Nurses function in a complex web of relationships including other nurses, supervisors, patients, and physicians. They are guided through these challenges with the task of managing relationships by professional standards; yet often experience role confusion, conflict, and incompatible goals. Given these conflicting factors, nurses at all levels face the difficulties of both educating and caring for patients while, at times, being each other’s own worst enemy. Numerous nurse researchers have explored the various facets of nurse conflict (e.g., Cavanagh, 1991; Cox, 2001; McKenna et al., 2003; Randle, 2003; Stanley et al., 2007). However, few scholars (for exceptions see Apker et al, 2005; Apker et al., 2009; Nicotera & Clinkscales, 2010; Nicotera et al., 2010) have taken a uniquely communication approach to understanding how the way in which nurses view themselves may predict the nature of their interpersonal communication (e.g., being engaged in conversation inside the organizational context), willingness to confront conflict with other nurses, feelings of learned helplessness, and employment turnover.
Through a social identity theoretical lens, this dissertation examines how nurses’ identification with their working small group, unit, or floor, nursing role (e.g., staff ER nurse, nurse practitioner), and the nursing profession relates to nurses interaction involvement, willingness to confront conflict, feelings of learned helplessness, and tenure intentions. Nurse identity is theorized to vary at three levels per nurses’ small group/unit/floor, role, and profession.
Key variables were explored via a cross-sectional survey including 446 nurse participants employed at Cleveland Clinic. Tenets of Dillman’s (2007) Tailored Design Method and Total Survey Error Approach (Weisberg, 2005) guided the creation and distribution of this survey. Structural equation modeling was used to uncover direct and indirect effects between the five primary variables in question. Findings demonstrate direct relationships between nurse identity (as a latent variable) and interaction involvement, willingness to confront conflict, and tenure intentions. Feelings of learned helplessness are attenuated by increased nurse identity through interaction involvement and willingness to confront conflict. Additionally, both willingness to confront conflict and learned helplessness mediate the relationship between interaction involvement and nurses’ tenure intentions.
Finally, this dissertation contributes to a small body of literature examining identity antecedents to communication phenomenon inside the nursing profession. Theoretical extensions include indirect links between nurse identity and learned helplessness via interaction involvement and willingness to confront conflict and interaction involvement and tenure predictions as mediated by willingness to confront conflict and learned helplessness. Findings in this study (e.g., those related to Packer’s [2008; Packer & Chasteen, 2010] normative conflict model of dissent) also echo prior work conducted by scholars interested in social identity occurrences in organizational arenas. Implications for communication theory development, health communication, and the nursing profession are presented and directions for future research discussed.