Running head: CONFLICT 1 4.0 Conflict Management Kayla G., Alfonso F., Madeline H., Jennifer Rouse, Amy S., and Ivy T. California State University, Stanislaus
CONFLICT 2 4.0 Conflict Management It is no surprise that conflict often arises in the hospital setting. For this reason, it is imperative that nurses recognize when there is conflict and understand how to respond appropriately to the situation (Yoder-Wise, 2015). In fact, the American Nurses Association considers conflict engagement a critical safety skill for all nurses (American Nurses Association [ANA], 2015). Conflict can be resolved in many ways (Ames, 2009). Self-awareness of one s own resolution style will contribute to successfully managing the problem (Yoder-Wise, 2015). The authors individual resolution styles will be revealed while also examining potential improvements to these styles. Because conflict is an incredibly diverse topic, it will be further explored and defined through an analysis of websites that meet specific criteria. Furthermore, an application of conflict resources will be utilized in a true case of a student nurse conflict. Defining Conflict Conflict is defined as a disagreement in values, beliefs, or attitudes within oneself or between two or more people that has the potential for a negative outcome (Stanton, 2014; Yoder- Wise, 2015). Demands on staff, a lack of resources, and difference in hierarchy levels cause many forms of conflict within a hospital environment (Stanton, 2014; Yoder-Wise, 2015; Zakari, Al Khamis, & Hamadi, 2010). There are four types of conflict that can occur: intrapersonal, interpersonal, intragroup, and intergroup (Rahim, 2011). Intrapersonal conflict occurs within oneself (Rahim, 2011; Yoder-Wise, 2015; Zakari et al., 2010). Interpersonal conflict, the most common type, occurs when two or more people have a disagreement (Rahim, 2011; Yoder-Wise, 2015; Zakari et al., 2010). Intragroup conflict occurs when there is disagreement among two or more members within a group (Pluut & Curşeu, 2013). Lastly, intergroup conflict occurs when there is conflict between two or more groups, such as between departments (Rahim, 2011).
CONFLICT 3 Real Case of Student Nurse Conflict In the first semester of clinical rotations on a medical-surgical unit, a student nurse found herself in a conflict with the registered nurse (RN). The RN was extremely cold with the student nurse and did not collaborate with her at the beginning of the shift. The student nurse did not know how to go about communicating with the RN. It was later discovered that the RN thought the student nurse was in her last semester of nursing school and was expecting her to do more than what the student nurse was currently capable of doing. Conflict management of this situation will be discussed. Website Credibility In order to improve conflict in the hospital setting, it is crucial that those involved understand the appropriate steps necessary for effective conflict resolution. There are many websites that offer solutions to improving conflict within the workforce, which may be applied to the profession of nursing. The websites used in this paper to address methods of successful and effective conflict resolution came from credible and reliable sources which use evidence-based practice to validate their use in the workplace. Website criteria that was used to depict credibility included the site having recent data, objective and factual information, an author, revised within the last year, and/or no advertisements (University of Maryland Libraries, 2014). The first website used was The Advanced Healthcare Network for Nurses, last revised in 2015. Although missing a specific author, this site met all other required criteria. An article by Ken Stanton (2014), will be used and was factually written using resources provided by the author. The website clearly states, the author has completed a disclosure form and reports no relationships relevant to the content of this article, which supports objectivity. Another website that will be used is CRM Learning: Compelling Interpersonal Skills Training for Powerful Organizations,
CONFLICT 4 which was last revised in 2015 and offers an article that discusses steps to improving conflict (CRM Learning, 2015; Truby & Truby, 2012). The website lists information about the authors and links to additional categories related to interpersonal skill training (CRM Learning, 2015). Resolving Conflict While there are four types of conflict, there are five modes of conflict resolution (Yoder- Wise, 2015). The five modes of conflict are: avoiding, accommodating, competing, compromising, and collaborating (Yoder-Wise, 2015). Avoiding is a passive approach due to the fact neither parties are able to have their own needs or concerns immediately addressed (Yoder- Wise, 2015). Avoidance prolongs conflict and can allow it to escalate when ignored; however, avoidance may also allow involved parties to separate and regroup at a better time (Yoder-Wise, 2015). The conflict presented earlier demonstrated avoidance by both the RN and the student nurse. While the student nurse was intimidated and did not want to upset the nurse, the RN made an assumption that led her to ignore the student nurse. Accommodating is a placatory mode of conflict resolution. It is a manner in which people sacrifice their own needs in an effort to satisfy those of others (Yoder-Wise, 2015). The third mode of conflict resolution is competing. Competing consists of people placing their own needs and goals at the expense of others (Yoder- Wise, 2015). Individuals utilizing this mode take every measure necessary in order to achieve their goals and often react by feeling threatened or behaving aggressively (Yoder-Wise, 2015). Compromising is an approach that requires negotiation, maturity, and cooperation amongst those involved in conflict (Yoder-Wise, 2015). Lastly, collaboration is a manner in which individuals work together through identifying both the conflict and their shared goals (Yoder-Wise, 2015). Understanding the varying mechanisms in which people respond to conflict is an integral aspect for constructing an effective mode of conflict resolution.
CONFLICT 5 Conflict Resolution Style People respond to conflict in different ways. However, there are conflict resolution styles that can be attributed to certain groups of nurses. For example, bedside nurses mostly use avoidance and accommodation, while compromise is used by nurse managers (Yoder-Wise, 2015). Student nurses, who are inexperienced and new to conflict in this setting, and younger nurses tend to use avoidance and accommodation (Pines et al., 2011). These resolution styles are found to be true of the authors in the clinical setting. It was determined that it is important for the authors, as student nurses, to avoid confrontation and accommodate to the nurse s needs so as not to jeopardize the offer to come back to the teaching hospital. This is also true for the student nurse in the presented conflict above. It is not necessarily important to the authors to win at this point but these feeling may change with the shift from student nurse to registered nurse. For nurse managers, the most commonly used resolution style is compromising, which is followed by competing, avoiding, accommodating, and collaborating. In the study by Iglesias and Vallejo (2012), it is discussed that compromising may be used so much by nurse managers in order to meet goals on both sides of the conflict where neither party loses or wins (Iglesias & Vallejo, 2012). Nurse managers are pushed toward collaboration as a conflict resolution style; however, it is not used by many (Iglesias & Vallejo, 2012; Yoder-Wise, 2015). This may have to do with the greater amount of time and effort that is needed to use collaboration. Improving Conflict Stanton (2014) emphasizes the importance of conflict resolution approaches and the implications they have in the outcome of a conflicting situation. Collaboration, as discussed above, is an active approach to resolution which gives greater weight to the substantive goal of achieving optimal workplace results than it does to affective concerns (Stanton, 2014). This is
CONFLICT 6 one method to improving the authors resolution styles of avoidance and accommodating. In using collaboration, the student nurses can effectively express their concerns while also contributing to an open discussion with his/her paired registered nurse. Similarly, Truby and Truby (2012) offer a more in-depth process to improving conflict that includes steps that can be taken to achieve a style of conflict resolution that promotes collaboration and a win-win outcome for those involved within the situation. Steps to be taken for successful conflict resolution include: diffuse emotion to prepare for the real issue, listen and accept the person s perceived issue, get permission, then speak what s on your mind, solicit agreement on your issues and concerns, work together toward resolution, and close and agree to let go (Truby & Truby, 2012). By using these steps within a team, it allows for cohesiveness and for members to work together effectively and efficiently for a common goal. Student nurses can easily use these steps to improve their conflict resolution style. The student nurse in the conflict situation could have utilized these steps to determine how she could have been more helpful to the RN she was paired with and to determine what was expected of her during the shift. When the end goal is successfully and safely providing care, collaboration will help aid toward improving conflict and meeting individual and team goals. Assertive Response to Conflict There are three ways individuals can respond to conflict: passively, assertively, and aggressively (Ames, 2009). In order to respond to conflict appropriately, nurses need to develop an assertive way to communicate effectively with the team (Okuyama, Wagner, & Bijnen, 2014). Assertiveness is often used to describe a behavior and is defined as the willingness to speak and stand firmly in what s/he believes, against resistance, in order to get things done (Ames, 2009). When dealing with a conflict, assertive behavior should be candid and constructive, not avoidant
CONFLICT 7 and trivializing, or belligerent and demanding (Ames, 2009). When nurses are able to adopt an assertive way to communicate, studies have found that it can improve overall patient care and aid in professionally handling conflicts in the workplace (Okuyama, Wagner, & Bijnen, 2014). If the student nurse would have used an assertive response with the RN at the beginning of the shift, she may have learned sooner that the RN assumed she was in another semester. Conclusion All in all, conflict management is an essential skill that all nurses must exhibit. There are many different kinds of conflict that can arise (Rahim, 2011) and various methods to resolving the conflict (Yoder-Wise, 2015). It has been established that avoidance and accommodation are resolution styles used by the authors, as student nurses, and that this can be improved through using collaboration (Stanton, 2014). Resolution styles, whether passive, assertive, or aggressive, can be used independently depending on the situation since not all conflict will require the same resolution style (Ames, 2009). Websites can provide useful information for nurses to use when looking into solving a problem. Ensuring the credibility of the source is another aspect that should be considered when using online resources (University of Maryland Libraries, 2014). Nurses should be aware of their own personal default resolution style and utilize resources when this style is not effective. In doing so, conflict can be effectively and efficiently settled.
CONFLICT 8 References American Nurses Association. (2015). Conflict engagement. Retrieved from http://www.nursingworld.org/mainmenucategories/certificationandaccreditation/conti nuing-professional-development/conflict-engagement Ames, D. (2009). Pushing up to a point: Assertiveness and effectiveness in leadership and interpersonal dynamics. Research in Organizational Behavior, 29, 111-133. doi:10.1016/j.riob.2009.06.010 Iglesias, M. E. L., & Vallejo, R. B. B. (2012). Conflict resolution styles in the nursing profession. Contemporary Nurse, 43(1), 73-80. Okuyama, A., Wagner, C., & Bijnen, B. (2014). How we can enhance nurses assertiveness: A literature review. Journal of Nursing & Care. 3:194. doi: 10.4172/2167-1168.1000194 Pines, E. U., Raushhuber, M. L., Norgan, G. H., Cook, J. D., Canchola, L., Richardson, C., & Jones, M. E. (2011). Stress resiliency, psychological empowerment and conflict management styles among baccalaureate nursing students. Journal of Advanced Nursing, 68(7), 1482-1493. Pluut, H., & Curşeu, P. (2013). Perceptions of intragroup conflict: The effect of coping strategies on conflict transformation and escalation. Group Processes & Intergroup Relations, 16(4), 412-425. doi:10.1177/1368430212453633 Rahim, M. (2011). Managing conflict in organizations (4 th ed.). New Brunswick, NJ: Transaction Publishers. Stanton, K. (2014). Resolving workplace conflict. Advance Healthcare Network. Retrieved from http://nursing.advanceweb.com/continuing-education/ce-articles/resolving-workplace -Conflict.aspx
CONFLICT 9 Truby, B., & Truby, J. (2012). Conflict resolutions: Six steps to manage disagreements successfully. CRM Learning. Retrieved from http://www.crmlearning.com/blog/index.php/2012/07/ conflict-resolution-six-steps-tomanage-disagreements-successfully-4/ University of Maryland Libraries. (2014). Evaluating web sites: A checklist. Retrieved from http://www.lib.umd.edu/binaries/content/assets/public/usereducation/evaluating-websites-checklist-form.pdf Yoder-Wise, P. S. (2015). Leading and managing in nursing (6 th ed.). St. Louis, MO: Elsevier. Zakari, N., Al Khamis, N., & Hamadi, H. (2010). Conflict and professionalism: Perceptions among nurses in Saudi Arabia. International Nursing Review, 57(3), 297-304. doi:10.1111/j.1466-7657.2009.00764.x