, and Communication, ISACC 2025 ANA

LUIZA FERREIRA AYDOGDU, Nurse. Post Graduation degree in Public Health Nursing. Master in Hospitals and Health Institutions Administration. Doctorate in Nursing Management. Assistant

professor at Istanbul Health and Technology University. BUSRA DISBUDAK, Nurse. Master in Surgical Nursing. Doctorate Student in Surgical Nursing. Research Assistant at Istanbul

University-Cerrahpasa Florence Nightingale Faculty of Nursing.View full text © 2024 Elsevier Ltd. All rights are reserved, including those for text and data mining, AI training, and similar

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