458214
ement Communication QuarterlyNicotera and Mahon
© The Author(s) 2012
MCQ27110.1177/0893318912458214Manag
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Between Rocks and
Hard Places: Exploring
the Impact of
Structurational
Divergence in the
Nursing Workplace
Management Communication Quarterly
27(1) 90­–120
© The Author(s) 2012
Reprints and permission:
sagepub.com/journalsPermissions.nav
DOI: 10.1177/0893318912458214
http://mcq.sagepub.com
Anne Maydan Nicotera1
and Margaret M. Mahon2
Abstract
Recurrent interpersonal conflict in organizational settings is common and
impedes goal-attainment. Structurational divergence (SD) theory conceptualizes a distinctive negative communication spiral rooted in unresolved conflict resulting from incompatible rules of intersecting meaning structures.
This article expands SD theory by examining the function of human agency,
positing that the rendering of communication patterns as incomprehensible
and untransformable diminishes agency. After explaining and expanding SD
theory, an exploratory study examines the relationship of SD to conflictrelated organizational- and communication-related constructs. Destructive
communication (verbal aggression, ambiguity intolerance, controlling conflict
management style, and taking conflict personally) is related to SD whereas
constructive communication (solution oriented conflict management style,
argumentativeness) is not. Implications are discussed for understanding conflict in nursing and other organizational settings as well as for intervention.
1
George Mason University, Fairfax,VA, USA
Catholic University of America, Fairfax,VA, USA
2
Corresponding Author:
Anne Maydan Nicotera, Department of Communication, George Mason University, 4400
University Blvd, MSN 3D6, Fairfax,VA 22030, USA
Email: anicoter@gmu.edu
Nicotera and Mahon
91
Keywords
structuration, nursing, conflict, agency
Introduction
Recurrent conflict is common, distressing, and complex. It impedes the ability
to accomplish organizational and personal goals. Conflict cycles and intractable negative or oppressive communication spirals have been explicated in
various ways in communication theory and research, such as coordinated
management of meaning (Pearce & Cronen, 1980), moral conflict (Pearce &
Littlejohn, 1997), paradoxes of participation (Stohl & Cheney, 2001), problematic integration theory (Babrow, 2001), and Barker’s (1993) classic illustration of concertive control during organizational restructuring. Recurrent
conflict is a multilayered phenomenon requiring complex explanation. Inspired
by the work cited above, and extending structuration theory (Giddens, 1979,
1984), structurational divergence (SD) theory (Nicotera & Clinkscales, 2003,
2010; Nicotera, Mahon, & Zhao, 2010) explicates this phenomenon, positing
that impasses stem from multiple meaning systems that simultaneously compel irreconcilably contrary obligations, creating a communication spiral:
Unresolved conflict, immobilization, and erosion of development, which
perpetuates the conflict.
For example, our recent research (Nicotera & Clinkscales, 2010) describes
a recurrent conflict cycle experienced by hospital nurses in a geriatric care
(GC) unit with the emergency department (ED). ED staff complained GC staff
was uncooperative with inpatient admissions. GC staff complained that ED
patients who should be admitted to intensive care (ICU) were transported to
GC to await admission. When these patients became unstable, requiring
immediate care, GC staff provided it, acting from a patient-centered ethic.
These patients were subsequently admitted to ICU. Records reflected admission to ICU from ED with no way to document care given by GC. When performance reviews, cost calculations, and other such management reviews
were conducted, GC care for those patients was credited to ED, but its negative impact (e.g., cost, time, and delayed care for other patients) resulted in
poor performance sanctions for GC. This deepened GC resentment for ED and
perpetuated the conflict. GC nurses became hesitant to provide care because
of bureaucratic consequences—a severely immobilizing ethical dilemma.
Although in a medical setting, this example illustrates organizational and
institutional, not clinical, problems. Applying SD theory, the structure
patient-centered ethic is incompatible with the bureaucratic departmental
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Management Communication Quarterly 27(1)
structure. To act, individuals choose which structure to violate—suffering its
normative sanctions and escalating conflict. ED admissions problems (unresolved conflict) resulted in inability to perform (immobilization), which
resulted in poor and unfair performance reviews (erosion of development),
perpetuating conflict. Seen in this way, the problem causes the problem, and
no rule/resource exists to prioritize one structure over another. These two
features represent the core of the phenomenon identified as SD.
Based on structuration theory, SD theory defines SD as an institutional
positioning at a nexus of incompatible meaning structures that creates recurrent conflict cycles. Agency is central to structuration theory, but no previous
work has considered agency in SD. The explication of agency loss in SD is
the central conceptual contribution of this article, which then documents the
relationship of SD to organizational and communication constructs common
in conflict research, establishing a conceptual distinction between SD theory
and conventional explanations of interpersonal conflict.
Structurational Divergence
and the Loss of Agency
Structuration theory posits that people act and interact coherently based on
meaning provided by institutionalized structures. Structure consists of “rules
and resources, recursively implicated in the reproduction of social systems”
(Giddens, 1984, p. 377). Rules are schemas (Sewell, 1992). Resources are
authoritative and allocative (command over persons and objects); human
(e.g., intelligence, strength, knowledge.) and nonhuman (e.g., tools, documents); material and nonmaterial (Giddens, 1979). Their nature is less important than the ontology of agency: Access to resources empowers people
(Sewell, 1992). “To be an agent means to be capable of exerting some degree
of control over the social relations in which one is enmeshed, which in turn
implies the ability to transform those social relations” (p. 20). Doing anything
rests on agency provided by rules/resources, but SD blocks that access. For
example, mobilizing GC resources to care for ED patients in the GC hallway
is possible by agency provided in the patient-centered ethic. However, this
act diminishes agency in the bureaucratic structure that negatively sanctions
it. This institutional incompatibility manifests in recurrent conflict between
ED and GC.
Knowledge of rules enables agency (Sewell, 1992), which explains the
duality of structure (Giddens, 1979, 1984): Structures shape social practices
that constitute structures. Production/reproduction of structures in social practice is the heart of structuration, agency the driving force. Knowing structure
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93
enables doing structure, but in SD such knowledge is hidden or contradictory.
Structure refers to “properties allowing the ‘binding’ of time-space in social
systems, the properties which make it possible for discernibly similar social
practices to exist across varying spans of time and space and which lend them
‘systemic’ form” (Giddens, 1984, p. 17). Rules, intertwined with resources, are
“the modes whereby transformative relations are actually incorporated into the
production and reproduction of social practices” (p. 18).Rules both constitute
meaning and sanction modes of social conduct. Rules tell us what things mean
and how to act; action produces, reproduces, and transforms structures in a
continuous cycle. Agency arises from knowledge of structure; structures arise
from agency (ability to act and to apply knowledge to new contexts; Sewell,
1992). So, when rules from multiple structures are irreconcilably incompatible,
agency suffers. SD theory can explicate this phenomenon.
SD Theory Fundamentals
SD has two components: The SD-nexus and the SD-cycle (Nicotera et al.,
2010). A nexus is a social/institutional position where multiple structures
compel simultaneous obligations. In an SD-nexus, those interpenetrating
structures are incompatible, with simultaneous, equally compelling, contradictory obligations. We cannot make coherent sense of interaction—cannot
adequately know what things mean and so cannot adequately choose what to
do. Following a game metaphor (Taylor & VanEvery, 2011), we are given
baseball equipment and football plays and put on a soccer field with others
who have differing equipment and plays. Rules, resources, and landscape are
multiply incompatible—and often invisible.
The SD-cycle is the resulting downward spiral of communication described
previously, which self-perpetuates. SD occurs when an SD-nexus creates an
SD-cycle. Figure 1 summarizes SD theory. The hallmark is immobilization—
not inactivity, but lack of progress—feeling stuck or facing recurrent problems with no foreseeable end. Heretofore, there has been no conceptual
device to explain why some SD-nexi escalate into SD-cycles and some do
not. Agency is posited here as that device. Agency is efficacy—ability to act
meaningfully. Our participants’ metaphors of paralysis, bondage, and slavery
and emotional descriptions of immobilization (frustration, futility, hopelessness) illustrate inefficacy in SD (Nicotera & Clinkscales, 2003, 2010).
SD sufferers cannot make sense of interaction, coherently use resources,
or apply rules because simultaneous oppositional structures are equally forceful. Re/production of one violates another, making the whole incoherent.
Without knowing, there is no doing, no way to re/produce structure, no
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Management Communication Quarterly 27(1)
Figure 1. Structurational divergence: The SD-Nexus and the SD-Cycle
efficacy (Sewell, 1992). In a structurationally divergent interaction system,
action cannot coherently re/produce or transform structure because the actor
does not control resources. Without coherent meaning, action is impotent and
agency lacks force. Our conceptual contribution herein is to explicate immobilization as agency loss.
Agency is never zero; doing nothing is a choice. However, individual
efficacy at the SD-nexus is so compromised that agency is nonfunctional.
Without control over structures, we cannot transform them. An SD system is
self-perpetuating; its contradictions re/produce contradictory actions. We
always have action choices, but in SD none satisfy all structurational constraints in place. This positioning is mystifying because the opposition is
invisible or stultifying because the opposition is unsolvable. If to avoid a kick
from the mule, I must choose being run over by the cart, I may just not move.
I have agency to decide not to act but no efficacy to impact either structure
transformatively. Acting on one structure subverts another, negating agency
for the whole. According to Sewell (1992), human capacity for agency is
inherent, and agency is enabled by knowledgeability of structure. But neither
he nor Giddens address what happens to agency under contradictory structures, a consideration SD theory can provide.
In summary, SD theory posits that interpenetration of equally compelling
oppositional structures creates unknowable structure (SD-nexus), negating
agency and giving rise to the self-perpetuating SD-cycle (unresolved conflict, immobilization, and inability to develop). SD is a holistic construct
capturing both the nexus of incompatible meanings/rules and the downward
Nicotera and Mahon
95
communicative spirals it creates. In SD, we cannot assign meaning in a comprehensible socially sanctioned way, so interaction cannot re/produce comprehensible structures. Emergent structures are unproductive or oppressive,
as seen in Barker’s (1993) transitioning management structures.
Modalities of Meaning
Giddens (1984) identifies structural modalities as signification, legitimation,
and domination, rules that allow us to assign every act/utterance a signification, judge its appropriateness, and ascertain our places in a domination
hierarchy. These modalities allow illustration of agency loss. Agency is not
power over others, but empowerment to act meaningfully. Power is transformative capacity to change the social and material world (Giddens, 1987).
Giddens’ structure is socially shared or common meaning in these modalities, that provides the agency to re/produce and transform structure. Nicotera
et al. (2010) illustrate
The physician writes a medication order. The nurse looks at the prescription and questions,‘‘50 mg?’’ setting off a too-familiar conflicted
interaction. Imagine that the nurse’s meaning system centers on safety
checks and the physician’s on an authority/compliance nurse-physician
relationship. For the nurse, that simple act (‘‘50 mg?’’) signifies a safety
check, is legitimate because nurses must be constantly vigilant for
medication errors, and presumes an egalitarian relationship in which all
caregivers are equally responsible for safety (nondominant). For the
physician, the act signifies disrespect for authority, is not legitimate
because a nurse must simply comply with physician orders, and presumes a dominant/submissive relationship. (p. 365)
The “verify order” rule is from a safety-check structure, but because this
particular physician does not ascribe to that structure, its intersection with an
equally forceful authority structure forbidding such questions is an SD-nexus.
Actions do not re/produce coherent structure, leaving both frustrated, blaming, and (with repetition) immobilized and unable to develop (SD-cycle).
Conflict is unresolvable if parties mobilize resources to enact rules of incompatible structures.
Agency loss would not happen if the nurse acted solely from knowledge of
the authority structure; the question would purposely signify disrespect for
physician authority, illegitimate because it subverts the dominance relationship. This act is bursting with the agency of resistance. Resistance re/produces
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domination; resistance cannot exist in the absence of something to resist. The
nurse is nondominant, as dictated by the structure, but she/he has agency.
Knowledge of the structure enables action upon it, empowers meaningful
action. This conflict would not be unresolvable. The nurse would still not
have power over the physician but would be empowered by knowledge of the
structure to act meaningfully upon it, resulting in its comprehensible reproduction and potentially its transformation to produce a new comprehensible
structure.
Structurational Divergence
as an Organizational Problem
The SD-nexus subverts agency. Because incompatible meaning structures
are not apparent, the underlying source of conflict is unclear, making efforts
to resolve it ineffective. Actions cannot reproduce a comprehensible structure, so resulting communication difficulties become entrenched. SD-nexi
result when institutional positioning crosses institutional and cultural boundaries. SD theory has been pursued in the nursing context, but it is an institutional phenomenon. Like structuration, SD theory is applicable to all human
social systems.
Background of SD Theory
The initial studies from which SD theory was developed included human
service, public sector, and educational settings. SD theory began as an explanation of African American organizations (Nicotera & Clinkscales, 2003).
Warfield-Coppock (1995) identified dysfunctional communication, termed
enculturation, as a unique problem of African American organizations,
explaining the phenomenon as rooted in incompatible intersection of African
American culture and Euro-centric organizational form. Enculturated organization is a narrow theory of African American organizations. In explicating
identical patterns in our own data from African American organizations, we
applied a structurational explanation making clear the intersection of incompatible structures as the root of the phenomenon—not the situated cultural
particularities of the structures themselves. To further broaden and clarify the
explanation, we illustrated the phenomenon as a deep structurational process
in an interpretation of the literature on organizational restructuring, mostly in
the private manufacturing sector. The communication difficulties encountered in restructuring mirror those of the enculturated organization and are
subject to the same structurational explanation. This explication of patterns
Nicotera and Mahon
97
across cultures, professions, and organizational settings demonstrates that
while specific issues that arise from SD may be unique to the organizational
setting, the root of the problem is structurational and applicable to any social
system in which multiple structures interpenetrate—in other words, organizational life. Warfield-Coppock theorized too narrowly, failing to theorize
explanatory roots and focusing on situated manifestations. Enculturated organization theory is applicable only to African American organizations, but SD
theory explains the factors that constitute enculturation. When these factors
exist in other settings, other specific issues arise, but patterns of the deeper SD
phenomenon are the same.
Organizational access for the seminal SD case study (Nicotera & Clinkscales,
2010) was initiated by a nurse manager who recognized her unit in the (2003)
book. SD was then applied to nurses, recognizing their institutional positioning
is at a complex nexus of multiple incompatible structures. Nursing is a fertile
setting in which to observe SD easily. Nurses are organizationally interesting,
living in a viper’s nest of potential SD. Given opportunity, SD theory could
have easily been expanded with other healthcare workers, human service
managers/administrators, schoolteachers, government workers, or social
workers (all represented in the original data).
SD as Organizational
Although developed in the nursing setting, SD is not a nursing—or healthcare—
phenomenon. SD is an organizational communication construct grounded in
institutional theory. While specific nursing issues that arise in conjunction
with SD may not generalize, the conceptual advantages of concentrating on
a consistent set of institutional structures (in the Giddensian sense) outweigh
concerns about specific issue generalizability. Focusing on a consistent set of
institutional constraints has fostered development of SD theory, allowing a
clear picture of structurational interpenetration to emerge. The particular
nature of those structures is less important than the observation of patterns
ensuing from their problematic intersection. An extensive literature addresses
the problem of generalizing from healthcare to other organizational settings.
Still, while healthcare institutions are unique settings, it is clear that the
organizational problems experienced in those settings are indeed organizational, not clinical. Ramanujam and Rousseau (2006b) devoted a Journal of
Organizational Behavior special issue to that problem; organization and
healthcare organization are not the same, but organizational dynamics are
still organizational. (See also Mintzberg, 1997, on organizational issues common to hospitals.)
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Management Communication Quarterly 27(1)
Ramanujam and Rousseau (2006a) use organizational theory to develop a
healthcare organization (HCO) theoretical framework applying organizational
constructs to primary HCO problems. Conflicting missions, interaction of multiple professions, multiple external stakeholders, and an ambiguous complex
external environment comprise a core set of HCO dynamics. These are structurational interpenetrations. Although specific HCO issues may not be generalizable to other organizational settings, underlying organizational explanations
can be applied to settings with similar dynamics. While structures, and the
agency they enable, “vary dramatically from one social world to another”
(Sewell, 1992, p. 21), the point is not in the desires, intentions, creative transpositions, or other performances of agency enacted by individuals. The point is
that structures enable agency, and SD renders agency impotent. In nursing, SD
is readily observable; this study observes SD in the nursing context.
An Exploratory Study
of SD and Communication
As a recently identified construct, SD’s published literature is limited. A
quantitative scale (Nicotera et al., 2010) allows us to identify related constructs. The original studies empirically linked SD to poor outcomes across
a range of human services and public sector settings. SD has since been
qualitatively related in nursing settings to destructive communication, turnover, and potentially dangerous outcomes (Anderson, 2009; Mahon &
Nicotera, 2011; Nicotera & Clinkscales, 2003, 2010). To provide a basis for
more sophisticated modeling, this study seeks to identify relationships
between SD and key destructive communication and organizational outcomes and to explore whether constructive communication is inversely
related to SD. We also examine the extent to which these constructs differentiate high SD from low. Identifying related constructs will allow us to
explore whether associated constructs are antecedents, results, mediators, or
moderators of SD.
Conceptually Associated Constructs
Role conflict (RC) and burnout have already been associated with SD as part
of validity-testing process for the SD scale. These are explored again here,
along with other variables associated with poor organizational outcomes in the
nursing literature: bullying, depression, and turnover intent. Communication
constructs included are argumentativeness, verbal aggressiveness, conflict
management style, taking conflict personally, and ambiguity intolerance.
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Role Conflict, Burnout, and Depression
Role conflict (RC) is defined as incompatible role expectations (House,
Schuler, & Lavanoni, 1983). Role expectations are action rules rooted in
institutional structures. When structures interpenetrate, incompatible action
rules manifest as RC. The nursing literature treats RC as an underlying cause
of poor outcomes (Chen, Chen, Tsai, & Lo, 2007; Musk, 2004; Schriner,
2007), but defining RC structurationally explains it as part of the SD-cycle.
RC produces stress, causing burnout (Ellis & Miller, 1993, 1994; Patrick
& Lavery, 2007; Shaha & Rabenschlag, 2007). Burnout is exhaustion caused
by long-term involvement in emotionally demanding situations (Pines &
Aronson, 1988). The Maslach Burnout Inventory (MBI), standard in nursing
research, has three subscales: Emotional exhaustion (EE), reduced personal
accomplishment (RPA), and depersonalization (Maslach & Jackson, 1981).
EE is work-related fatigue; sufferers feel worn down—the essence of SD
immobilization. RPA is specific to efficacy in providing patient care, which
does not result from nursing SD. The ability to provide quality care in spite
of SD is a source of pride (Nicotera & Clinkscales, 2010). Depersonalization
is callousness about patient needs and is likewise not related to SD. We expect
burnout to be related to SD, with EE most closely related, RPA less so, and
depersonalization not related.
Burnout is associated with depression among nurses (e.g., seminal work
by Firth, McIntee, McKeown, & Britton, 1986; Meier, 1984), especially as
linked to EE. Bandura’s (1977, 2001) social cognitive approach to depression
suits our central focus. Bandura defines agency (self-efficacy) as human
capacity to exercise control over one’s life. Through agentic transactions,
people are both products and producers of social systems (Bandura, 2001).
Self-efficacy beliefs, judgments of one’s own “capabilities to organize and
execute courses of action” (Bandura, 1986, p. 391), are directly related to
depression vulnerability. SD may contribute to depression among nurses if it
affects self-efficacy beliefs.
Bullying
Workplace bullying is related to structural factors and depressive individual
outcomes. Job demands (e.g., RC) and resources (e.g., decision authority, coworker
support) are powerful predictors of bullying, which mediates the relationship
between job demands and depressive symptoms (Balducci, Fraccaroli, &
Schaufeli, 2011). The healthcare sector leads in reported workplace bullying incidents (Zapf, Einarsen, Hoel, & Vartia, 2003), and nurse-nurse bullying has been
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studied for decades. (For literature reviews, see Hutchinson, Vickers, Jackson,
& Wilkes, 2005, 2006a, 2006b; Hutchinson, Wilkes, Vickers, & Jackson, 2008,
in nursing, and Lutgen-Sandvik, Namie, & Namie, 2009, in general workplace.)
Hutchinson’s treatment of bullying in nursing is consistent with LutgenSandvik et al.’s (2009) communication-grounded definition: “repeated, healthharming mistreatment that takes one or more of the following forms: verbal
abuse; offensive conduct and behaviors (including nonverbal) that are threatening, humiliating, or intimidating; or work interference and sabotage that prevent work from getting done” (p. 27). Repetition, duration, escalation, harm,
attributed intent, hostile work environment, communication patterning, and
distorted communication networks differentiate bullying from onetime incidents (Lutgen-Sandvik et al., 2009). Bullying can be dispute-related, predatory,
or rooted in organizational practice. When interpersonal disagreements escalate
to entrenched conflict (like SD), dispute-related bullying results (Einarsen,
1999, cited in Lutgen-Sandvik et al., 2009). Predatory bullying types are
authoritative (abuse of power), displaced (taking workplace frustration out on
coworkers), and discriminatory (out-group prejudice; Lutgen-Sandvik et al.,
2009). Of these, displaced-bullying is most closely related to SD.
Workplace bullying occurs in negative stressful environments characterized by role-conflict and -ambiguity (Hoel & Salin 2003). Together, incoherence of organizational procedures and relational powerlessness predict
bullying (Hodson, Roscigno, & Lopez, 2006): “Unresolved contradictions in
[the] meaning, nature, and implementation” of incoherent procedures “fail to
prevent bullying” (p. 407). Under such SD conditions, bullying may be a
frustrated attempt by individuals to reclaim agency lost to incoherent structures. Bullying, however, serves only to deepen the cycle of SD, further subverting agency.
Turnover Intent
Bullying predicts nursing job or profession turnover intent (McKenna, Smith,
& Poole, 2003), burnout (Leiter & Maslach, 2009), RC (Gormley & Kennerly,
2011), and depression (Lai et al., 2008). Exit is the ultimate agentic strategy
when the only comprehensible way to act upon the structure is to leave it.
H1: The following destructive organizational variables are positively
associated with SD: role conflict, burnout, bullying, depression, and
turnover intent.
RQ1: How do destructive organizational variables differentiate high
SD from low?
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Communication-Related Constructs
To explore how communication constructs link to SD, we identified several
communication variables traditionally associated with aggression and conflict,
assuming destructive communication is positively related to SD. Constructive
communication may be inversely related, mitigating SD. Communication
variables may mediate or moderate the effects of SD on professional, work
product, or organizational outcomes.
Because interpersonal communication associated with SD is marked by
hostility, anger, and frustration, we included communicative predispositions
to aggression: Verbal aggressiveness (VA) and its constructive counterpart
argumentativeness (Infante & Rancer 1982; Infante & Wigley, 1986). VA, the
tendency to approach disagreement with personal attack (Infante & Wigley,
1986), is related to bullying (Wigley, 1998) and is expected to be associated
with SD. The nursing literature has examined bullying from the victim’s
perspective—the degree to which one is bullied. Examining VA explores
whether the perpetration of destructive acts may be related to SD. VA may be
a destructive expression of agency.
Argumentativeness is a tendency to approach disagreement with issue
attack (Infante & Rancer, 1982). Although argumentativeness is a constructive expression of agency, reasoned argument cannot likely solve fundamental invisible meaning incompatibility. Though it is probably ineffective once
the SD-cycle entrenches, argument may discover fundamental meaning differences to prevent escalation of an SD-nexus into an SD-cycle. We expect
argumentativeness to be inversely related to SD.
Beliefs about arguing underlie argumentativeness (Rancer, Kosberg, &
Baukus, 1992). While teasing out experiences, behaviors, and attitudes is
beyond the present scope, it is worthwhile to explore whether beliefs about
arguing might be associated with SD. Individuals experiencing SD may
develop negative beliefs about arguing. We expect that SD is associated with
negative beliefs and inversely related to positive beliefs. Identifying patterns
can generate questions about the intersections of SD, argumentative behavioral tendencies, and attitudes.
Conflict management style (CMS) allows direct examination of agentic
conflict communication tendencies. Putnam and Wilson’s (1982) organizational communication conflict instrument (OCCI) focuses on strategic communicative messages. The conceptualization is based on the dual concern
model, five styles along two dimensions (assertiveness and cooperativeness).
Avoiding is neither; smoothing is cooperative but not assertive; controlling is
assertive but not cooperative; collaborative is both; and compromise is in
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moderate ranges. Factor analysis created three independent subscales: Solution
orientation (compromise and collaboration); nonconfrontational (smoothing
and avoiding); and controlling. Because SD-associated conflict is rooted in
incompatible meaning, productive conflict management does not solve it, but
solution oriented CMS is skilled interaction that may prevent escalation of an
SD-nexus into an SD-cycle. We expect solution-oriented CMS to be inversely
related to SD. Controlling CMS is expected to exacerbate SD, and vice versa,
displaying an association with SD. Finally, we expect nonconfrontational
CMS, a form of immobilization, to be associated with SD.
Hample and Dalliger’s (1995) taking conflict personally (TCP) may also
be related to SD. TCP has six dimensions. The first three are reactions to
conflict: Direct personalization (hurt feelings from feeling criticized); persecution feelings (combative and feeling picked on); and stress reaction (tension and discomfort). Two others are general attitudes about effects of
conflict: Positive and negative relational effects. The sixth is like/dislike
valence. Individuals who feel conflict personally and negatively may experience SD and its loss of agency more intensely. We expect negative dimensions of TCP to be associated positively with SD and the positive dimensions
to be associated negatively.
Finally, given the ambiguity associated with the SD-nexus, ambiguity
intolerance (Norton, 1975) may be related. Individuals who cannot tolerate
ambiguity may experience SD more intensely. We expect SD to be positively
associated with ambiguity intolerance.
H2: The following destructive communication variables are positively
associated with SD: VA; negative beliefs about argument; controlling CMS; nonconfrontational CMS; TCP direct personalization;
TCP persecution feelings; TCP stress reactions; TCP negative relational effects; and ambiguity intolerance.
H3: The following constructive communication variables are inversely
associated with SD: Argumentativeness; positive beliefs about argument; solution-oriented CMS; TCP positive relational effects; and
TCP like/dislike valence.
RQ2: How do these communication variables differentiate high levels
of SD from low?
Method
These data were gathered for this exploratory study and, for part of the sample,
as a pretest for assessment of a training intervention. The sample (N = 86) was
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103
recruited through several healthcare systems in a major metropolitan area
(administered as web-based survey; n = 50) and from nursing school graduate courses in three states (paper-and-pencil survey; n = 36). All participants
were full-time practicing nurses for at least the year prior to the survey.
Sample, Instrumentation, and Analysis
The sample consisted of 71 females, 3 males, and 12 undisclosed; average
age 38.49; 59% European American, 10% African American, 7% Latina, 7%
African, with the remainder other ethnicity (3%) or undisclosed (14%).
Participants represented a wide variety of specialties and experience,
25% with managerial experience, and had been in nursing for an average
of 14 years (range 1-40), in their current setting for an average of 5 years
(range 1-31), in their current job for an average of 3 years (range 1-10), and
in their current specialty for an average of 4 years (range 1-21). Inpatient
settings represented 54% of the sample. Thirty-six respondents were training
participants who took the survey when they enrolled, before they had any
contact with instructors or the course material. The course assessment is
reported elsewhere.
Table 1 lists measures and reliabilities. SD (Nicotera et al., 2010), RC
(House et al., 1983), bullying (Hutchinson et al., 2008), burnout (Maslach &
Jackson, 1981), depression (Radloff, 1977), VA (Infante & Wigley, 1986),
argumentativeness (Infante & Rancer, 1982), beliefs about arguing (Rancer et
al., 1995), TCP (Hample & Dallinger, 1995), CMS (Putnam & Wilson, 1982),
and ambiguity intolerance (Norton, 1975) are measured with standard scales.
Turnover intent was operationalized with two single yes/no questions about
intent to leave current job and the nursing profession. Analyses were Pearson
correlations, independent t tests or chi-squares; for some, respondents were
grouped as high- and low-SD by the scale midpoint.
Measuring SD
The self-report SD scale measures SD in the nursing context. Using 50 items
generated from interview transcripts of nurses describing SD, a 17-item scale
resulted from expert review, extensive exploratory and confirmatory factor
analysis, and validity-testing with a sizable sample of nurses. (See Nicotera
et al., 2010, for details, scale items and instructions.) The instrument operationalizes SD at the individual level, holistically capturing SD and targeting
each of its components. The summed subscales are unresolved conflict,
immobilization/individual development, and managerial/organizational
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Table 1. Reliabilities
Measure
Instrument
Structurational
divergence
Role conflict
Burnout
Nicotera et al. (2010)
Bullying
Depression
Verbal aggressiveness
Argumentativeness
Beliefs about arguing
Hutchinson et al. (2008)
Radloff (1977)
Levine et al. (2009)
Kotowski et al. (2009)
Rancer, Kosberg, & Baukus
(1992)
Putnam and Wilson (1982)
Conflict management
style
House et al. (1983)
Maslach and Jackson (1981)
Taking conflict
personally
Hample and Dallinger
(1995)
Ambiguity intolerance
Norton (1975)
Cronbach’s alpha (subscale)
.90
.84
.89 total
(.93 emotional exhaustion)
(.74 reduced personal
accomplishment)
(.78 depersonalization)
.93
.79
.87
.62
.87 positive beliefs
.82 negative beliefs
.83 solution oriented
.90 nonconfrontational
.71 controlling
.85 direct personalization
.85 persecution feelings
.74 stress reaction
.86 positive relational
effects
.81 negative relational
effects
.81 like/dislike valence
.82 total
(.62 philosophy)
(.60 interpersonal
communication)
(.64 public image)
(.64 job-related)
(.76 problem-solving)
development. There is an operational connection between immobilization
and individual development; whereas individual-level development and
organizational-level are conceptually collapsed in the theory, they are operationally distinct. The scale can be used as an individual or group diagnostic tool. Scores above the midpoint label an individual as high-SD. For
Nicotera and Mahon
105
aggregates, a mean score above the midpoint is used in the same way. It must
be cautioned, however, that full diagnosis of SD involves observation to
identify the particular intersecting oppositional meanings. The instrument
operationalizes the SD-nexus and the SD-cycle but cannot identify specific
intersections.
Results
Results reveal several significant relationships with medium to large effect
sizes. Both organizational and communication variables are associated with
structurational divergence. (Throughout the reporting of results, with the
exception of tables, the variable name structurational divergence will be
spelled out, reserving the abbreviation SD for standard deviation.) The first
hypothesis predicted that RC, burnout, bullying, depression, and turnover
intent would be associated with structurational divergence. All of these
destructive variables were positively associated with structurational divergence: RC (r = .68; p = .000; N = 80); burnout (r = .48; p = .000; N = 79);
bullying (r = .64; p = .000; N = 76); and depression (r = .49; p = .000; N =
78). For burnout subscales, only EE was correlated with structurational divergence on its own (r = .60; p = .000; N = 81). Structurational divergence was
significantly higher for those who indicated an intention to leave their current
job (using statistics for unequal variances: t (53.85) = 3.64; p = .001; d = .85;
intention to leave M = 42.73, SD = 13.78, n = 34; and no intention to leave
M = 32.78, SD = 8.69, n = 40). It was impossible to test intention to leave the
profession because only one person indicated such intention. Her explanation is, however, consistent with structurational divergence: “[I] feel that
many times the contribution of nurses are overlooked and belittled. If any
mistep [sic] is made, too much effort is made by peers and superiors to
expose your ‘incompetence.’ [I am] growing weary of the ‘backstabbing’
nature of the profession.”
To answer the first RQ, examining whether these variables differentiate
high levels of structurational divergence from low, the sample was split into
two groups at the midpoint of the structurational divergence scale (high structurational divergence n = 13; low structurational divergence n = 71; and missing n = 2). Again, all tests were significant, with EE being the only subscale
of burnout related on its own. See Table 2 for t tests. A chi-square test also
indicated that the high structurational divergence group is differentiated from
the low structurational divergence group by turnover intent as well (X2 =
10.52; p = .001; Φ = .38).
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Management Communication Quarterly 27(1)
Table 2. Organizational Variables That Differentiate Low SD From High SD (t tests)
Variable
t
Role conflict
5.62*
Burnout
3.41*
Emotional exhaustion 5.18*
Bullying
4.39*
Depression
4.19*
df
d
78
77
79
74
76
1.76
1.07
1.62
1.43
1.36
Low-SD SD
Low- (standard
SD M deviation) n
HighSD M
23.08
41.75
17.18
33.77
16.71
31.67
52.67
27.00
55.70
22.38
4.97
10.38
6.17
14.88
4.07
68
67
69
65
67
High-SD SD
(standard
deviation) n
4.23
9.24
5.36
17.88
4.72
12
12
12
11
11
*p < .001
The second hypothesis predicted that VA, controlling CMS, nonconfrontational CMS, TCP direct personalization, TCP persecution feelings, TCP
stress reaction, TCP negative relational effects, and ambiguity intolerance
would be positively associated with structurational divergence. The hypothesis was supported for VA (r = .30; p = .006; N = 80), negative argument
beliefs (r = .31; p = .006; N = 79), controlling CMS (r = .36; p = .001; N =
80), TCP persecution feelings (r = 0.35; p = .001; N = 82), TCP stress reaction
(r = .22; p = .048; N = 82), TCP negative relational effects (r = .34; p = .002;
N = 81), and ambiguity intolerance (r = .27; p = .013; N = 81). When analyzed separately, only the problem-solving ambiguity intolerance subscale
was significant: (r = .26; p = .02; N = 82). H2 was not supported for nonconfrontational CMS and TCP direct personalization.
The third hypothesis predicted that argumentativeness, positive beliefs
about arguing, solution oriented CMS, TCP positive relational effects, and
TCP like/dislike valence would be inversely associated with structurational
divergence. This hypothesis was unsupported. The second RQ was explored
using the same groups as the first (see Table 3). Negative beliefs about arguing and all four negative TCP variables differentiate the high structurational
divergence group from the low structurational divergence group. VA, controlling CMS, nonconfrontational CMS, ambiguity intolerance, argumentativeness, positive beliefs about arguing, solution oriented CMS, TCP positive
relational effects and TCP like/dislike valence do not.
Discussion
SD is strongly related to the major organizational problems examined in this
study: RC; burnout; bullying; and depression. Each of these problems can be
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Nicotera and Mahon
Table 3. Communication Variables That Differentiate Low SD From High SD (t tests)
Variable
Negative argument
beliefs
TCP direct
personalization
TCP persecution
feelings
TCP stress reaction
TCP negative
relational effects
t
Low-SD SD
Low- (standard
df d SD M deviation) n
HighSD M
High-SD SD
(standard
deviation) n
2.25* 77 .71 29.87
5.03
67 33.50
527
12
2.16* 79 .68 21.92
5.26
69 25.40
4.41
12
2.44* 80 76 15.30
4.05
70 18.42
4.34
12
2.37* 80 .74 15.83
2.89* 79 .90 16.68
3.41
3.32
70 18.33
69 19.58
3.14
2.43
12
12
Note: TCP = taking conflict personally
*p < .05
argued as a loss of agency. All are associated with SD as measured on its
continuous scale and differentiate those with a problematically high level of
SD from those with low SD. Clearly, our pursuit of understanding the association of this phenomenon with troublesome workplace environment variables is warranted. The effect sizes for these findings were quite large.
Theorizing SD as Agentic Impotence
The loss of agency theorized here is not a total loss of human agency, which
would be antithetical to the structurational premise. Structuration theory solves
the conceptual tension between individual will and societal constraint,
accounts for evolution of social structures, and bridges sociology and psychology. The introduction of Giddens to organizational communication served to
solve similar tensions among the structural-functionalist, social psychological,
and behaviorist approaches. Structuration provided what other theoretical
frameworks (Weick’s organizing and Cushman's rules theory, for example)
could accomplish only in part. The popularity of structurational approaches in
organizational communication can be attributed to our continuing need to
understand institutional/organizational structure and human behavior in concert with one another as their connections manifest in communication.
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Management Communication Quarterly 27(1)
Agency, the primary construct meeting that need, presumes a teleological
ontology. As agent, each individual member of an organizational system mobilizes resources and invokes existing structures to follow and use purposively.
Agency allows individuals to choose, accidentally or strategically, actions
that transform structures. This transformative agency is compromised by SD.
RC reduces ability to meet the needs of others; meeting the needs of others is
central to the nursing job function—the agentic goal. RC has been conceptualized as a surface level manifestation of SD, so its association is not surprising. When occupying an internally conflicted role, actions invoking one set
of rules necessarily violate another set. In SD, moreover, the individual cannot effectively reproduce oppositional structures simultaneously and thus cannot transform them. The simultaneous nature of the demands conceptually
differentiates SD from RC. Examining this through Giddens' modalities, communication signifies oppositional meanings for behaviors that are simultaneously legitimate and illegitimate, and the SD sufferer’s powerless position
limits his/her ability to respond transformationally. Individuals in SD-entrenched
systems consistently report feelings of powerlessness and inability to create
effective changes that improve their lives and allow them to get things done.
When productivity and performance are monitored by those in authority, the
inability to meet those goals effectively because of the cross-purposes created
in the SD system is defined here as impotent agency.
Metaphors such as “running in concrete,” “between a rock and a hard
place,” and “the hamster wheel” have all been used to describe SD. The inability to accomplish tasks, meet goals, and achieve development resonates with
our agency impotence interpretation of SD. Since development is a transformational phenomenon, the inability to transform structurationally divergent
intersections of meaning into a coherent system seems a good explanation for
the entirety of the SD-cycle. The constant repetition of attempts to solve
intractable problems is highly stressful, so it is expected that SD is associated
with burnout, particularly with emotional exhaustion. When it does not result in
turnover, burnout leaves people feeling hopeless and trapped—immobilization
in the SD-cycle. Burnout has long been associated with diminished efficacy,
validating our interpretation. If SD creates and/or exacerbates RC at the same
time that it generates intractable interpersonal and organizational conflicts, it
is not surprising that SD is also associated with bullying and depression.
Bullying is a long-recognized intractable problem in nursing. Anecdotal data
from the portion of this sample who took the training course following this
survey suggests a widespread belief among nurses that bullying is due to problem personalities. Indeed, a common cliché among nurses is that they “eat
their young” (e.g., Anderson, 2009). Under the reasoning that the SD-nexus
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Nicotera and Mahon
Table 4. Organizational Variables Related to Intent to Leave Current Job
Variable
t
Role conflict
3.40*
Burnout
2.90*
Emotional exhaustion 3.18*
Bullying
2.79*
Intent SD
No intent SD
Intent (standard
No
(standard
df d
M deviation) n intent M deviation)
n
72
72
72
70
.79
.68
.74
.66
26.27
47.25
21.15
42.40
6.07
10.40
6.64
17.45
34
34
34
32
22.10
40.22
16.40
31.57
4.47
10.35
6.20
15.40
40
40
40
40
*p < .05
countermands agency and the SD-cycle deepens due to an inability to effect
structural transformation, it seems that the frustration and anger generated by
SD gets turned outward as bullying and inward as depression. Of course,
under the adage that the only real fix for a bad job is finding a better job, an
equally common manifestation of agency is exit, which brings us to turnover.
The fact that nearly half the sample indicated intention to leave their current jobs is chilling. Turnover, an oft-cited problem in nursing, leads to shortages and discontinuities in patient care. We conducted post hoc analyses to
examine which variables are independently related to intentions to leave current job. All except depression are significantly related in the expected direction. (Again, for burnout subscales only EE is related on its own; see Table 4).
More research is needed to investigate the complex relationships among SD,
communication, individual and organizational outcomes. Based on these
promising results, a large (N = 713) follow-up study to conduct more sophisticated analysis replicates them and finds strong inverse relationships between
SD and additional organizational variables: job satisfaction; professional identification; and organizational identification (Nicotera & Kim, 2012; Nicotera,
Zhao, Kim, Peterson & Mahon, 2012). Preliminary analyses also reveal that
burnout, RC, bullying, and organizational identification partially mediate the
relationships of SD with job satisfaction and turnover intent. This new dataset
also includes hospital-provided performance measures (errors, cost overruns,
actual turnover, and patient satisfaction) not yet analyzed.
Challenging Notions of Good Communication
The most intriguing finding in the present study is that while destructive
communication variables are positively related to SD, all with large effect
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Management Communication Quarterly 27(1)
sizes, no constructive communication variables are significantly associated
with SD. This is not an inverse relationship, but none at all. Good communication skills traditionally applied to conflict seem irrelevant—offering no
protection from or recourse for this set of problems. To further explore this
finding, the large follow-up study (Nicotera et al., 2012; Nicotera & Kim,
2012) also included Duran and Spitzberg’s (1995) cognitive communication
competence (CCC), which operationalizes communication competence as
conscious reflection on one's communication before, during, and after interaction. Remarkably, CCC is positively correlated with SD, albeit weakly,
suggesting that thinking about one's communication, normally considered a
constructive communication skill, not only is unhelpful under SD, but may
actually contribute to the problem.
The present results suggest that skilled and unskilled communicators alike
are sucked into the SD-cycle. It is not that lack of good communication fosters SD; it is that our level of good conflict communication skills means nothing to SD; evidence from our more recent data suggests it may even make it
worse. Our findings validate our contention that conflict cycles, as explained
by SD theory, require a more sophisticated understanding than individual differences (in values, goals, etc.), which might be called ordinary conflict.
Good communication skills for ordinary conflict do not solve SD-related
problems. Good interpersonal communication skills are irrelevant to SD
because SD is not an interpersonal problem. SD is an organizational problem
manifesting in interpersonal communication. The apparent irrelevance of the
agentic activities of good communication also supports our contention that
SD strips human agency.
The nature of the relationship between SD and destructive communication, while important, remains inconclusive. Destructive communication
variables may be moderators, leading the SD-nexus to escalate to an SD-cycle,
while constructive communication is irrelevant. It is interesting to note that
while neither argumentativeness nor positive argument beliefs are related to
SD, negative argument beliefs are positively associated. The distinction
between argumentativeness and argument beliefs is behavior and attitude. SD
may create a negative attitude toward the agentic activity of argument, stripping the individual both of agency and of belief in its value and suggesting
developmental regression rather than just stagnation.
Implications for Intervention
To further examine the relationships of these variables with SD and assess
potential for intervention, we compared significant bivariate correlations to
Nicotera and Mahon
111
t tests differentiating high- and low-SD. First, we identified variables with
significant bivariate relationships that also differentiate high- from low-SD.
All the organizational variables fell into this category. For communication
variables, TCP persecution feelings, TCP negative relational effects, and
TCP stress reaction also are each related in both ways. TCP direct personalization, on the other hand, differentiates high and low SD groups, but does
not have a significant bivariate relationship with SD as a continuous variable.
An intervention must directly address SD consciousness, helping participants to reframe interpretations of personal conflict as structural positioning
problems—reframing opponents as allies with a common problem.
Second, we identified variables with a significant bivariate relationship
with SD that do not differentiate high- from low-SD. Controlling management style, VA, and ambiguity intolerance (and its problem-solving subscale)
fell into this group. This finding may indicate that these variables moderate
the effects of SD; those diagnosed as high-SD were not significantly different
from low-SDs for these destructive communication variables. TCP appears to
operate differently with SD than all the other communication variables. The
specific TCP subscales that seem most important are interesting. Feeling personally criticized, believing that conflict impacts relationships negatively,
reacting with stress, and directly personalizing likely stem from an underlying dysfunctional presumption that conflict is necessarily destructive.
Fundamental biases in Western organizational life frame conflict as necessarily dysfunctional and emotion as counterproductive; these are primary obstacles to the application of effective conflict intervention (Bodtker & Jameson,
2001). Any intervention needs to dispel these biases.
Third, concluding that skills associated with good conflict management
are not applicable to SD presents an interventionist quandary. SD masquerades as interpersonal conflict; lurking beneath the surface to manifest as something it is not, so any intervention must provide conflict analysis training,
consciousness-raising, and skills for transcendence (following Bodtker &
Jameson’s, 2001, application of Galtung’s, 1996, triadic theory, and Pearce
& Littlejohn’s, 1997, transcendent eloquence). Our intervention consists of
consciousness-raising focus groups that teach narrative skills for transformational change by empowering individuals to reframe their stressful conflicts and choose their own positioning. Reframing, or rewriting one’s own
narrative, may or may not result in the resolution of incompatibility. However,
transcendence occurs in the redefining of an enemy as a comrade with a common structural problem. Recurrent interpersonal conflicts are reframed as
joint problem-solving tasks (as conceptualized in Canary and Spitzberg’s,
1989, model of competent conflict communication). This reframing provides
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Management Communication Quarterly 27(1)
choices for action, restoring transformational agency. If the SD-nexus cannot
be resolved, reframing relationships transforms structure, allowing evolution
of social practices to prevent escalation of the SD-cycle. The assessment of
the training (attended by some of the participants in the present study after
these data were collected) are reported elsewhere.
Finally, although SD is an institutional phenomenon, all variables in the
study were measured at the individual level because SD is manifested at the
individual level and communication skills are individually based. It now is
clear that the institutional forces driving SD are impervious to good conflict
communication skills at the individual level, even as they encourage poor
communication. More specialized skills, relying on deeper awareness of
institutional forces and on an understanding of the SD phenomenon, may
mitigate the effects of SD at the individual level. Our SD education program
focuses energy on problems without blaming individuals or suggesting personal failings but by providing a framework to understand the underlying
source of daily frustrations and a set of skills to navigate a difficult landscape.
Nurses in this sample who later participated in the training course reported
after the course that they felt a great sense of relief and renewed energy when
their feelings that something was just not right were validated and a set of
analytic and dialogic skills were provided for them to map their treacherous
landscape. This response appears to be a resurgence of agency.
Nursing as an Organizational Setting
Nursing’s professional culture is conflict avoidant: Nurses do not seem to
recognize the benefits of healthy conflict management, viewing direct
confrontation of conflict as unprofessional (Mahon & Nicotera, 2011).
Further study should examine the nature of the relationships among TCP
variables and SD among nurses and in other populations. The nursing literature is flooded with descriptions of organizational challenges. A
plethora of constructs has emerged (e.g., RC, burnout, moral distress, bullying), but because they lack grounding in organizational and communication theory, explanations are incomplete. Perhaps the most striking tone in
this literature is the blame placed on the individual: If only the nurse had
more skill, greater understanding, or advanced knowledge, the problem
would disappear.
We hope our interdisciplinary effort to apply organizational communication theory to nursing fosters a new paradigm in nursing research and communication research in nursing settings that views the setting through the
lenses of organizational theory. The nursing literature’s individual-focus,
Nicotera and Mahon
113
individual-blame approach has been unfruitful. SD theory as applied to nursing reveals that incompatible structural intersections foster cultures in which
agency is impotent and unhealthy communication perpetuates.
Generalizing to Other Organizational Settings
Organizational communication researchers commonly conduct research in
healthcare settings with scant, if any, attention to unique dynamics and constraints posed by the setting. Few pay attention to context. The organizational
literature is applied to healthcare settings with inadequate regard to their distinct organizational features. Findings from these settings are often generalized to “organizations,” without acknowledging any organizationally distinct
features of the healthcare organizational context. A cursory search of organizational research in the last 5 years in hospital settings generated a concerning
number of published studies done this way, many by well-known scholars
(e.g., Benoit-Barné & Cooren, 2009; Bordia, Jones, Gallois, Callan, &
DiFonzo, 2006; Coyle-Shapiro, Kessler, & Purcell, 2004; Doorewaard &
Brouns, 2003; Ferres, Connell, & Travaglione, 2005; Goodier & Eisenberg,
2006; Grice, Gallois, Jones, Paulsen, & Callen, 2007; Jamal & Baba, 2003;
Kaplan & Patel, 2008; Lewis, 2000; Murray & Peyrefitte, 2007; Rooney,
Paulson, Callan, Barbant, Gallois & Jones, 2010). There are fewer that attend
to the unique organizational features of HCOs, and in those that do, generic
“organization” is the theoretic focus (e.g., Fitzgerald & Desjardins, 2004;
Gittel & Weiss, 2004; Viitanen & Piiraninen, 2003; Winch & Derrick, 2006;
Ye, Marinova, & Singh, 2007).
Ramanujam and Rousseau (2006a) highlight the fundamental pluralism of
HCOs with four unique organizational features that amplify the administrative complexity of day-to-day tasks. First, HCOs have multiple conflicting
missions (e.g., patient care, community service, medical education, profit,
health research, religious values). Assessment of mission achievement must
be based on multiple dimensions. Second, the HCO workforce is comprised
of multiple professions with differing training and licensing requirements,
salary structures, and power roles. Furthermore, they are socialized in other
organizational systems.
So dominant are institutionalized pre-employment processes that many
HCOs attempt little or no socialization of their own workforce. Weak
organization-based socialization means that individuals can have as
many different professional practices and care-giving behaviors as the
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Management Communication Quarterly 27(1)
institutions that educated them. . . . The result is strong professional
identification and weak organizational identification. (pp. 813-814)
Third, HCOs face multiple external stakeholders, including government
and multiple professional associations. Finally, the HCO has a complex task
environment—ambiguous, dynamic, local, and subject to the simultaneous
demands of standardization and flexibility.
SD is undoubtedly an institutional phenomenon, but this identification
does not predict SD in all organizational settings. The fundamental pluralism
of HCOs likely makes the nursing environment susceptible. The identification
of nursing as ripe for SD because of intersecting meaning systems is conceptually captured by this notion of fundamental pluralism, but the connection
remains an empirical question. A full understanding can only be accomplished
by expanding beyond nursing and healthcare to a variety of professional, organizational, and industrial settings. Wherever an SD-nexus can be identified,
development of SD-cycles is possible. The question remains in what organizational settings SD-nexi might occur. SD is likely in settings marked by the
kind of fundamental pluralism seen in HCOs, such as other human service and
public sector organizations in government, education, social services, nonprofits, and so on, as well as in private sector organizations with pluralistic
dynamic environments and structures, such as health insurance companies,
highly regulated industries, and any organization undergoing fundamental
restructuring or volatility in its environment.
Limitation
The respondents enrolled in the course following this survey were interested
in learning about workplace conflict. The potential confounds between this
self-selected group and rest of the sample was checked by t tests, revealing
no significant differences on any variables, including SD. A chi-square
between the SD-grouping split and the self-selected sampling split showed
no significant difference. About 16% of the sample classify as high-SD, not
predicted by self-selection. Still, there may be some unknown differences
between the two groups.
Conclusion
These analyses offer a good beginning for exploring SD, which seems a
fruitful avenue to understand more deeply, from a communication theory
perspective, organizational conflict cycles and related problems. We have
Nicotera and Mahon
115
shown that organizational and communication variables are differently
related to SD and that destructive and constructive communication variables
must also be treated differently. In addition to deepening our understanding
of SD and nursing, future research must examine SD across other professions
and organizational settings.
Acknowledgement
This research was funded by the George Mason University Center for
Consciousness and Transformation.
Declaration of Conflicting Interests
The author declared no potential conflicts of interest with respect to the research,
authorship, and/or publication of this article.
Funding
The author disclosed receipt of the following financial support for the research,
authorship, and/or publication of this article: This research was funded by the George
Mason University Center for Consciousness and Transformation.
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Bios
Anne Maydan Nicotera (PhD, Ohio University) is an associate professor in the
Department of Communication at George Mason University, USA. Her main research
interests include workplace conflict, communicative constitution of organization,
nursing communication, and diversity.
Margaret M. Mahon (PhD, University of Pennsylvania) is an associate professor in
the School of Nursing at Catholic University of America, USA. Her main research
interests include nursing workplace environment and ethical decision making in palliative care.