"I should have been more proactive when I realized there were problems"
I believe that this particular scenario could have been prevented when the nurse manager first realized that there were issues involving communication and among her staff as well as realizing the nurses not feeling valued or important.
Interprofessional education goes a long way in helping hospital staff understand each others work duties and responsibilities.
The nurse manager should have also gone to the medical director sooner, and collaborated on solutions to the problem between the medical staff and the nurses. There are many reasons why conflict exists between nurses and physicians. One suggestion that Finkleman suggests is "interprofessional education". Education should be made mandatory related to this subject. This prepares each discipline to be able to work together with respect.
A meeting of the minds of nurses!!
A staff meeting among the nurses should be held, and the nurse manager should ask why she keeps hearing them say that they are second class citizens. They are obviously feeling unappreciated. The nurse manager should not be judgmental about their responses, but be genuinely concerned with how to fix things. She should ask for input from the nursing staff on some of the things that are making them feel this way, as well as input as to how to make it better. A nursing retention and satisfaction committee would be a great place to start.
DePree states in his text, that there must be "courage in relationships". He goes on to say that "followers expect a leader to face up to tough decisions". I think the staff have been trying to give clues maybe subconsciously that they are unhappy by calling in to work, and by making passive aggressive statements. They desperately want their nurse manager to step up and make things better.
Think hard and evaluate your current situation
I feel that this nurse manger should re-evaluate her ability, skills and passion related to her job title. If she feels that she is not right for management she should gracefully step down. If she was truly just to busy to notice her employees unhappiness then she needs to sit down and make some serious changes. She may need to ask for help with her work load or delegate some responsibilities to others like clinical team leaders. She should also do some research or take a class on effective leadership to gain new ideas and insight on new approaches she can implement.
Overall, I feel that this nurse manager should have recognized the breakdown in communication earlier. Since she didn't, there will have to be some kind of conflict resolution between the two staff members who had a verbal argument. This was unprofessional and they should be held accountable for their behavior. Saying that you refuse to work with someone again is also unacceptable. These two need to sit down with a mediator and listen to each other tell their version of the situation and how they are feeling. They need to try and resolve this issue with a mediator and to be able to commit to having a professional relationship at work and treat each other with respect. If the issue has been ongoing for either of them, then separation or reassignment may be necessary.
Staff members should also be offered educational opportunities or help in reflecting on their own behavior. "Staff members need to be aware of their own feelings, and need to be able to make problem solving decisions" (Finkleman, 2016, pg. 319). Staff members should also learn what positive collaboration looks like, as well as how to achieve it. Offering education on new skills such as communication and problem solving techniques, and negotiation skills would be beneficial as well.
Team building exercises are a great addition to any unit.
Having conflict in the workplace, decreased morale and constant tension will ultimately lead to a decrease in the quality of patient care given. Theses issues need to be prevented with education and team building exercises, and when they do arise, they need to be dealt with immediately.
Finkleman, A. (2016). Leadership and management for nurses (3rd e.d.). Boston MA: Pearson
DePree, M. (2008). The essential elements of a great leader: Leadership jazz. New York NY: Crown Business