Definition Conflict ◦ Internal or external discord that results from differences in ideas, values, or feelings between two or more people(Marquis & Huston, 2009). Conflict management ◦ The long-term management of intractable conflicts and the people involved in them so that they do not escalate out of control and become violent (University of Colorado). Problem solving ◦ Systematic process that focuses on analyzing a difficult situation (Marquis &Huston, 2009). Common ground ◦ A basis of mutual interest or agreement.
Issues with conflict in nursing 20% of managerial time is spent dealing with conflict (Valentine, 2001). Higher death rates co-related with higher conflicts between doctors and nurses. Main cause is communication failure (Northam, 2009). Medication error, peri-natal deaths and injuries resulted due to workplace conflict (Northam, 2009). 70% ICU staff members report conflicts, among which 80% were perceived harmful rather than useful and half as severe or dangerous. Conflict threatens quality of care (Azoulay, et.al 2009) “Studies have shown that the most frequent source of verbal abuse of the nurses is the other nurses” (Northam, 2009, pg. 3).
Implications Social : ◦ Unresolved conflicts results in declining physical, and emotional health as well as relationships with their family. Legal : ◦ JCAHO requires all its health organizations to develop a process of identifying the causes of conflict and train all the employees in relationship-building and collaborative practice in managing conflict. Cultural : ◦ There is a difference in values, beliefs and preferences among all the nurses from various cultures which can add to conflict.
What are nursing professionals saying about conflict management? Nursing is a female dominated profession. Most of the females use passive approach in dealing with conflict management such as avoidance and withdrawal. Thus, unresolved conflicts leads to unhealthy work environment Literatures suggests that all nurses are not well trained in conflict management Dynamic health care system requires nurses to be efficient in managing conflict (Northam, 2009,Part 1) Conflict is viewed as good and bad as well depending on how it is managed. It can produce growth or destruction (Marquis & Huston, 2009).
Types of conflict Intrapersonal ◦ Occurs within the person. ◦ Internal struggle to clarify contradictory values or wants Interpersonal ◦ Also known as “horizontal violence” or “bullying”. ◦ It is significant issue confronting the nursing profession, especially in new graduates Intergroup ◦ Between two or more people, department or organization. ◦ Nurses experience this conflict with work and family issues
Assigned article #1 Conflict in the workplace: Part 1 by Sally Northam 2009
Causes of conflict among nurses Cultural differences Difference in age or position in the organizational hierarchy Gender(sex) Workplace factors
Causes contd… Cultural differences ◦ Language and communication difficulties: fluency, accent, unaware of slangs ◦ For example: Asian emphasize respectful attention to the speaker or a superior Avoidance of conflict and maintenance of harmony Age/ hierarchy ◦ Young nurses are not taken seriously by older nurses ◦ Generational issues: cell phone use, late arrival create tensions with older nurses.
Causes contd… Gender ◦ Men are more assertive to resolve conflict whereas women are more prone to avoid it. Workplace factors ◦ Workplace has rules which decides who is right and who is wrong. Conflict arises when both parties think they are right. Common ground is difficult to obtain. ◦ Schedule and workload.
Assigned article #2 A gender perspective on conflict management strategies of nurses by Patricia E.B. Valentine 2001
What is your strategy? 2. competition 5. Collaboration 3. compromise 1.Avoidance4. Accommodation
Common strategies to conflict management Avoiding: lose-lose, used when people have feeling of powerlessness, creates unhealthy work environment Accommodating: lose-win, one party neglects own concerns, self sacrificing Compromising: no win-no lose, one party gives up something to satisfy other, middle ground Collaborating: win-win, one party collaborates with other to find solution that satisfies both parties, long term resolution Competing: win-lose, one party wins other lose.
Assigned article #3 Conflict in the workplace: Part 2 by Sally Northam 2009
Ways to manage conflict Through effective communication, collaborative relationships, and promotion of nurse’s decision making Agree on a common goal ◦ Listening with an open mind and assuming trustworthiness on everyone’s part, even if beliefs are different Culture: ◦ Adaptation: acknowledge the cultural gaps and work around them
Ways to manage conflict Change the pronouns to “we” ◦ For example, “let’s discuss the ways to reach our goal.” Listen actively ◦ Active listening with reflection Mediator ◦ Neutral party who listens to both side of the story.
Ways to manage conflict Position equally ◦ Maintain eye contact by sitting at same level and meeting should be in a neutral location to provide comfort Set ground rules for the discussion ◦ Such as no yelling and no name calling ◦ Leave anger at the door to maintain professionalism ◦ To find solution, nurses need to talk calmly and rationally Limit the number of the people in the discussion ◦ Many people can elicit more arguments and its hard to find a common ground ◦ Privacy should be maintained
References Azoulay, E., Timsit, J.F., Sprung., C.L., Soares, M., Rusinova, K., Lafabrie, A., Abizanda, R., Svantesson, M., Rubulotta, F., Ricou, B., Benoit, D., Heyland, D., Joynt, G., Francia, A., Maia, P.A., Owczuk, R., Bebensishty, J., Vita, M.D., Valentin, A., Ksomos, A., Cohen, S., Kompan, L., Ho, K., Abroug, F., Kaarlola, Gerlach, H., Kyprianou, T., Michalsen, A., Chevret, S. & Schlemmer, B. (2009). Prevalence and factors of intensive care unit conflicts: The conflicus study. American Journal of Respiratory and Critical Care Medicine. 180. (853-860). DOI: 10.1164/rccm.200810-1214OC Marquis, B.L.& Huston, C.J., (2009). Leadership roles and management functions in nursing: Theory and application (6 th Ed.). Philadelphia, PA: Lippincott Williams and Wilkins. Northam, S. (2009). Conflict in the workplace: part 1. American Journal of Nursing, 109 (6), 1-9. Retrieved February 22, 2010 from Ovid. Northam, S. (2009). Conflict in the workplace: part 2. American Journal of Nursing, 109 (6), 1-9. Retrieved February 22, 2010 from Ovid. University of Colorado (1998). International online training program on intractable conflict. Conflict Research Consortium, University of Colorado, USA. Retrieved February 22, 2010 from http://www.colorado.edu/conflict/peace/glossary.htmhttp://www.colorado.edu/conflict/peace/glossary.htm Valentine, P.E.B. (2001). A gender perspective on conflict management strategies of nurses. Journal of Nursing Scholarship, 33 (1), 69-74. Retrieved February 22, 2010 from Proquest Nursing and Allied Health Source Zarda, M. (2009). Managing conflict in health care. Retrieved February 22, 2010 from http://www.mediationworks.com/mti/certconf/healthcare.htm
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