Conflict is one of the inevitable facets that arise in an organization with people from different backgrounds. Conflict occurs when there are disagreements between individuals or groups of people over an issue of importance (Finkelman, 2015). Whenever a conflict arises in a work setting, it is an indication of something being out of sync usually due to a lack of clear understanding. The nursing setting is one of the areas that are highly prone to conflicts due to the nature of work in a healthcare system. While different work environments will always experience some form of conflict, the nursing profession is highly volatile with small disputes having the magnitude of erupting into full-fledged conflicts. Nurses usually work in environments that can be described as stressful and frustrating, requiring them to develop a thick skin and learn how to interact and work with other people. All workplace conflicts have negative implications in the workplace if they are poorly handled. In nursing settings, unresolved conflicts can impact the quality of care provision, nurse wellbeing, and satisfaction ( Aamir et al., 2016) . Such disputes can be triggered by differences of opinions, values, and perspectives between nurses and the management or competition for some positions and resources.
Case Scenario
One of the workplace conflicts I encountered in a care delivery setting involving work scheduling and role assignment for nurses. This conflict happened within the intensive care unit that was a ten-bedded unit with a medical officer, unit manager for the floor and five staff nurses. The unit manager was in charge of assigning shifts and schedules to the staff who would either work through a day-shift or night shift. However, problems began when these scheduling decisions were made without involving nurses and in the end affected their working environment. Some of these decisions such as mandatory overtime, nurses given undesirable shifts and sometimes allocated non-nursing tasks created a situation for a conflict. For example, nurses could be called upon to attend to a patient when they are engaged somewhere else or forced to work beyond the shift time whenever there is a critical situation without prior communication or elaboration.
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In this conflict situation, nurses felt they were being mistreated and made to work in a hostile environment affecting their ability to offer quality care. Their motivation was being crushed with such scheduling decisions while fatigue was also on the rise. Some individuals mentioned being undervalued, undermined and underappreciated while being treated as second-class individuals. They could not plan for their personal lives due to uncertainties in the scheduling, which means the decision was physically and mentally draining them. The dispute escalated due to a lack of communication between nurses and the unit manager and threatened the safety of patients.
This was an interpersonal conflict between a nurse unit manager and nurses in the hospital setting who felt they were being mistreated ( Lee & Lee, 2015) . The nurse staff complained of a hostile working environment where leaders made decisions without involving them even when such decisions touched on their ability to provide care. As such, nurses were disagreeing with the scheduling decisions made by the nurse unit manager which was seen with disrupted productivity. Interpersonal conflicts occur due to a lack of communication between workers causing confusion and disputes.
Stages of Conflict
Conflicts occur in phases starting from the latent to the manifest stage. The first phase of the conflict is known as the latent stage described by individuals being unaware of an impending conflict (Finkelman, 2016). The problem has not manifested itself though there will be signs of a potential conflict. In this case scenario, a latent phase is when communication between nurse leaders and the staff is poor or nonexistent, and the unit manager is making decisions without consulting with or involving all stakeholders. However, neither of the parties is aware of the existence of a problem at this stage.
The second phase of conflict according to Finkelman is the perceived stage, which happens when disputing parties become aware of an existing problem. During this stage, individuals may not be discussing the issue among themselves but will start showing signs of problems in the working relationship (Finkelman, 2016). For example, nurses who are affected by the scheduling decisions will start to feel its effect and be aware of the problem.
The third stage is when a conflict is felt among a group of people, known as the felt phase. This is a time when disputing parties start to display feelings such as distress or anxiety due to the conflict as the issue becomes to openly show up. This is an important stage in conflict resolution since any delay can result in explosions and a situation getting out of hand when nothing is done to handle it (Finkelman, 2016). For example, nurses can begin to feel disgusted with the way they are treated in the organization and start to speak among themselves.
The last stage of conflict is the manifest phase, shown by the conflict being openly realized among disputing parties. This is where disputing staff openly displays it through verbal engagement, ignoring or orders or even more physical confrontations (Finkelman, 2016). During this stage, nurses can begin to complain about their issues with scheduling and how they feel about it making their issues known. Conflict at this stage can either be constructive or destructive depending on how parties approach it. For example, nurses can decide to leave the working environment is the situation is not handled appropriately.
Delegation of an Issue
Delegation is an issue that comes out in this conflict case scenario and forms part of the problem. The nurse leader tends to delegate nurses to extra duties that are beyond their specification or requiring them to work beyond the shift time. The managers were responsible for mandatory overtime decisions that angered the nurses, assigning them undesirable shifts as well as the decision to assign them tasks that were considered non-essential to them. Delegation can be seen as a form of showing trust to employees. However, an improper delegation of duties or allocating wrong tasks can affect the work environment and lead to conflicts ( Moreland & Apker, 2016) . The nurse unit manager in this case scenario is engaging in the inappropriate and improper delegation of duties to nurses which made them feel devalued and
Conflict Resolution
Conflict resolution is particularly crucial in this intensive care unit that requires nurse alert, timely decision making and perfect coordination among the physicians. There are several types of conflict resolution such as compromise, collaboration, avoidance, competition and accommodation. Avoidance is when parties ignore the existence of a conflict because nothing can be done about it ( Lee & Lee, 2015) . Accommodation refers to accepting the demands of another party to solve the dispute. Competition is a form of fighting where only one party wins while compromise is when both parties give up part of what they wanted to settle a problem.
The solution to this case study is collaboration, which is a conflict management method where parties involved in a dispute work together through the difficulties to come up with an amicable solution that is agreeable to all. A collaborative resolution plan allows the disputing parties to find a creative solution by looking at different sides of each argument and augmenting the points to one solution (Finkelman, 2016). Both parties need to listen to the other’s case and use the discussion to agree on the best solution that has a mutual benefit. The idea is to talk about the issue by creating a platform for nurses to air their grievances.
When applied to this case scenario, the nursing unit manager needs to set up a meeting with all nurses to brainstorm the source of conflict and work towards finding a solution. The disputing parties can use this meeting to discuss the issue and agree to formulate a solution that will benefit everyone ( Moreland & Apker, 2016) . During the meeting between a nurse unit manager and staff, they can discuss issues such as scheduling of shifts and roles, as well as the importance of communication. The solutions to the dispute can entail ensuring fare scheduling of shifts that puts into consideration the personal lives of nurses and allows for flexibility ( Aamir et al., 2016) . Nurses should also only work in their specific roles as opposed to putting them in non-nursing duties.
Working with the Nurse Leader
Open communication frameworks and feedback can be one of the triggers needed to solve conflicts in a nursing setting. The nurse leader should use open communication to understand the root cause of conflicts and solve it, particularly because most of the issues came from a lack of communication. In this case scenario, the nurse leader should involve everyone before making the schedules. This entails inquiring about their availability especially involving overtime and allowing flexibility to nurses ( Aamir et al., 2016) . Nurses have a life outside of their professional position and would love to have a say in their shifts.
Proper communication regarding the scheduling of roles and shifts in the workplace could have reduced a chance of this conflict to occur. It is open knowledge of how difficult it can be to schedule shifts that can please everyone. However, being open regarding the decisions can help reduce the chances of a conflict. For example, the nurse leader should communicate with nurses by asking them when they can be available off duty before making the scheduling decisions ( Lee & Lee, 2015) . This can be crucial to ensure nurses are allocated shifts that do not interfere with their personal lives.
Secondly, the nurse leader should respect employees in the health setting and allocate them to their respective roles. Some nurses were complaining of being placed in work areas that are outside of their specialization, which comes down to a lack of respect from the nurse unit manager. In essence, better communication between the nurse leader and staff could reduce confusion and any risks of disputes to arise. As a result, the nurse leader should implement this aspect in the conflict resolution plan to reduce the chance of confusion and risk of conflict ( Lee & Lee, 2015) . In the end, the care delivery to patients will benefit from a harmonious workforce between nurse leaders and the staff.
Conclusion
Conflict in the nursing setting and healthcare system is a common problem that has the potential to affect the provision and delivery of care. In such settings, a dispute can arise between nurses, or involving a nurse leader and staff with a risk of escalating when not promptly solved. Some causes of conflict include holding divergent opinions regarding an issue, or feelings of a hostile working environment due to poor communication between leaders and the staff. The resolution to this conflict issue in healthcare involves using collaboration to understand the cause of disputes and take appropriate measures to solve it before it becomes fatal and affect care. The nurse leaders should understand how to counter such disputes through open forums allowing employees and staff to air their concerns.
Poor communication, unreasonable expectations and improper delegation of duties have been the core causes of conflicts in nursing. These causes can be solved by having open and appropriate communication and feedback in the organization. At the same time, nurse leaders should focus on creating a positive working environment that is characterized by respecting nurses, motivating them and involving them in decision making. In essence, a well-managed conflict in the nursing setting is crucial in reducing the rate of staff turnout and improve job satisfaction. It is also a recipe for improving care provision in the hospital.
References
Aamir, A., Hamid, A. B. A., Haider, M., & Akhtar, C. S. (2016). Work-life balance, job satisfaction and nurses retention: moderating role of work volition. International Journal of Business Excellence , 10 (4), 488-501.
Finkelman, A. (2016). Leadership and management for nurses: Core competencies for quality care. Pearson. pp. 324-333
Lee, Y., & Lee, H. (2015). Role conflict and conflict management styles of hospital nurses. Korean Journal of Stress Research , 23 (3), 147-158.
Moreland, J. J., & Apker, J. (2016). Conflict and stress in hospital nursing: Improving communicative responses to enduring professional challenges. Health communication , 31 (7), 815-823.
