Conflict Analysis Abstract
The healthcare setting is highly diverse. While diversity may add to the richness of such a setting, it may also be the basis for conflict to erupt. In the presented case, a pregnant Islam woman refused to be examined when she arrived at the hospital feeling pain around her belly. She felt that only her husband or a female doctor are allowed to see her stomach or examine her in any other way yet the doctor who took up her case immediately she arrived at the hospital was male. This research outlines the process of conflict resolution in the case by outlining several steps aligned to the conflict mapping model by Wehr (1979). The steps include conflict history, conflict context, conflict parties, issues, dynamics and alternate routes to the problem.
Healthcare is important presently because it seeks to boost people`s qualities of life. Access to healthcare is rated as one of the most important determinants of livelihood. Healthcare institutions inevitably serve diverse people and their employees are in most instances diverse too. The diversity presented in the healthcare setting is a plus for healthcare practitioners and patients in some cases but in other instances, it may be the source of conflict. Medical personnel have to deal with conflicts almost on a daily basis and as a result, they ought to develop adequate conflict resolution skills. Wehr (1979) came up with the concept “Conflict Mapping” that would assist people to resolve conflicts. Below is an analysis of one such conflict that arose as a result of religious differences, the analysis is based on Wehr`s model of 1979.
The first step under the model by Wehr (1979) is conflict history. Religion is a major determinant of people`s values and beliefs which in turn determine their actions. In the case I witnessed, conflict arose as a result of the patient`s, refusal to expose any part of her body and in this case her stomach because of her religious beliefs. The lady, referred to as Halima in this case which is not her real name, was brought in by good Samaritans who had spotted her expressing pain and she was in her third trimester of her first pregnancy (week 32). While she was in hospital, her husband was called and he went to the hospital with other family members. The conflict arose as a result of Halima`s refusal to be examined. She was in pain but she would not let the doctor examine her. When asked about it at first she did not state her concern (which she stated later on) but went on to refuse to be examined. The doctor was concerned because both her and her baby could be in danger but he had to carry out an examination to determine where the problem was and most especially if she was in premature labor.
The patient had been taken to Hospital X which is located within Florida. Hospital X is a government hospital which means it is open to all people who are eligible for medical care under the government`s umbrella. The hospital is within the state`s jurisdiction. The hospital has both internal and external communication channels. Internal communication channels in the hospital are characteristically both vertical and horizontal because communication takes the top-down, down-top and horizontal channels. Medical personnel have pagers but there are other imminent communication channels such as notice boards and written communication such a letters. The hospital also has an intranet to facilitate internal communication. The hospital also has external communication with other public and private hospitals plus other external stakeholders including the Florida Department of Health. Decisions in the hospital are in some instances made individually by doctors attending to cases and other personnel in charge of specific dockets. There are however instances when the hospital board has to make decisions together or when communication comes from the state department of health.
Bartos & Wehr (2002) outlined that conflict parties are classified as primary, secondary and tertiary and they are classified according to the level to which they are involved in the conflict. The conflict in question has two primary parties and these are Halima and the male doctor attending to her. The doctor in this case was driven by the need to execute his duties to his patient and avert any complication from her situation. On the other hand, the patient was driven by the need to adhere to her religious beliefs and values.
Secondary parties are the other medical personnel in the hospital and most especially the male medical personnel. The family members of the patient are also secondary parties because they belong to the same religion and held the same beliefs. The management of the hospital is an interested third party because the successful or unsuccessful resolution of the conflict would determine the patient`s satisfaction and may inform future action. Other interested third parties may include Halima`s distant relatives and the members of her religious group plus the state`s hospitals overseeing body.
In this case, the conflict is values-based at one level. Islam spells out stringent rules that are in turn turned into the values and beliefs of the religion`s practitioners. The doctor on the other hand is driven by medical values that support service to the patient disregarding gender, age and other differences. The patient feels that religion should be the basis of decision making but the doctor feels that medical values should be the basis of decision making and action. The conflict is also facts-based because the two major parties in the situation have different perceptions about the situation. It is based on interests because Halima is more interested in respect and obedience to her religion but her doctor is interested in professionalism and resolving her medical problem.
Bartos & Wehr (2002) noted that conflicts do not stay static but rather alter and this makes them highly dynamic. In the noted case, the patient started by refusing to be examined through holding on to her clothing and refusing to let herself to be examined. The issues then started emerging because Halima eventually started vocalizing her concerns stating that the doctor was not her husband and that only her husband or a female could see any part of her stomach or carry out any physical examination on her. The patient was vocalizing her thoughts and they signified coalition with her husband, family and members of her religion. The doctor on the other hand told her that it was just part of his job to examine her just as any other doctor in the hospital would. The doctor`s actions later signified a deescalatory spiral because he asked her if all she wanted was a female doctor and she said that is her preference. Such a situation may have resulted to stereotyping on the parts of each major party involved because of their divergent views.
Alternate Routes to Solutions of the Problems
Isenhart & Spangle (2000) and Morre (1986) outlined several steps that can be taken to ensure there is smooth conflict resolution. The first step is negotiation which involves reaching a solution that is beneficial to all the involved parties by the involved parties. In this case, it would involve selecting a choice that would be useful to Halima and the doctor and to other interested parties. This option has a limitation factor in that it may take the conflict back to the start where the two parties started the disagreement. Negotiation requires compromise and neither party may be willing to relent on their case.
Another step according to Isenhart & Spangle (2000) is mediation. In this case, a third party would get involved and act as a mediator in the conflict. This means that the party would possibly converge with the two primary parties, ask them their views and spearhead solution formulation. A problem may arise with regard to the selected mediator and the impartiality of the mediator. Mediation is subject to bias because the mediator may easily adopt the view of either party subjectively.
The next step that may be used is facilitation. A facilitator may be involved but he would take a more subtle position than a negotiator. The role of the facilitator in this case would be to direct the two parties towards a formidable solution by making them see sense (Isenhart & Spangle, 2000). Facilitation may be limited because of suspicion and dishonesty on the part of the facilitator.
The last option is arbitration. Arbitration involves an adjudicatory process that is held at a private and low level. Isenhart & Spangle (2000) claim arbitration also involves a third party (parties) who acts as an adjudicator. The process involves sitting down and coming up with a feasible solution to the problem and the same would be made known to the parties involved. The arbitrator may make a decision that is not acceptable to the parties involved since he stands as the final decision maker.
Going by any of the steps outlined above, several solutions may be reached. There are different alternative solutions in this case but all of them require compromise by either of the involved parties. The first route would have been for Halima to forego her religious values and beliefs and accept to be examined by the doctor who was in charge of her case. This route would have given the doctor the chance to perform his duties.
The second route would have been for the doctor to withdraw from the case completely and let the case be assigned to a female doctor who would handle the examination and continue to deal with the case as it progressed. This would mean that Halima`s values would be preserved and adhered to.
The third route would have been for the doctor to involve a female doctor at the level of examination and work collaboratively with the female doctor throughout the case`s progression. This would counter the conflict.
Mediation and facilitation seemed most feasible because of the lower levels of involvement by negotiators and facilitators. Negotiation may not work because the two involved parties may not be willing to compromise on their positions fully while arbitration is rigid. In the presented case, mediation was involved and the solution reached was to transfer the case to a female medical doctor. The patient felt more comfortable with that idea and therefore her wishes were granted thus the conflict was resolved.
The research above highlights one of the conflicts that were witnessed in Hospital X in Florida. The case involves a pregnant Islam woman who refused to be examined even when she seemed to have a problem with her pregnancy. This research outlines the process of conflict resolution in the case by outlining several steps aligned to the conflict mapping model by Wehr (1979). The steps include conflict history, conflict context, conflict parties, issues, dynamics and alternate routes to the problem.
Bartos, O. & Wehr, P. (2002). Using Conflict Theory. Cambridge: Cambridge University Press.
Isenhart, M. & Spangle, M. (2000). Collaborative Approaches to Resolving Conflict. Thousand Oaks: Sage.
Moore, C. (1986). The Mediation Process: Practical Strategies for Resolving Conflict. Hoboken: Jossy-Bass.
Wehr, P. (1979). Conflict regulation. Boulder, CO: Westview Press.