conflict and resolution in nursing

Conflict is frequently thought to be detrimental and damaging. However, the behavioral scientist conducted research and came to the conclusion that not all conflicts are harmful and that, to a certain extent, conflict is necessary. However, the issue of conflict affects all professions, and in the health profession it is particularly sensitive since the nature and environment of the work require a lot of dedication, which is frequently linked to stress. Therefore, a nursing workplace that is effective must have effective conflict management. The most common source of conflict within a nursing setting includes the divergent styles of management and the perception of the staff, limited resources for staff which results in high levels of stress, competition and the difference in goals and aspiration among the workers. Another very crucial source of conflict is the doctors-nurses relationships.

Case Study

In the following case study, an oncology setting within a hospital will provide an insight of the conflict that affects nurses. In this case, the nursing team is made up of a head that is delegated to monitor the wards and 11 staff nurses. Of the eleven, five registered nurses have been in practice for at least nine years, and the new registered nurses are six. To the outside world, the head and staff nurses may seem to be working in harmony together without any perceived conflict. But they are issues of excessive use of power and authority on the leadership which come out as the primary source of conflict within service. What is unfortunate is that no members in the hospital are able to bring this uncomfortable situation. The staff is more concerned about their jobs and if they speak they may worsen matters; hence their troubles are handled through inaction and silence (Marques et al. 2015).

At a personal level, a look at a nurse by name Beatrice who has been working in the oncology unit for two years would be considered. The management has complimented her on the work and for that was given some additional work as a part-time charge nurse. When the unit has a low census, she is asked to go on the surgical and medical unit. She doesn’t like living her unit, but she has to cooperate and show that she can handle clinical assignment and express flexibility.

One Friday she comes at work and asked by the supervisors to report to obstetrics because his oncology unit is low on census and it is time to be shifted to another unit. But Beatrice explains that she knows nothing about OB and her inability to undertake the assignment. Her supervisor still thinks that she is the most qualified person for the assignment. At this moment Beatrice is torn between organizational, professional and personal conflict.

Type of Conflict

In the following setup they are two broad types of conflict:

Organizational or intergroup conflict. Organizational/intergroup conflict occurs if a nurse or nurses as seen above, perceive hospital protocol and policies to be unfair. During some instances, the organization may be the source of conflict if the staff is not contented.

Intrapersonal conflicts. Intrapersonal conflicts are personal, like in the case of Beatrice, which includes a situation where a nurse is asked to work beyond schedule when they are supposed to live and fend for their families.

Stages of Conflict

Based on Finkelman, he developed a model that is used in understanding the beginning of the conflict and the progress it makes up to the aftermath. Conflict exists, and is normally brought up by changes in an organization. It may have positive feedback, but most nurses associate it with negative outcomes and scenarios. The profession is female dominated; who the public view them as self-sacrificing women. As viewed above conflict can occur at both personal and work level as noted out by methods shown prior. They are both positive and negative methods which are as a result of conflict and may lead to a positive outcome, promote work-group cohesion and deepen the relationship (Wallensteein 2015).

The stages of conflict are as follows:





Latent

This stage includes factors that have a potential of causing conflict or inducing forces of conflict. It has the four forces, i.e., competition for the scarce resources, divergent goals, the role of conflict and drive of autonomy.

Perceived Conflict

Sometimes conflict arises even if they are no latent. It's brought about when one has a perception that another person is likely to frustrate or thwart his or her goals. It’s a result of one party being unable to understand the true position of the other person.

Felt Conflict

At this stage, conflict is not only perceived but felt. It’s characterized by the personalization of conflict which makes people dysfunctional of the conflict; it makes one feel the conflict. Two factors lead to this anxiety which include caused pressure originating externally, and conflict is also personalized if an individual laid out all his feelings in a relationship and then something unfortunate happens.

Manifest Conflict

In this stage parties always invoke behaviours which tend to produce a response from the other party. The distinct responses include apathy, aggression, sabotage, perfect obedience, and withdrawal. The motive behind violence always is apparent, but it tends to be expressed in non-violent form.

Conflict Resolution

Conflict is resolved in two ways managing the conflict and following the primary mode of resolving the conflict.

Managing Conflict

They are three strategies which are involved in managing conflict: win-win, lose-lose and win-lose.

Win-lose. Win lose scenario is commonly seen in cases of groups. To Vote an issue or more precisely the “majority rule” place participants in the winning end and the others on the losing side. The only disadvantage is that losing can erode the cohesion of a group and diminish the authority of the leader.

Lose-lose. Lose-Lose is a unique since no party participating wins or rather each party loses, in the case where both parties lose the resolutions reached are never satisfactory for either of the parties.

Win-win. In win-win scenarios, the both parties involved working together in ensuring that they meet their goals and they set objectives among the individuals involved. In such situations management of conflict is arrived at through a consensus by fully investigating the problem, parties’ needs are checked, and a viable resolution is arrived at. Averaging, no voting and other traditional dispute resolution methods are employed. A true group consensus is reached at (Chan et al. 2014).

Models of Conflict Resolution

They are five common approaches which have been identified to resolve conflict, and they include avoidance, compromise, accommodation, collaboration, and competition. The first aspect is competition or using force; it’s a win-lose model type of strategy. It designates a situation which one party or individual focuses on acquiring complete dominance. It's an appropriate approach while making quick decisions and no time is available for discussions, it's good for emergencies. Second is avoidance, which is used as a form of denial on issues, people or situations. The people who deploy this technique ignore the existence of a problem. So at this stage, there is no active resolution of conflict. However it can be significant to avoid situation until more information is provided and analysis of the problem has been made, this can be an effective method of conflict resolution. Although research has raised concerns that it may be an efficient method of affronting collective situations in short-term, if elongated it may be dysfunctional because it denies the existence of the problem.

The third strategy is accommodation or giving-in; it’s an antithesis for a competition where it emphasizes more on cooperation and less on assertiveness. It’s a conciliation technique which involves one group being ready to yield down to the other. At times the method may look relevant because it supports the expression of views. The forth perhaps is the compromising strategy, which emerges when there are negotiation and concurrent swapping between the two parties. Each person may get something but also has to give something in return. Finally, there is collaboration which in short allows for a win-win. The parties involved meet different guideline within given circumstance.

In a very diverse manner, both culture and context dictate how an individual would manage conflict (Fry et al. 2013). About the current nursing case study, it was easy to note that both new and trained nurse uses avoidance as the primary approach to handling the tensions that come with the head of nurses. As earlier seen avoidance may be an appropriate way of handling problems during its prior stages, but based on the case study until now this has not been effective for both the nurses and Beatrice. They are no attempts by the nurses in trying to resolve their issues and due that the problem remains unsolved. The staff is applying the avoidance technique while the head nurse is using competition as conflict resolution technique.

Conclusion

From the report it’s clear that conflict can either be positive or negative, it may increase creativity, but it also has the potential of leading to sabotage. So it’s important for people first to analyze the type of conflict they are dealing with. Additionally, it's important to know appropriate conflict management strategies to apply: competition, avoidance, compromise, collaboration, and accommodation. No line differentiates an appropriate from an inappropriate strategy for dealing with conflict. However, availability of time, culture, context, and personality should be taken into consideration in resolving the conflict.

In a hospital setting nurses in hospitals apply the avoidance strategy. In many cases, the approaches may be appropriate because it gives time to analyze a problem, but if done for long it provides an impression that the problem doesn’t exist. In the long run, it may lead to the problem not getting fixed. It's advisable that courses on personnel and conflict management be available in nursing leadership. Additionally, improvements in human and material conditions should be considered. Since at the moment they are fewer courses to deal with conflict resolution, providing basic education thus becomes a mean to empower young nurses to use the acquired skills in pursuing conflict resolution.



References

Fry, Douglas P., & Kaj Bjorkqvist, eds. (2013).Cultural variation in conflict resolution:

Alternatives to violence. Psychology Press.

Chan, Joanne CY, Emily NM Sit, and W. M. Lau. "Conflict management styles, emotional

intelligence and implicit theories of personality of nursing students: A cross-sectional study." Nurse education today 34, no. 6 (2014): 934-939.

Marques, F., Lourenço, P., Dimas, I., & Rebelo, T. (2015). The Relationship between Types of

Conflict, Conflict Handling Strategies and Group Effectiveness. Journal of Spatial and Organizational Dynamics, 3(1), 58-77.

Wallensteen, P. (2015). Understanding conflict resolution. Sage.