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Can J Nurs Res. 2023 Jun;55(2):230-240. doi: 10.1177/08445621221115250. Epub 2022 Jul 28.
Research conducted on conflict between Registered Nurses (RNs) has established that it happens regularly within the hospital setting, that it adversely affects the health and well-being of RNs, impacts the effective functioning of the health care organization, and compromises quality patient care. In this article, the phrase conflicting working relationships (CWRs) is used to represent working relationships between RN peers that are non-collegial, uncaring, and non- supportive, and inclusive of the behaviours associated with incivility, horizontal violence, and bullying, among others.
To examine how nursing, including nursing knowledge and practice, is socially organized within the hospital setting and how this organization is linked to CWRs between RN peers.
Interviews were conducted with 17 RNs, followed by text analysis and mapping guided by institutional ethnography (IE) as the research methodology.
The intersections between should nursing, double domination, and the big picture threads shows work environments where RNs struggle to provide appropriate care and conflict has become institutionalized. The intersection between threads can be used as caution areas for RNs and individuals in leadership positions to reflect on nursing practice when conflict is being experienced.
The contextual variables surrounding professional nursing practice are very influential with respect to how RNs relate to each other. A new type of dialogue about the organization of nursing practice in the hospital setting is needed to support more relational practices between RNs.
对注册护士（RN）之间冲突的研究表明，这种冲突经常发生在医院环境中，对 RN 的健康和幸福产生不利影响，影响医疗保健组织的有效运作，并损害患者护理质量。在本文中，“冲突的工作关系（CWR）”一词用于表示 RN 同行之间非同事关系、不关心、不支持的工作关系，并包括不文明、横向暴力和欺凌等行为。
探讨护理（包括护理知识和实践）在医院环境中的社会组织方式，以及这种组织方式如何与 RN 同行之间的 CWR 相关联。
对 17 名 RN 进行了访谈，然后进行了文本分析，并根据机构民族志（IE）作为研究方法进行了映射。
“应该护理”、“双重统治”和“大局”线程的交叉点表明，工作环境使 RN 难以提供适当的护理，冲突已经制度化。当出现冲突时，线程之间的交叉点可以作为 RN 和领导职位人员的警示区域，以反思护理实践。
围绕专业护理实践的环境变量对 RN 之间的相互关系有很大影响。需要就医院环境中护理实践的组织问题展开新的对话，以支持 RN 之间更具关系性的实践。
