About

➀ Read and Learn

The following course content

Introduction

Every organization will experience some conflict at once; healthcare is no exception. Conflict can create severe issues regarding care delivery, patient safety, and patient outcomes. Other results include cost impacts related to staff turnover in an already understaffed industry, regulatory fines, and even lawsuits due to errors; more serious results include psychological implications for staff members. Conflict often stems from opposing personalities, biases, perceptions, and internal or external stressors. As a nurse leader, you may need to provide guidance and coaching to help your team members resolve conflicts (1).  

Characteristics, leadership styles, and the ability to handle conflict are vital to fulfilling a nurse leader role. This educational course will help you identify conflict, its components, reasons for conflict in healthcare, and management strategies. Conflict management is not just the responsibility of one in a nurse leader role but that of all team members, especially the registered nurse.  

Conflict 

Conflict is a natural occurrence within human interactions. It is an internal discord resulting from actual or perceived differences in ideas, objectives, values, goals, preferences, attitudes, expectations, beliefs, or feelings between two or more parties (8). Conflict can occur between any healthcare team member, including nurses, nursing students, managers or nurse leaders, physicians, patients, and family members.

Evoking feelings of hostility, anxiety, and stress can be highly disruptive to a unit or department's functioning. Another definition includes a disagreement through which the parties involved perceive a threat to their needs, interests, or concerns. In the workplace, conflict often involves personal agendas, insights, or goals (11).  

Conflict is often seen as unfavorable, but if managed correctly, it can be positive and lead to personal and organizational growth. Conflict can promote team-building skills, critical thinking, new ideas, and alternative resolutions (11). If conflict is not managed effectively, it can hinder a healthcare team from providing quality patient care and can escalate into violence and abuse (16). Because of this, nurse leaders need to be aware of how conflict can escalate and be prepared to prevent or manage it in the workplace (8). 

Stages

Once you have accepted that conflict is inevitable, you can learn how to deal with it within the nursing leader role. Awareness of these five stages will help you identify conflict and intervene before it escalates. Conflict within organizations often follows five different stages.  

Stage 1: Potential opposition or incompatibility – Organizations themselves can cause conflict due to environmental factors. Factors within the organization include: 

• A lack of communication or misunderstandings can cause communication difficulties.  

• Leadership styles, role hierarchy, or reward systems  

• Personal variables such as differences in values or beliefs 

Stage 2: Condition and personalization- Those within the organization become aware of the environmental factors causing conflict and perceive them as unpleasant. Negative emotions develop, such as anger, frustration, or anger, and are aggressively directed at management or supervisors.  

Stage 3: Intentions—Once one or both parties involved have identified conflict, it needs to be decided how the conflict should be managed. Conflict is often handled using five conflict management strategies: accommodating, avoiding, collaborating, compromising, and forcing. 

Stage 4: Behavior- conflict has become visible to others, and managers or human resources intervene.  

Stage 5: Outcomes—Conflict has now resulted in positive consequences that can lead to improved outcomes. Alternatively, it can remain unresolved and divide individuals, creating cliques or "sides," which leads to gossip, hostility, chronic complaining, competing for power, and decreased productivity.  

Types of Conflict

The first step in managing conflict is to identify the type of conflict. Conflict can be categorized into three different types that nurse leaders will encounter. Understanding what type will help dictate how you will respond and enhance your conflict resolution skills. Healthcare and nursing present a unique environment, which can lead to different kinds of conflict. We all bring our values, ideas, thoughts, and education to this work environment. Conflict can occur in other types: interpersonal, organizational, intrapersonal, intra-group, or inter-group. Let’s break these down.  

Interpersonal conflict (3) 

• Most common type of conflict 
• This can occur between fellow nurses, nursing students, patients, or colleagues. 
• This occurs when two people can not agree on a topic; in other words, they can not see eye to eye.  

This can often happen due to the following: 

• Shortage of information 
• Environmental stressors 
• Differences in morals or opinions 
• This can lead to social distancing, dominance, miscommunication, stigmatization, prejudice, stereotyping, coercion, and bullying.  
• Obstructs professional interactions between healthcare teams, which weakens overall collaboration 
• Example: When a team member feels another team member is not pulling their weight, or they disagree with another nurse’s assessment or a physician’s recommendation 

Intrapersonal conflict (3) 

• Internal disagreement with your thoughts, emotions, or values 

• Can arise from ethical concerns, work-life imbalance, or uncertainty about role  

• It can be the most challenging to solve  

• This can often result in burnout  
• Example: Nurse is overwhelmed with nursing tasks while trying to find the time for bathroom and meal breaks or if they are at work and their child is at home sick 

Organizational (3) 

• Disagreement occurs within large organizations such as hospitals. When policies, procedures, or communication patterns. differ  
• Example: How are hospital funds distributed? Does the money go to the lab for new equipment or the emergency room for new stretchers? Conflict arises when one group believes their need is more important than the other.  

Inter-group (3) 

• Conflict exists between members of different organizational groups that have different values, beliefs, or goals. It could be team members who feel like their needs are unheard of or feel undervalued by administration or management, or it can occur between different units or departments. Conflict such as this can decrease productivity and interrupt quality patient care throughout the organization.  

Intra-group (3) 

• Conflict occurs between members of the same team (unit or department). Teamwork and a sense of belonging are essential for running a unit smoothly. Differences and disagreements can cause tension for everyone, even if they are not directly involved in the conflict. If this type of conflict is left untreated, it will divide the unit/department into groups, creating cliques or "sides," which leads to gossip, hostility, chronic complaining, competing for power, and decreased productivity.  

Generational Conflict (4) 

Generational Differences 

The generational conflict has grown within organizations due to having more generations than ever working together, especially in healthcare. Unprecedented, the nursing workforce spans five generations, each with distinct characteristics and work ethics. The various generations are described as follows: 

• Baby Boomers: Born between 1947 – 1964. Characteristics include a belief that workers need to pay their dues. Often, the generation includes workaholics with traditional learning styles; rewards are expected for hard work (3). 

• Generation X: Born between 1965 – 1977. Characteristics include independence, self-reliance, and skepticism of authority. This generation tends to work better with flexibility (3). 

• Millennials (or Generation Y): These people were born between 1978 and 1991. Their characteristics include being goal-oriented, technological, entrepreneurial, and needing feedback. This generation wants to be coached and mentored (3).  

• Generation Z: This generation was born after 1991. Although we do not know much about this generation yet, some of its characteristics include tech-savviness, self-starting, and pragmaticity (3).  

Most of you know the phrase, "nurses eat their young." This is not a new concept, and despite the valiant efforts of organizations, this type of conflict has persisted. Usually, horizontal, nurse-to-nurse bullying with the older generations makes the new generations feel unwelcome, incapable, and unwilling to help when asked (4). However, it is essential to note that the opposite is also a workplace issue. Younger, newer nurses are perceived as faster, able to utilize technology at lightning speed, and can cope better with variable shifts than older nurses. This gives the newer nurse a perceived power gradient over the older nurse and can be used as a form of bullying (4). 

Types of Generational Conflict (4) 

As previously discussed, each generation has its own defining characteristics, and conflict can arise when they are forced to work together. Each generation will have a different outlook on how work should be done, and with that comes different expectations. Let’s take a look at intergenerational conflicts and the three major differences among generations within organizations.   

Behavior-based conflict  

• It arises when the other's behavior due to generational differences conflicts with their own and comes from how each generation communicates. They often do not communicate with one another, which causes conflict. Examples of communication styles between the generations:  
  • Baby Boomers prefer face-to-face  
  • Gen X prefers using what they believe is most efficient 
  • Gen Y prefers instant messaging, social media, or emails and is often considered poor communicators 
  • Gen Z and Millennials prefer text messaging and instant messaging  

These differences in communication styles lead to conflicts of communication and collaboration between different generations. This lack of communication can cause team members to work individually instead of collaboratively. It can also lead to work-value conflicts, intrapersonal conflicts, and other conflicts. The success of the organization or the team depends on managing these different types of communication styles.   

Another behavior-based conflict is the difference in each generation's expectation of feedback. Examples of feedback expectations per generation: 

• Baby Boomers like feedback but not constantly  
• Gen Y and Z require constant feedback  

Conflicts arise based on how different generations view and expect feedback; it can cause frustration among team members and potentially affect teamwork and patient care.  

Value-based conflict  

The perception is that each generation has different values (intrinsic or extrinsic) and what motivates them. Conflicts can arise if team members are not motivated with certain methods.  

• Baby Boomers believe in hard work and are motivated extrinsically (promotions, titles, corner offices, reserved parking) 
• Gen Xs are distrustful of organizations and are intrinsically motivated by work independence and achieving work-life balance.  
• Gen Y is motivated both extrinsically and intrinsically. They value personal achievement and work-life balance and place high importance on technology's ability to make work faster and easier. 
• Gen Z is intrinsically motivated and values financial stability. They understand the importance of work but will not sacrifice their lives for work success.
  

Identity-based conflict  

This type of conflict arises when there are differences between how generations see their own identity and the identities of other generations. It comes from wanting to belong to a group or comparing themselves to different groups. Conflicts arise when generations make comparisons to one another. This is often where hostile generalizations and stereotypes that create stigma against a group come from.  

Examples of Nursing Conflicts (1) 

• Staff conflicts regarding workloads, staffing ratios, and shift preferences 

• Interdisciplinary disagreements about treatment plans, responsibilities, or the current decision-making process 

• Ethical disputes on topics such as: 

• End-of-life care 

• Patient autonomy 

• Organizational policies 

• Poor communication resulting in misunderstandings or lack of information  

• Role conflicts resulting from overlapping roles or uncertainty in responsibilities  

• Resource conflicts due to limited supplies, equipment, or budget allocations 

Leadership 

A person’s conflict management skills are only one component of effectively managing conflict in the leadership role; they help raise future managers' emotional intelligence. Leadership skills and style are likely to affect the outcomes of conflict, while the relationship between leadership styles and conflict management (8) 

Qualities 

Leadership, by definition, is when one group or person sets the direction for others and helps them to achieve their goals (11). Leadership is a process that requires many different qualities; this should begin with relational intelligence. Relational intelligence revolves around the idea of how you positively navigate through relationships with others. For one fulfilling a nurse leader role, this skill is necessary for your team’s success (5). Although nurse leaders are looked to when there is conflict, it is not solely their responsibility to resolve it but that of all team members (5).  

Other qualities needed include integrity, critical thinking, communication, dedication, self-awareness, and professionalism. There is not an adequate or inadequate strategy to deal with conflict. However, early detection of conflict and adoption of the most effective conflict resolution behavior is essential in organizations as soon as possible (6). How these qualities are learned is an important issue. Many nurse leaders need more training to prepare them for the responsibility of conflict resolution. However, unresolved or unmanaged conflict may end with work disruption, poor performance, tardiness, absenteeism, low staff morale, low productivity, increased psychological distress, and burnout (6). It can affect the productivity of the organization. 

Another essential quality to develop at all levels of nursing, especially for those in a nurse leader role, is communication skills, including both how the message is sent and how the message is received. Listening skills are a vital aspect of nursing, and often, we move quickly and think about an answer before the person finishes speaking; misunderstandings are easy to cause but only sometimes so easy to fix.  

For nurse leaders, it is essential to recognize and manage conflict. Barriers often exist, including time constraints, fear of retaliation, and fear of exclusion. Of course, no one wants conflict, which sometimes results in an attempt to soothe and prematurely find a solution. Those in the nurse leader role must learn to positively engage in conflict resolution and stay committed to promoting collaboration and effective care. Being successful includes dialogue, coaching, the identification of potential conflict, education, and training. 

Styles 

Leadership styles are management thoughts and behaviors related to your personality, communication preferences, strengths, weaknesses, and values (11). Styles can develop over time or be influenced by the organization. To prevent or limit conflict, leaders should implement a professional code of conduct, ground rules, and discipline (11). Leadership styles in healthcare are found to be strongly tied to quality care, patient outcomes, mortality rates, injuries, patient satisfaction, and pain (11). Leadership styles that are more successful and effective include collaboration, multifaceted, and dynamic. Believe it or not, leadership styles play a role in conflict resolution and team dynamics. The most common styles leadership styles are (11):  

• Servant Leader and Lean Leader: This style is team-oriented and involves openness in conversations and management. It ensures others are a priority by focusing on their needs and growth and putting them first. This style improves processes, eliminates waste, and promotes high-quality, cost-effective care. 

• Authoritarian Leader: This leader leads via dictation and controls all team actions and decision-making. All decisions are based on the leader's ideas, judgments, and personal beliefs, and the leader does not consider or consult team members. The leader and little input from team members involve a lot of enforcement. 

• Transformational Leader: Transformational leaders assist the team in aligning their beliefs and values with those of the organization. This leader fosters trust, relationship building, and sharing of ideas and visions for the organization. The transformational style has defined goals, a clear direction, and looks at the big picture. Those in the leadership role share their vision with staff and think outside the traditional path. This has the idea that when involved in a conflict, responses will reflect the organization's greater good. The ability to manage conflict effectively is a quality seen by transformational leaders. This style is seen as being positive.  

• Lassiez-Faire Leader: The laissez-faire style is casual and laid back, meaning there needs to be more leadership; they leave the decision-making to their team members. This type of leader trusts their team members to problem solve, create new projects, make and meet goals, and self-monitor. Authority is turned over to the staff; there is no feedback, oversight, direct leadership, discipline, or praise. Productivity is often low among team members, and conflict is highly likely. Generally, this style is seen as being negative because it wants to avoid conflict and is unsuccessful.  

• Visionary Leader: This leader has a vision or long-term goal in mind. These leaders often have insight, imagination, and passion related to goals and ideas. They are constantly looking out for the team's best interests by sharing ideas and goals. They empower their team members by building a solid team dynamic capable of managing conflicts via communication in a positive way.  

• Transactional Leader: Leaders with this style are focused on workflow, meaning they focus on incentives for “doing the work” in a timely and efficient manner. Components of this style include rewards and discipline based on finishing work ahead of schedule or if the work is delayed. These leaders need to plan for the future of their organization by being focused on the present. This type of leadership is harmful as it fails to promote ideas required for the rapidly changing healthcare industry.  

While developing a style, it is essential to allow for the expression of multiple viewpoints and how to build better relationships (11). The absentee leader needs to do more to communicate, mentor, and plan. The incompetent leader needs more involvement in planning and faces severe moral issues. If the environment is maintained and cohesive, job satisfaction and performance can be positively impacted.   

Nurse Leader Role: Conflict Strategy 

As one involved in a nurse leader role, in order to effectively eliminate or manage conflict, it cannot be ignored. Engagement must be an ongoing process. To be successful, one must learn to not only engage in conflict, but remain engaged to promote collaboration and effective care coordination (11). The earlier conflict is identified, the better, as dysfunctional patterns can take place and can potentially define the culture of the department.   

Common Strategies (11):

• Safe Space: It is important that staff feel they are meeting in a safe space, and that there is privacy and support. 
• Coaching: Coaching can be in either group or individual settings. Coaching sessions are confidential (unless otherwise agreed upon), must follow a consistent format, and include a written summary of the session. 
• Facilitation: There is usually a defined agenda. You will need someone neutral who can see past the fireworks or walls of silence and assist the group with arriving at the core problems or issues. 
• Dialogue: The importance is to have a discussion that addresses the issue and clears the air; avoid saying “always” and “never.” Nursing leaders and direct care nurses need to engage in dialogues that address conflict and conflict management behavior as a first step in creating a healthy work environment (1).  
• Collaborative: Collaborative works with the group problem solving together.  
• Storytelling: Storytelling works with traditional stories that are told to help move from personal experiences to broader, helping to negotiate group conflict.  
• Mediation: Can be formal or informal. 
• Education and training: Nurses need to be educated on conflict and conflict management strategies that address and effectively resolve conflict. Learning conflict management strategies empowers nurses to resolve conflict early and influence the work environment in which they deliver patient care. "The training should not be limited to the handling of interpersonal conflicts; it should include all types of conflict commonly encountered in the healthcare setting. Additionally, individuals who have a propensity for managing conflict well should be identified and developed” (1). Education and training should also include communication skills.  

"Leaders can change the climate in the workplace and promote better collaboration among workers by interrupting a group's dysfunctional behavior patterns," (12). Adding the skills of self-awareness and emotional skills helps to bring a team together. Relational ethics emphasizes the importance of mutually respectful relationships. People work to improve their awareness of how their choices and actions help shape their conversations and social interactions. The relational approach addresses conflict as it unfolds – just as a relationship evolves and unfolds over time. It incorporates the essential qualities that form the core of human relationships. It is hard to imagine an approach to conflict that excludes consideration of integrity, respect, identity, compassion, humility, shame, trust, fear, hope, pride, acceptance. Love, joy, and other human dynamics are at the heart of most conflicts (12). 

Emotional and social intelligence are defined as "skills that enable an individual to understand the impact of emotions on behavior and thinking, to regulate emotions and behavior, to understand the importance of emotions in others, and to understand social interactions and engage in adaptive ways with others in social situations," (12).  

Regulatory Issues and Conflict 

In 2008, The Joint Commission released a sentinel event alert addressing disruptive behaviors and recommended how organizations should address their relational issues and conflicts. The defined behaviors recognized more physician-to-nurse issues but placed all disruptive behavior on its radar. Identified behaviors included verbal outbursts, physical threats, uncooperative attitudes, and cooperation refusal (i.e., not taking pages or answering calls). Other behaviors include condescending language and refusing to complete tasks (9).

Disruptive behaviors often go unreported and, therefore, unaddressed for several reasons. Whether that is fear of retaliation, the stigma associated with "blowing the whistle" on a colleague, or a general reluctance to confront an intimidator, it all contributes to underreporting intimidating and disruptive behavior (9).

Part of the sentinel event has given guidance on what defines behaviors and required resolutions. Organizations are needed within this mandate to develop a specific ‘Code of Conduct’ that outlines acceptable and disruptive behaviors and the processes managing these behaviors. Additionally, organizations should establish policies and procedures that clearly state zero tolerance and provide training and education for physicians.    

Regarding nurse-to-nurse (horizontal) disruptive behavior, the American Nurses Association (ANA) Code of Ethics for Nurses includes interpretive statements outlining that nurses are required to "create an ethical environment and culture of civility and kindness, treating colleagues, coworkers, employees, students, and others with dignity and respect" (10).

Similarly, nurses must be afforded the same respect and dignity as others; thus, the nursing profession should no longer tolerate violence from any source. As someone fulfilling a nurse leader role, you must refer to the ANA Code of Ethics for Nurses when managing conflict within the workplace.  

Negative Behaviors  

Familiar sources of conflict can include passive-aggressive communication, clique behaviors, lateral or vertical aggression, and other types of incivility. These sources can cause unprofessionalism and disruptive actions that can compromise patient safety, increase turnover and absenteeism, and reduce the overall joy of work (7). Let's look at the following negative behaviors often seen in conflict and how to deal with them potentially (7). 

• Defensiveness (7) 

• It is human nature to deflect when we hear something negative about ourselves, our interests, or our friends. Critical conversations will be redirected to focus on someone else's flaws instead.   

• Redirect behavior and state facts.  

• Victim mentality  

• Individuals feel mistreated, singled out, or held to a higher standard.  

• Remind people that personal conversations are confidential and held to the same standard as everyone else. 

• Restate all expectations are clear  

• Passive aggressiveness 

• Confront and be direct 

• Encourage open communication and concerns  

• Vertical aggression  

• Bullying of new leadership  

• Address head-on and state expectations 

• Bullying  

• Identify and address immediately  

• Provide clear examples of actions  

• The informer 

• Performance information given by peers and not leadership  

•  Hold team members accountable  

• Address behaviors expressed by other team members 

How to Manage Conflict (1) 

Nursing requires a teamwork approach to provide safe, quality care; therefore, everyone must work together to solve conflicts. How you and your team respond to conflict will vary based on the situation and the individual personalities involved. Conflict resolution is defined in various ways. Thomas and Kilmann formulated a matrix with five distinct responses (methods, modes, or styles) to conflict resolution or management. Here are five different conflict management styles (Thomas-Kilman Conflict Modes) to try within your team when resolving conflicts. 

Accommodation (11) 

• Using this style results in a win-lose situation. The resolution to the conflict will only benefit one person and will not satisfy all involved. This style of conflict management can cause resentment. It is a strategy often used to maintain peace by smoothing over differences. It can be appropriate to escalate the issue if it results in a severe disruption. 

Collaboration (11) 

• In this particular style, all team members are brought together to resolve. It allows for solving the conflict by objectively evaluating different views. This style encourages open and respectful communication, active listening, and open-mindedness. Everyone involved will have a say in what caused the conflict and how to achieve a resolution. Collaboration often leads to new ideas and creativity and is the best outcome for all team members.  

Compromise (11) 

• No team members will be satisfied with the solution during this management style. The resolution to the conflict will cause resentment between all individuals involved because those involved will have to sacrifice a part of their solution. It is a bargaining strategy that protects the relationship's importance and can provide a temporary solution. 

Avoidance (11) 

• When using this conflict management style, some or all people involved will avoid or ignore the situation. This ends up being a losing situation, and the conflict remains unresolved. It will continue to build up disputes among team members. No cooperativeness exists between the parties involved, and no one’s concerns are met. The purpose is to delay or walk away, often due to immense anger. This is considered a short-term resolution to de-escalate an agitated, non-emergent situation.  

Competition (11) 

• This style creates another win-lose situation. It is a short-term solution strategy to resolve the problem. It can involve aggressively resolving the conflict when one individual has more decision-making power. It will not promote a team approach to problem-solving or resolving future disputes.  

Steps for Conflict Management (11) 

• Set rules on how to communicate effectively and respectfully  

• Ask all team members to set aside previous judgments about one another 

• Encourage active listening without interruption to ensure all are heard equally 

• Have everyone involved write down the problem and then state the problem out loud. This will help to provide understanding and agreement about what is causing the conflict.  

• Ask everyone involved to devise a solution to the problem or conflict. 

• Set time aside to discuss each solution along with the positives and negatives of each solution.  

Nurse Leader Role: Conflict Strategy Resolution  

As one involved in a nurse leader role, it must be addressed to eliminate or manage conflict effectively. Ignoring the conflict or problem can result in your team developing resentment towards one another, making the work environment uncomfortable (1). Rushing to fix conflicts without determining the source of the issue can often lead to other future problems (1).

You must take the time to analyze the situation and identify the source of the conflict before proceeding to resolution. Conflict resolution requires patience, active listening skills, and commitment to finding a solution that benefits both parties (1). The goal is to address conflicts within your team and promote a safe and harmonious work environment that provides quality patient care (1). Engagement must be an ongoing process. To be successful, one must learn to not only engage in conflict but also remain engaged to promote collaboration and effective care coordination (1). The earlier conflict is identified, the better, as dysfunctional patterns can take place and potentially define the department's culture. Conflict resolution in nursing requires communication, collaboration, and listening skills. Here are some tips for handling conflicts: 

Common Strategies (1): 

• Safe Space: Create a safe place or mutual ground for all parties involved. It is essential that staff feel they are meeting in a safe space and that there is privacy and support. 

• Guidance and Coaching: Develop effective communication and conflict-resolution skills and support suggestions for productive and creative solutions. Coaching can be in either group or individual settings. Coaching sessions are confidential (unless otherwise agreed upon), must follow a consistent format, and include a written summary of the session. 

• Facilitation: There is usually a defined agenda. You will need someone neutral who can see past the fireworks or walls of silence and assist the group in identifying the core problems or issues. 

• Foster Open Communication: Create a supportive environment that encourages active listening and honest communication. Be sure to understand the situation entirely. It is essential to have a discussion that addresses the issue and clears the air; avoid saying “always” and “never.” Nursing leaders and direct care nurses must engage in dialogues that address conflict and conflict management behavior as a first step in creating a healthy work environment. 

• Collaborative: Collaborative works with the group problem-solving together.  

• Storytelling: Storytelling uses traditional stories to help people move from personal experiences to broader ones and negotiate group conflict.  

• Mediation: This can be formal or informal. 

• Education and training: Nurses need to be educated on conflict and conflict management strategies that address and effectively resolve conflict. Providing team members with strategies to resolve disputes early before impacting patient care is essential. Learning conflict management strategies empowers nurses to resolve conflict early and influences the work environment in which they deliver patient care. Training should include all strategies one would encounter in the healthcare setting, not just those limited to coworkers. Education and training should also include communication skills.  

• Mediate and negotiate: Approach the conflict objectively and seek additional perspectives from human resources or another nurse leader if necessary. Facilitate constructive dialogue to reach a mutually agreeable solution.  

• Identify underlying issues: Identifying the conflict's root cause is crucial. Work on finding solutions that aren’t quick fixes and address the core problem. This is also an opportunity for growth and development, including developing policies and procedures to help identify future conflicts.   

• Encourage empathy: Ask questions that promote different perspectives and creative solutions. Identify and discuss underlying interests that can often interfere with views.  

• Seek a compromise: Find common ground and work together toward a mutual agreement. Stress the importance of collaboration.  

• Encourage professional behavior: Rule out and quickly address bullying and rude, discourteous, or disrespectful behaviors. Identify, admit, and apologize if you have contributed to the conflict.  

• Follow established policies and procedures: Be consistent with standards and potential consequences while handling conflicts fairly and openly. 

• Document the issue and provide follow-up: Document the situation, steps taken, and the resolution. Continue to monitor to ensure the problem is resolved and does not reoccur 

"Leaders can change the climate in the workplace and promote better collaboration among workers by interrupting a group's dysfunctional behavior patterns (12)." Adding self-awareness and emotional skills helps bring a team together. Relational ethics emphasizes the importance of mutually respectful relationships. People work to improve their awareness of how their choices and actions help shape their conversations and social interactions. The relational approach addresses conflict as it unfolds – just as a relationship evolves and unfolds over time. It incorporates the essential qualities that form the core of human relationships. It is hard to imagine an approach to conflict that excludes consideration of integrity, respect, identity, compassion, humility, shame, trust, fear, hope, pride, and acceptance. Love, joy, and other human dynamics are at the heart of most conflicts (12). 

Emotional and social intelligence is defined as "skills that enable an individual to understand the impact of emotions on behavior and thinking, to regulate emotions and behavior, to understand the importance of emotions in others, and to understand social interactions and engage in adaptive ways with others in social situations" (12).  

An Example of Failed Conflict Management from a Nurse Leader Role 

This story is based on a true example experienced by the author; names and locations have been changed. 

Looking back to the 1980s, nursing struggled with shortages and how to produce more nurses quickly. During this time, the entry-level for nursing was either a three-year hospital diploma program or a BSN. Many times, inexperienced nurses were made managers out of necessity. In a small California Neonatal Intensive Care Unit (NICU) in the mid-1980s, this unit called ‘neonatal’ was staffed by only nurses. The original manager was a graduate with a diploma who had newborn experience for many years but not in the NICU specialty; however, she was beloved.

Over the next two years, four different managers needed to work out. The staff did not want it to work out but were weary and wanted some leadership. The next nurse manager, Mary, was a BSN graduate with little NICU experience and no management experience; she immediately made several changes that ultimately divided the staff. During this time, one staff nurse, Jane, was undergoing some extreme personal issues. She and Jane did not get along. Jane had been a nurse in this unit for over ten years and was an excellent clinician, but she had become a nightmare. She was mean to her colleagues and had become a bully. Additionally, she would never help other team members except for the few in her “inner circle.”  

Human Resources offered no help.  

 Morale was dismal, and staff began to leave. During this time, to the horror of the staff, Jane committed suicide. The note she left cited personal issues but also included the horrible work relationship she had with Mary as part of her reason. Staff felt responsible and guilty; they ultimately divided, making work a nightmare. Few resources were given to help with the situation, and many staff members left within the year; perhaps an experienced manager may have been able to diffuse the situation differently.  

 This is an extreme example that illustrates what can happen without leadership at the unit and senior management levels. In conflict situations, our most potent weapon is control over our behavior. If there is a single contributory factor that reduces and eliminates negative conflict, it is trust. Our ability to trust each other dramatically impacts our working lives, family interactions, and achievement of personal and organizational goals. To create trust, it is necessary to avoid aggressive behaviors and simultaneously develop supportive behaviors where people are respected for what they are or believe in and are treated equally without bias or prejudice. If a conflict develops at any level, it should be resolved with mutual benefit in mind (12).   

Conclusion 

Conflicts in nursing can vary in nature and complexity. Those in a nurse leader role have significant responsibilities regarding conflict management. They need to understand the definitions of conflict, how to manage it as soon as possible and acknowledge the responsibilities of conflict resolution. Part of this responsibility involves understanding the type of conflict, leadership qualities and styles, regulatory issues, and the ramifications of poor management. These ramifications can result in serious medical errors, patient safety concerns, poor patient outcomes, and psychological manifestations for staff.  

Conflict is not always negative; it can be positive if managed correctly. Dealing with conflict fairly and effectively can help you gain the respect of your team and grow as a nursing leader. It can promote team-building skills, critical thinking, new ideas, and alternative resolutions. Conflict resolution within the nursing role identifies underlying issues and creates better solutions. By actively listening and promoting collaboration, you can resolve conflicts constructively while maintaining a positive work environment.  

Keep in mind that other strategies, such as arbitration or involving an ethics committee, may sometimes be appropriate depending on the circumstances surrounding the conflict. Be alert for signs of conflict before the situation becomes explosive or uncomfortable. Sometimes, disciplinary action may be required despite your best efforts to resolve the conflict.  

➁ Complete Survey

Give us your thoughts and feedback

➂ Click Complete

To receive your certificate