CHAPTER ONE

INTRODUCTION

Background to the Study

Conflict is a normal part of any healthy relationship (George, 2011). After all, two people cannot be expected to agree on everything, all the time. Although there is no universal definition of conflict (Kelly, 2006; Patton, 2014), it can be described as a process in which one party perceives that its interest are being opposed or negatively affected by another party (Kreitner & Kinick, 2010). It can be competitive or opposing action of incompatibles. Which triggers strong emotions and can lead to hurt feelings, disappointment and discomfort. Learning how to deal with conflict rather than avoiding it is crucial. when conflict is mismanaged or handled in an unhealthy manner, it can cause great harm to a relationship, cause irreparable rifte, resentments and break ups, but when handled in a respectful, positive way, it increases the understanding of one another, builds trust and strengthens the relationship bonds that exists between people in the workplace (Introduction to Conflict Resolution, Concepts and Definition, 2011).

 

In health care industry managing conflict is a difficult task as the health care institutions is composed of individuals, professionals and clients with different ethical and cultural background. Health care is delivered by people who walk in organizations, large and small Successful health outcomes depend on the effort of many people within the organization, including clinicians, supports staff and managers, each organization, in turn depends on many other organizations, such as insurance companies, vendors and other health organization. Each individual is part of many groups both formal and informal. Nurses see themselves as members of the health care team on their shifts and their clinical units, as members of the nursing department, and as employees of their health care organizations. An environment characterized by interactions among many people within a defined setting is conducive to conflict (Krogerus & Tschappler, 2012).

 

Today’s health care environment provides a ‘’perfect storm’’ of opportunities for conflict. Buckley (2008) described health care in the midst of many changes which bring forth misunderstanding, hard feelings and definitely conflict. The hospital in particular is an arena with many diverse players with diverse interests, goals, personalities and levels of achievement. All of this provides the atmospheric conditions for the growth of conflict.

There are five styles of handling conflict, according to the Rahim and Bonoma model: avoidance, compromise, obliging, dominating, and integrating (Kreitner and Kinicki, 2010; Leever et al., 2010). Avoidance and compromise are common styles used among physicians and nurses (Leever, 2010; Tabak & Koprak 2007). ). According to Kreitner and Kinicki, these two choices are temporary fixes. In certain circumstances, however, they may be useful (Rahim, 2002). Nonetheless, when dealing with complex issues, the preferred style of conflict handling is integrating (Kreitner & Kinicki, 2010; Rahim, 2002). Kelly (2006) reported that a study of intensive care nurses revealed that they tended to use avoidance in order to protect relationships, prevent open arguments, act as proper role models in the presence of students and so they are not “branded [as] emotional or unfeminine women. Those who avoid conflict “neglect their own needs, goals, and concerns” in order to satisfy others. This self-sacrificial approach may be considered an expectation in a career that ascribes to the philosophy of altruism. However, compromise was found to be the most prominent style of choice among doctors and nurses working in five Israeli hospitals, whereas a qualitative study done in a Norwegian hospital determined that physicians and nurses used avoidance, compromise, and dominating styles depending on the contextual factors of perceived interrelationship between the members, and the urgency of taking action regarding the situation (Leever et al., 2010.) Shin (2008) suggests that by increasing awareness about health care conflict may catalyze more useful approaches in conflict resolution within the industry. She continues that by addressing negative conflict early on, workplace relations are strengthened and a healthier environment is developed. Kelly (2006) concurs; she asserts that when conflict management is ignored, the team can dismantle and human potential is wasted.

Unresolved conflict among nurses and other health care provider’s also interferes with the achievement of successful clinical outcomes as well as with personal and professional satisfaction. Therefore since conflict is inevitable in any environment of human interaction the unit heads are faced with the task of resolving conflict both among nurses and between nurses and other health care team members, effective conflict resolution will help to prevent deadlock and recrimination and restore stability as well as to foster wholesome and functional communication within the clinical team, improve  job cooperation ,help foster teamwork which lead to good patient outcome ,satisfaction and high  turnover,

 

Since all these are benefits of conflict resolution the researcher therefore want to find out the strategies the unit heads apply in resolving conflicts as it will help to study how they resolve conflict resolution.

 

Statement of the Problem

In all places where there are interactions between people there is bound to be misunderstand resulting from differences in perception, behavior and approach of life issues. The researcher observed during her practice as a nurse at Nnamdi Azikiwe University Teaching Hospital Nnewi, that there are sometimes cases of conflict among the nurses, nurses and patients, or other health professionals and even within the nurse himself. This poses problem to collaboration in client care to the detriment of the patients. The researcher observed that despite the available rules and regulations guiding practice as well as professional ethics, conflict still exists. Does it mean that the nurse managers do not know what to do or that they do not apply the best strategy in conflict resolution? This prompted the researcher to conduct this study in other to ascertain the various conflicts resolution strategies adopted by heads of nursing units in Teaching Hospitals in Anambra State, to manage and reduce conflict to the barest minimum.

 Purpose of Study

The purpose of the study is to determine the conflict resolution strategies used by heads of nursing units in Federal and State Teaching Hospitals in Anambra State.

Objectives of the Study

The specific objectives of the study are:

1. To identify the sources of conflicts experienced by Nurse Managers in Federal and State Teaching Hospitals in Anambra State.
2. To assess the ways the nurse managers handle these conflicts in their units.
3. To identify the challenges encountered by the Nurse Managers in implementing these conflict resolution strategies in the units.

Hypothesis

1. There is no significant difference between the conflict resolution strategies used by nurse managers in Federal and in State Teaching Hospitals in Anambra State.

 

Significance of the Study

Findings from the study will help to identify ineffective strategies applied by nurse managers in conflict resolution on the basis of which appropriate recommendation can be made to the nurse managers and managers in health care system generally on better approaches to unavoidable but unhealthy conflicts that may arise among staff. Findings will also help to address the best way forward in coexistence among health providers within a unit to enable good patient turnover through good conflict resolution practice.

 

Findings from the study will assist policy makers in understanding the best approach in dealing with conflicts among staff members. The result of this study will provide basis for further studies and local literature for references.

 

Research Question

1. What are the sources/causes of conflict encountered as nurse managers by Nurse Managers in Federal and State Teaching Hospitals in Anambra State?
2. What are the strategies the unit heads apply in resolving conflicts?
3. What are the challenges encountered by the Nurse Managers in implementing these conflict resolution strategies?

 

Scope of the Study

The work is delimited to the identification of sources of conflict experienced, the strategies applied in resolving conflict and the challenges the nurse managers in Federal and State Teaching Hospitals in Anambra State encounter in application of conflict resolution strategies.

 

Operational Definition

Conflict Resolution Strategies: This means what the nurse managers do when they experience any conflict as a unit head in their units to see that the conflict is controlled and does not continue example compromising avoiding accommodating competing and collaborating

Nurse Managers: They are individuals registered by Nursing and midwifery council of Nigeria to practice as nurses, who are in the rank of Principal Nursing Officer and above who are in charge/leaders of their ward/units/clinics.

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ABSTRACT

There is increased demand for nurses with higher degree to man the existing Department of Nursing to meet both the National University Commission and the Nursing and Midwifery Council of Nigeria student teacher ratio of 1:10 and 1: 6 for basic and post basic Nursing programmes. However, the completion rate required to meet these demand is low. This study was conducted to determine the perceived factors responsible for delay in successful completion of postgraduate programme in Department of Nursing Sciences, UNEC. Four objectives were formulated and the significance of the study was to provide useful information to enhance timely completion of postgraduate programme in the Department. The design was descriptive. Population consisted of all registered postgraduate students from 2003/2004-2010/2011 and approved supervisors. The instrument for data collection was the questionnaire. Data was analyzed using percentages, mean and Standard Deviation. 4 points Likert scale was also used and the decision rule was based on mean score of 2.5. Result showed that the major personal factors that contributed to delay in completion were conflicting roles competing with academic work (mean 3.15); not satisfied with the way the programme is organized and no study leave granted for the programme had the same mean of 2.91. For the supervisors, the major personal factor was that, most of the students lacked knowledge in research work (mean 3.67). The main environmental factor that contributed to delay was interference of job with academic work (mean 3.00). For the supervisors, the major environmental factors were that students combined work with their academic studies (mean 3.12) and that most of the students live and work outside Enugu (mean 2.83). The major institutional factors were that library was not adequately equipped (3.24) and too much work load for lecturers (mean 3.22). For the supervisors, they equally indicated that there was too much work load from undergraduate to postgraduate programme with a mean of 3.33. There was no association between demographic (age, marital status and years of experience) and students completion of studies. Based   on the findings it was recommended that, students should see both the course work and dissertation as an entity and not separate programmes. The Departmental library should be well equipped with computers and adequate classrooms provided. The supervisor-student relationships should be built on effective communication and the supervisors should be mentors to their supervisees.

 

 

 

 

 

 

 

 

 

 

 

 

 

CHAPTER ONE

INTRODUCTION

Background to the Study

Education is the bedrock of any nation because it is the training of the mind and character of an individual to ensure change of unwanted behaviour or strengthening encouraging behaviours. It is the process of helping an individual to discover, develop and make use of his inner abilities, potentials and capabilities for successful living in the society (Olubiyi, 2009). Education is the development of all those capacities in the individual which will enable him to control his environment and fulfill his potentials.  Obasa, (2006) stated that, nursing education represents the foundation for nursing practice. Thus by implication, whatever the nursing care given is a reflection of the nursing education received.

 

The concept of postgraduate education depends upon the system of awarding degrees at different levels of study, and can be traced to the workings of European medieval universities. Postgraduate education or graduate education involves learning and studying for degrees or other qualifications for which a first or Bachelor’s degree generally is required, and is normally considered to be part of higher education. Abiddin and Ismail, (2011), stated that a postgraduate study is a growth process by which students, need to develop as scholars under the thoughtful support and guidance by the institution. Postgraduate students are matured persons, building an academic career path after their Bachelor Degree or Higher Education.

 

Since the 1960s, the global higher education sector has seen a steady increase in numbers of postgraduate students. The global move towards mass higher education has resulted in large increases in both student numbers and institutions offering postgraduate education (Smith, in Jiranek, 2010).  In Australia, from 1991 to 2000 there was a 54% increase in higher degree research enrolments. With this expansion, changes in the delivery method of postgraduate courses along with changes in enrolment criteria have resulted in increased access to higher education for many people. In the field of health and in particular nurse education, this explosion of postgraduate education is very evident. There has been a threefold increase in PhD commencements and large increases in Masters Degree by research in health during this period (Kemp in Jiranek, 2010). According to him, completion rate of postgraduate nursing research students however is not high with completion rates being below 40% on average compared to other health postgraduate student completion rates that is greater than 50%. The gradual shift in the employment market, towards the requirement of postgraduate as well as undergraduate qualifications, places increasing importance on the issue of postgraduate attrition which has long been a problem in the postgraduate sector. With the importance attached to the completion of a postgraduate research programme, it is now high on the political agenda. This has resulted in a surge of research into factors affecting postgraduate completion (Wright & Cochrane in Jiranek, 2010).

 

Graduate education programmes worldwide attract professionally-based, non residential students studying part-time and the learning that takes place during postgraduate studies is a maturing process. It must be enhanced with timely and appropriate support. Support and guidance should be provided to postgraduate students without sacrificing the coherence and generic input needed in any academic programme. (Abiddin & Ismail, 2011).  Part-time students struggle to cope with their simultaneous academic and professional workloads and experience lack of support and understanding from their supervisors, inflexible program organization and structures, and a feeling of isolation (Lessing & Lessing, 2004; Mackinnon, 2004). They are under increasing pressure to complete their programme within a particular time frame, and faculty on the other hand are also under similar pressure to attract and retain quality candidates who will be able to complete on time and raise the level and status of the institution’s research profile (Abiddin & Ismmail, 2011).

 

The submission of an original essay, commonly referred to as ‘dissertation report’ is an essential component of the requirements for the fulfillment of the award of a Masters degree. The submission of a dissertation report at the end of 18- 24 months Masters Programme is an important component of the course. Participants are required to investigate a selected problem of their choice within their field of study and discuss their experience with their supervisors in order to present a rich and informative report which contributes significantly to the existing body of knowledge in the field (Olakulehin & Ojo, 2008).  In undertaking a postgraduate research program, the student commences on a pathway that initiates many relationships. Relationships the student develops include with themselves, the department, their supervisor and their peers. These relationships are central to the quality of the supervisor-student relationship and the outcomes achieved by the student (Phillips & Smith in Abididin & Ismail, 2011). They have been shown to influence both the progression and completion rates of students in their postgraduate programme. However, the choice of research area and formulation of a suitable problem are the most difficult tasks confronting postgraduate research students (Olakulehin & Ojo, 2008). Successful and timely completion of dissertation by Masters and PhD student is increasingly important for students, supervisors and the University (Jiranek, 2010).This is due to the fact that the identified problem is expected to meet three conditions- significance, originality and feasibility. In addition to these conditions, students writing dissertations are required to consider whatever problems they identify vis-à-vis individual competence and professional experience, and possible difficulties such as availability of data, financial constraints and limitations of time.

Evaluation of factors affecting completion rates of postgraduate programmes must consider all these relationships and the many factors that impact on them. Based on the data gathered by Graduate School of Studies (GSS) of one public University in Malaysia, in 2005 graduate student with thesis (research and coursework) completed their Masters averagely within 2.69 years and PhD students completed their PhD within 4.84 years averagely where as they could complete it earlier than that (Abiddin & Ismail, 2011).

 

In Nigeria, there are only three universities offering post graduate programme in nursing. The institutions include: University of Ibadan (1991), University of Ife (1972) and University of Nigeria, Nsukka (2003). Despite the few number of universities offering the programme, the number of students applying for admission on yearly basis is on the increase. For instance in the 2007/2008 admission of post graduate students in the Department of Nursing Sciences, University of Nigeria Enugu campus (UNEC), 57 students were admitted while in 2008/2009 session a total of 87 students were given admission. (Department of Nursing Sciences records, UNEC). From the University postgraduate programme, the duration of a master’s programme is 18 months for full time students and 24 calendar months for part-time students (UNN Postgraduate Hand book). Majority of the students finished their course work and fail to submit their research work within this period.

 

Numerous research studies have pointed out that there are high proportions of graduate students who fail to complete their studies within the time given (Cochrane & Park, 2005, Olakulehin & Ojo, 2008). Many factors contribute to this and the major problem is related to the information and services offered by the institution. Poor information and services affect attrition and completion rates of post graduate studies (Abiddin & Ismail, 2011). The course work and research process should run smoothly if there are adequate and excellent supports by the institution. Lots of challenges force postgraduate students to deal with issues such as family commitment, work commitment, finance etc., which may affect their achievements since most of them are working and married students (Lovitts & Malfroy, 2005). Inadequate allocation of time and lack of time management may contribute to delay in successful completion of a programme.

It is therefore pertinent to investigate empirically whether the challenges faced by postgraduate students as found in the literature are the same with postgraduate students in University of Nigeria, Enugu, Campus.

 

Statement of Problem

The Department of Nursing Sciences, University of Nigeria, Enugu Campus commenced its postgraduate programme in 2003/2004 academic session. Most of the students finance their study by themselves while others receive sponsorship by their employers. Available records show that out of a total number of 280 students admitted within the period of study (2004-2010) only six (2%) students have successfully completed the programme. The low completion rate is critical since the department is the only institution in the South East and South South zones of Nigeria offering opportunities for graduate nurses to pursue a post graduate programme in nursing. In addition there is increased demand for nurses with higher degree to man the existing nursing departments to meet both the National Universities Commission (NUC) and Nursing and Midwifery Council of Nigeria (N&MCN) student teacher ratio of not more than1:10 and 1:6 for all post basic Nursing programme (Standards of Nursing-Midwifery Education and Practice in Nigeria, 2010).  The question is what are the factors militating against the successful completion of post graduate programme by students of this institution within the given time frame. This scenario is worrisome and has prompted the researcher to investigate factors responsible for delay in successful completion of this programme.

 

Purpose of the Study

The study is aimed at identifying perceived factors responsible for delay in successful completion of postgraduate programme in Nursing Sciences Department, University of Nigeria, Enugu Campus (UNEC).

 

Objectives of the Study

Specifically, the objectives are to:

1. Determine personal factors responsible for delay in successful completion of postgraduate programme in Department of Nursing Sciences, UNEC.
2. Explore the environmental factors responsible for delay in successful completion of postgraduate programme in Nursing Sciences Department, UNEC.
3. Identify the institutional factors responsible for delay in successful completion of postgraduate programme in Nursing Sciences Department, UNEC.
4. Determine whether there is an association between demographic factors and student’s delay in successful completion of postgraduate programme in Nursing Sciences Department, UNEC.

 

Significance of the Study

Findings from this study will help the students to face their course work and dissertation as a learning task.

It will also help the Nursing Sciences Department to devote more time in teaching and supervision of students research work.

Findings from this study will be useful to the Department on how to re-organize the postgraduate programme in a way that will help the postgraduate students to complete their programme within the stipulated time frame.

It will provide useful information for the development of realistic strategies to improve and stimulate the interest of postgraduate students on the completion of their postgraduate programme.

It will contribute to the existing body of knowledge and serve as reference material for future researchers on this topic

 

Scope of Study

The scope of the study is delimited to postgraduate students and all approved project supervisors in Department of Nursing Sciences, UNEC. It covers students admitted from 2004 to 2010 including students who have graduated and those still in school. The variables under study include- the personal, environmental, institutional and demographic factors.

 

Operational Definition of Terms

1. Perceived factors responsible for delay in successful completion of postgraduate programme refers to students’ and supervisors’ opinion on factors such as personal, environmental, institutional and demographic that constitutes barriers in the completion of postgraduate programme.
2. Personal factors refer to interest, anxiety and stress, experience and skills, financial, multiple roles, time/study leave that delays the successful completion of the programme.
3. Multiple roles refer to marital, parental and occupational roles that delay the successful completion of the programme.
4. Environmental factors refer to the influence of home, family and isolation that delay the successful completion of the programme. Isolation refer to insufficient interaction with other students and project supervisors
5. Institutional factors refer to the number of courses taught by a lecturer, number of courses taken by students, relationship between supervisors/ supervisees, facilities available e.g. library, computers, classrooms, seminar room, the way courses are organized and arranged e.g. time table that delays the successful completion of the programme.
6. Demographic factors refer to age, marital status and years of experience that delay successful completion of the programme.
7. Successful completion of postgraduate programme refer to the students’ completion of both course work and dissertation within the stipulated time frame for completion of a MSc programme which should not exceed a period of two (2) years from the time of admission.
8. Supervisors refer to all approved supervisors in the Department.

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