Doctor-Nurse Conflict in Nigerian Hospitals: Causes and Modes of Expression

Abstract

Background: Conflict within the health team is a recognized problem known to hinder quality health care service delivery. In order to achieve the objective for which a hospital is set up, interactions between all members within a medical team must be conducted in such a way that conflicts are minimized as much as possible. Aims: To examine conflict issues between doctors and nurses and to determine the causes and modes of expression of such conflicts in Nigerian hospitals. Methods: A cross-sectional study with quantitative and qualitative approaches was carried out in 2 tertiary hospitals in Ekiti State, Nigeria. Data was collected over 4 weeks in April 2005. Pre-tested semi-structured questionnaires were self-administered to 323 participants (Response rate=96.4%) recruited. Focused group discussions (FGDs) were conducted with three groups each of doctors and nurses in the selected hospitals. Data were analyzed using frequencies, percentages and logistic regression. Results: Majority of our respondents were females (81.7%); below 40 years (53.0%); married (75.9%); nurses (84.5%) and with less than 15 years of professional experience (50.3%). Odds of conflicts were significantly higher with limited opportunities for staff interaction (OR=1.8, CI=1.1-2.9); desire for power (autonomy) by doctors (OR=3.2, CI=1.9-5.2) and desire for more influence by nurses (OR=12.5, CI=4.8-41.3). Chances of expressing conflicts were significantly higher as strikes (OR=2.1; 1.3-3.5) but less with physical assaults (OR=0.1, CI=0.03-0.41). Conclusion: Doctor-nurse conflict is associated with a combination of socio-economic and interpersonal-intergroup factors. Hospital management must understand the interplay of these factors and recognize its role in the handling of such conflicts. Doctors and nurses must also acquire the understanding of team building and group dynamics through training.