All healthcare organizations will have some form of conflict between their staff. Plainly stated, conflict is a disagreement or argument between two individuals or a group of people, usually when there is a difference in opinion, values, or beliefs. In the nursing profession, there can be conflict among nurses, or other members of the healthcare team. If conflict goes unaddressed the results can be damaging: loss of staff, mistrust, ineffective collaboration, and poor work performance. In order for patients to receive high quality care, the healthcare team must be able to communicate and work together effectively. There will always be conflict, but it can be managed, as nurse managers, it is important to be knowledgeable on conflict resolution (Finkelman, 2016).
When conflict arises, the first step in effective resolution is to perform a thorough assessment to establish the cause of the conflict. There may be several reasons that led to the conflict, or there may be just one. “Two predictors of conflict are the existence of competition for resources and inadequate communication” (Finkelman, 2016, p. 325). Understanding the four stages of conflict is required in order to determine the cause . Meet individually or as a group with staff members to discuss problems within the department in order to establish the cause or causes that led to the conflict.
The four stages of conflict are: latent (anticipation), perceived (perception conflict exists), felt (feelings of stress and anxiety), and manifest (overt, behavior displayed in front of others)(Finkelman, 2016).
In the case study of the nurse manager of the operating room. The conflict was in the perceived stage when the manger noticed problems with communication among the nurses and physicians. In the felt stage, the nurses where calling out and complaining they were "second class citizens". The surgical resident and nurse yelling in the hallway was overt behavior (manifest conflict).
Conflict will never go away, but at times it can be prevented. By establishing open communication with staff, ensuring staff awareness of policies and procedures, staff roles and responsibilities, and standards of behavior, managers can be successful in preventing potential conflict in their departments. By establishing ground rules, leaders can coach and educate staff on how to handle improper behavior among peers and other members of the healthcare team (Cohen, 2014).
"Leaders need to encourage conflict resolution that shifts from a culture of avoidance or inappropriate resolution methods to scenarios that mentor professionalism, personal growth, and respect" (Cohen, 2014, p. 17). Nurse leaders can assess their departments ability level to handle conflict through staff meetings, or lunch and learns. Teaching them the skills needed to confront and resolve conflict effectively. This helps the work unit to grow as a team, by dealing with conflict through a healthy approach.
As the model of healthcare delivery changes, nurses and physicians need to have a good working relationship for the delivery of safe high quality care. Often, there is friction between the two disciplines due to the different job roles of each, and lack of understanding of those roles. Physicians have a different approach to patient care than nurses, resulting in a difference of opinion of the plan of care. A key element to improving this relationship is for each party to have a better understanding of each discipline (Finkelman, 2016).
One way the healthcare organization that I work in, is doing to improve nurse-physician relationships is through teaching conscious leadership. In my department, the providers have a monthly session of conscious leadership that they are required to attend. This has been very successful in improving the collaborative relationship between nurses and physicians. The nurses role is recognized, and he/she is involved in discussions and input regarding patient outcomes. Each department does a daily huddle to review the patient schedule and the delivery of care. This approach has proven effective in reducing the conflict between nurses and physicians.
A key factor to resolving conflict in the unit is through the action of negotiation. Through negotiation, all parties involved in the conflict are questioned in order to clarify the involved situation. It is imperative that patients and their family members should not suffer as a result of the conflict among the staff. Afterwards, the manager will establish clear guidelines for resolution, which will be presented to staff in writing (Finkelman, 2016).
There is a right and wrong time to address conflict. When emotions are high, it best to allow time for the situation to deescalate before addressing the conflict. In order for a manger to effectively negotiate, some approaches a manager can take are: listen attentively, good eye contact, shut down emotional outbursts, knowledge of policies & procedures, and establish trust (Finkelman, 2016).
"When conflict must be resolved, ... these are the times when leaders act with ruthless honesty and live up to their covenant with the people they lead" (Du Pree, 1992, p. 175).
Whenever we find ourselves getting angry we can control our temper by reflecting on the message given by Paul to the Ephesians. “Let all bitterness and wrath and anger and clamor and slander be put away from you, along with all malice. Be kind to one another, tenderhearted, forgiving one another, as God in Christ forgave you” (Ephesians, 4:31-32, English Standard Version). We should always treat others as we would like to be treated.
Cohen, S. (2014). Resolving conflict by setting ground rules. Nursing Management, 45(5), 17-21. Retrieved from http://ovidsp.tx.ovid.com.ezproxy.liberty.edu/sp-3.24.1b/ovidweb.cgi
De Pree, M. (1992). Leadership jazz. New York: Crown Business.
Finkelman, A. (2016). Leadership and management for nurses (3rd ed.). Boston, MA: Pearson.