NURSING CONFLICT MANAGEMENT 8
Staff conflicts in hospitals are commonchallenges that arise in the institutions, just like otherorganizations. To face the challenge, the strategy is to come up withgood conflict resolution measures in hospitals to ensure effectiveand harmonious working environment that promote excellent patientcare (Finkelman, 2012). Conflicts in hospitals can take place betweenindividuals, units or departments (Finkelman & Kenner, 2010).Many individual nurse conflicts occur between nurses or nurses andphysicians. Various hospital departments can also be in conflictbased on many causes such as inequitable resource allocation,improper communication and disrespectful attitudes towards colleaguesbased on education level and expertise (Finkelman & Kenner,2010).
As a nursing officer I have had a share ofconflicts with my colleagues. My vivid conflict occurred when Iworked at Eastside Medical Center as a Contract RN and asked a CNA(Certified Nursing Assistant/ED technician) to transport my patientto the CT department. It was part of his main duties as theprofessional nurse to be on the unit and be available for emergenciesunless he or she was on break or had to transport a critical patientto another unit or department. His remark to me was hostile and rude.He said, "Nurses can transport patients too”.
I reiterated by outlining the policy and hisjob description to him, but rather than jeopardize patient care ordelay treatment, I took the patient to CT. I wrote this up to thenurse manager and he was reprimanded and told that was part of hisjob. The issue was not resolved as he continued to do it with myselfas well as other nurses. He would conspicuously disappear or be verybusy when he was needed to transport patients. This was a delegationproblem and it was an on-going issue. He never wanted to help out insituations where he was mandated to do so.
This was an individual conflict since itinvolved two parties and showed conflicts of roles (Finkelman, 2012).There was inherent incompatibility in roles each person was supposedto play between the CNA and other nurses and myself. Since the CNAfailed to respect the policy and job descriptions of the othercolleagues, there was misunderstanding on the roles. Most of the timeduring hospital emergencies, everyone is on toes, rushing here andthere in an attempt to save life.
The CNA took our work for granted and failed usall the time we needed his help. He made my work difficult andstressful since I juggled from one to task to another. I wasresuscitating a patient in one minute, dressing a wound in the nextand called to transport a patient to radiology in another. Usuallytransporting patients is not in my job description unless inemergencies and that why I was very critical of him. If the CNA waspresent, he would take over some of the work and that would promotebetter working environment.
Stages of Conflict
Conflicts like these occur in many setups tooand may involve various individuals. Every conflict belongs tospecific stage. The various stages of conflicts include latent,perceived, felt and manifest conflicts (Marquis et al 2010). Latentconflicts are anticipatory conflicts and the main predictors areinsufficient communication as well as resource competition. Thisanticipatory mood can increase the tension and may preempt a loomingcrisis. For my case, latent conflict started when I was called on totransport the patient and the CNA was absent all the time. I used towonder where he was all the time when he should be around. I knewsoon or later we would have a problem with him.
The second stage of conflict process isperceived conflict where one recognizes the existence of a conflictat a specified time (Marquis et al 2010). In this stage the conflictperceived is not spoken out or confronted but is just felt by theindividual. The next stage of conflict is felt conflict where aperson starts having feelings and emotions towards the inherent issue(Marquis et al 2010). One may feel anxious, angered or remorsefulabout the issue at hand. This grows into stress and many people maychoose to take an avoidant approach or confront the issue head on.Avoidance may not solve the problem but postpones it for a later datewhere the problem may ripen into a crisis.
Sometimes it’s good to play avoidant but thatdepends on the trust one has that the problem will end soon or later.For my case, I was angered extremely by the CNA’s behavior andopted to confront him about the issue. I took the fourth stage ofconflict process. The fourth stage is called manifest conflict(Marquis et al 2010). This is where overt measures are taken and theycan either be constructive or destructive measures (Marquis et al2010). Destructive measures would include such thing as ignorance,denial, avoidance or negative discussion of the issue at hand(Finkelman, 2012). Some constructive measures would be to encouragesolution seeking, expression of appropriate and non-abusive feelingsand aiding colleagues to recognize the problem or task at hand(Finkelman, 2012).
For my case I choose the destructive measuredue to the anger I was feeling. I decided to face the problem andspeak my mind by outlining the policy and job description to the CNA.I went further to report the matter to the nurse manager who tookanother destructive measure to reprimand the CNA. Ultimately, thismay have ruined everything since the CNA continued with his initialbehavior. It means that we might hurt his feelings and lowered hisstatus as a staff and as a colleague. Reporting a fellow worker tosuperiors or reprimanding them usually creates more animosity thansolutions.
Strategies to Resolve the Conflict
To reverse this trend a sustainable solutionwas needed. The main strategies to be employed should be aimed ateliminating or decreasing the nature of the conflict (Finkelman,2012). They should also be aimed at finding a suitable fair groundwhere parties involved felt positive and absolute unanimous with theresolution. The strategies should also be oriented on betterment ofpatient care and creation of a good working environment for smoothrunning of the hospital (Finkelman, 2012). The first part of theconflict resolution should be to form a panel comprised an impartialthird party from the top hospital management, the nursing manager,the CNA and the nurses. Under the guidance of the nursing manager andthe impartial third party in the hospital management, we needed tosit together and deliberate on the issue to achieve a common goal.
The purpose of this panel would be to come upwith a resolution that does not leave any particular party powerlessin their capacity as hospital staff. Powerlessness often reduces themoral of the workers and makes them feel that they are not wanted inthe place and cannot make any impact there (Finkelman, 2012). Thebest way to solve between the CNA and the nurses would be to find aground where none was left powerless or less motivated. The mediatorsshould also exercise their legitimate, persuasive, informational andexpert powers to guide the conflict management process (Finkelman &Kenner, 2010). They shouldn’t use any coercive means to win aselfish objective but they should strike a balanced resolution. Themediators should not control or dominate the staff but create asuitable environment for discussion.
Empowerment should also be a key goal in theresolution process since it would enable all the parties to actaccordingly (Finkelman & Kenner, 2010). The process would requirethat each party give their own part of story and give insight onthings that they are uncomfortable and disagree on. Each party shouldbe encouraged to influence the decision that would bring a lastingsolution to the conflict. A collaborative approach among all theparties involved would be the best way to tackle the problem.
During the deliberations, the roles andresponsibilities of each staff should be outlined and emphasized(Finkelman & Kenner, 2010). Hospital policy and code-of-conductof each staff member should also be revisited and emphasized.Sometimes the roles of a certain parties may be too demanding andstressful that they feel over worked. The CNA’s roles also need tobe considered to enable proper evaluation of the nature of his job sothat he is not negatively impacted by the decision of the panel. Ifneed be, a new CNA should be recommended for hire to ensure that thehospital runs smoothly.
Effective communication which is the mostimportant part of every conflict resolution should be emphasized. Inthe conflict at hand the response given by the CNA prompted me to actirrationally and escalated the issue. Such ineffective communicationbrings many problems in hospital operations. Effective communicationpromotes harmonious working relationship among staff and theirsuperiors which translate to increased productivity (Finkelman,2012). Increased internal conferences and meetings to promotetraining to impart new skills, networking and effective communicationshould be recommended for all the staff members.
Ultimately, a collaborative approach should beencouraged and adopted. Accommodation of each person’s sentiments,dislikes, points of view and insights should be advocated such that awin-win situation is reached. Such collaborative nature ensures thateach member feels that they have participated in a gainful andfruitful resolution. The parties compromise on what they can’tachieve as long as they gain on some pertinent and critical issuesthey wanted to achieve. The resolution achieved is all-accommodativeand unanimous and is often sustainable. I believe this would havesolved the impulse between the CNA and the nurses.
In conclusion, the best way to solve anyconflict in organization or hospitals is to adopt a collaborativeapproach that brings all parties involved on a table to deliberate onthe possible solution. Each party should take interest in citing thepertinent discomforts and dissatisfactions that they have. As anursing officer who has faced such conflicts and reacted irrationallywithout considering the feelings of another party, I would recommenda more rational approach. Rushing to report issues without firstdiscussing the matter with the involved party only serves to escalatethe issue into a crisis. Hospital staff should be trained more oftenon effective communication and conflict resolution.
Finkelman, A. (2012). Leadershipand management for nurses: Core competencies for quality care.London: Pearson.
Finkelman, A. & Kenner, C. (2010).Professional nursing concepts.Competencies for quality leadership.Boston: Jones and Bartlett Publishers
Marquis, B. & Huston, C., BessieL., Marquis, R.N., Carol J. & Huston, R.N.(2010). Leadership roles andmanagement functions in nursing.Philadelphia: Lippincott Williams & Wilkins.