The role of dominance and subordination in the disruptive behaviors of nurses working at military hospitals: a qualitative content analysis

Background and aims: The existence of disruptive behaviors in medical centers is a long term problem that has very negative consequences for nurses, organizations, and patients. Since the disruptive behaviors are a complex, multi-dimensional, interactive, and social phenomenon, and they are depended on the culture and religion of each community; therefore, this study aimed to explore perceptions of nurses on disruptive behaviors in the Iranian medical centers. Methods: This qualitative study was conducted with the participation of 15 nurses working in six military hospitals in Tehran, Iran in 2016. The targeted sampling method was used during semi-structured interviews to collect data. Data analysis was performed by contractual content analysis and was conducted continuously and simultaneously with the data collection. Results: Two main categories and five subcategories were recognized, including: 1) domination in nursing (bullying and violence, abuse of power); and 2) subordination in nursing (lack of power over physicians, silence and passive compromise, hatred of organization and reduced self-confidence). Conclusion: One of the most important reasons for nurses’ disruptive behaviors is the phenomenon of oppression, dominance­subordination in nursing, and power hierarchy in Iranian medical centers. Therefore, in order to solve this problem and improve professional behaviors, the concept of empowering nurses to deal with dominance­subordination in nursing should be emphasized.