From tall poppies to squashed weeds*: why don't nurses pull together more?

Aims. To develop a conceptual framework to account for interpersonal conflict in nursing. To extend the boundaries of debate on the causes of interpersonal conflict in nursing. Background/Rationale. In nursing, attempts to offer an explanation for staff conflict or, as it is traditionally referred to, horizontal violence, have, nearly always, been influenced by oppression and feminist theories. Such macrolevel analyses avoid discussing the details of individual acts of aggression in favour of considering nurses' alleged disempowerment in relation to other perceived dominant groups, especially male doctors, and the violence these groups inflict in terms of the denial of power, control, and access to rewards - material or otherwise. Methodology. A critical analysis of an extended literature review adapted from a doctoral dissertation. Discussion. While the oppression and feminist perspectives can be insightful they are also limiting in that they omit the finer grained-analysis necessary for a fuller understanding of staff conflict. At least three levels of explanation can be offered to account for poor staff relationships - a macrolevel, which focuses on nurses' relationships vis-à-vis dominant groups, a mesolevel analysis, which concentrates on organizational structures, including workplace practices - many of which are controlled by nurses themselves, and a microlevel analysis, which emphasizes the interactional nature of interpersonal conflict. Conclusions. It is contented that it is not only the alleged misogyny intrinsic to oppression theory that shackles and impedes nurses, but nurses themselves, who in their everyday work and interpersonal interactions, act as insidious gatekeepers to an iniquitous status quo.