Conflict is inevitable even in the healthcare setting because of the various interacting factors which cause complexity. Thus, conflict cannot be eliminated but can be managed to ensure a functional setting which will not negatively impact patient care. In this context, conflict according to Finkelman (2016), is defined as an argument or a disagreement between a group of people or two individuals, which is caused by a difference in values, beliefs, or opinions.
In the profession of nursing, conflict may exist among nurses or other supporting staff members. Also, conflict may occur between patients and their families and the nurses. As such if a conflict is not addressed appropriately, the outcome can be damaging, for instance, it may lead to ineffective collaboration, loss of staff, the poor performance of work, and mistrust. On the other hand, it can bring numerous befits if it well managed and resolved. Therefore, for patients to get quality care, the team of healthcare must be able to work together and communicate effectively. As such, it is important for nurse managers to have knowledge of conflict resolution.
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On this background, this paper will focus on conflict resolution. The first part will discuss the causes and types of conflict within the healthcare setting, while the second section addresses the four stages of conflict healthcare environment. The next part discusses the delegation and strategies for conflict resolution, and collaboration with management and peers, and finally, a concluding paragraph based on the observation from the discussion.
The Causes and Types of Conflicts in the Healthcare Setting
The healthcare setting is composed of interactive people with different ideas and perceptions making conflict inevitable. Also, the delivery of healthcare takes place within a complex scheme of multidisciplinary professionals, financial reimbursement, technology, regulatory and legal requirements, institutional environments, and family and patient based needs. As such, the complex system makes conflict arise majorly from circumstances which include lack of inter-professional and interpersonal recognition and respect, and competition for scarce resources (Mills, 2012). Spagnol et al (2010) add that conflict may also be triggered by communication problems, role disputes, misunderstandings, high pressure of work, poor management approaches, opposing interests, beliefs and values, and lack of professional commitment among others.
These causes result in different types of conflict. One is interpersonal conflict, which occurs between two or more individuals. It arises when there is a disagreement between interdependent persons leading to negative reactions that may interfere with the achievement of their goals. This conflict may occur among nurses themselves, between nurses and patients, between nurses and nurse manager, or between nurses and other supporting staff within the healthcare context. This type of conflict may take the form of relationship conflict (incompatible values, styles, and opinions), task conflict (a disagreement about the tasks contents) or process conflict, which is a disagreement about delegation of resources and duties, how a job should be accomplished or who should perform the task (Almost et al., 2016).
Secondly, intrapersonal conflict may also exist in healthcare organizations. This type of conflict occurs within oneself. It may take the form of a nurse struggling to balance personal life stresses with the job requirement. An ethical dilemma is one source of this type of conflict, but there are other reasons attached to it. For instance, difficulty in balancing work and family issues such as child sickness, thereby affecting the productivity (Dodge, 2017).
Stages of Conflict
According to Finkelman (2016), there are four stages of conflict which include latent (anticipation) stage, perceived stage, felt stage, and manifest stage.
Latent stage- this is the first stage of conflict where antecedent conditions may predict the behavior of conflict exists. At this stage, individuals or groups recognize that there is diversity in culture, language or religion, role conflict, scarcity of resources, or divergence goals which they may anticipate to result in active conflict. The latent conflict may not emerge to active conflict until an event triggers it. Its emergence may be followed by a resolution or an escalation which may turn destructive.
Perceived stage- this is the stage where there is cognitive awareness of the existence of stressful situations, and it normally happens when no latent conflict emerges. Here, an individual may start to perceive the other to frustrate or thwart the achievement of his or her goals. It mainly results from the misunderstanding of the true position of one another, which may be notifiable. For instance, a manager may notice communication issues between physicians and nurses.
Felt stage- at this stage, conflict is recognized and felt. The attitudes and feelings of anxiety and stress are present which affect conflict. For instance, nurses may argue over policy, but that may not raise concerns of conflict unless both parties start to personalize the issue. Personalization causes the concerns with dysfunctions of conflicts, which makes people feel the conflict. The personalization may result from two reasons. First is the inconsistent demands on personal growth and efficient organizations caused from inside an individual. Also, anxieties may result from extra-organizational pressures, thus, to maintain internal balance, one may need to vent these anxieties. Secondly, personalization of conflict occurs when an individual personality is involved in the relationship, which brings hostile feelings.
Manifest stage- this is the stage where conflict can be observed and the parties display behaviors which may evoke negative responses in front of others. These responses usually take the form of aggression, withdrawal, anger expression, apathy, or sabotage expressed in less violent forms. The more people get involved in the conflict, the longer the conflict may continue; hence, the conflict becomes escalated.
Impacts of Conflict in Healthcare Organizations
According to Almost (2016), conflict may have both positive and negative impacts depending on how it addressed. If conflict remains unaddressed, it can bring negative impacts which include interfering with individual personal well-being, undermine the quality of patient care outcome, bring the negative relationship between healthcare workers, bring disruptions to the organization, increased stress levels, and negatively affect the performance of an individual. Additionally, perceived disagreements about different goals or desires often lead to negative emotions like frustrations, fear, jealousy, anxiety. Finkelman (2016) adds that if a conflict is not addressed, it may lead ineffective collaboration, loss of staff, the poor performance of work, and mistrust.
On the contrary, appropriate conflict resolution is associated with many beneficial impacts such as leading to a better provision of service or quality patient care outcome, improving innovation and ideas quality, enhance a constructive debate, and facilitating a more useful resource utilization. It is therefore essential that healthcare organizations develop strategies of conflict resolution to benefit from the positive impacts and spar organizational growth while minimizing negative impacts (Almost, 2016).
Delegation and Strategies for Conflict Resolution, and Collaboration with Management and Peers
As Finkelman (2016) asserts, conflict may never go away but can be managed. As such, this author outlines strategies for dealing with conflict. These strategies include:
Establishing open communication with staff- open communication gives nurse managers a priority to open an environment which assists in resolving conflicts as well as preventing disputes between healthcare workers. Therefore, providing open communication, and ensuring the staffs are aware of their responsibilities and roles, procedures and policies, and behavior standards can help assist nurse managers in preventing potential conflicts that may occur in their departments. Through establishing ground rules, leaders can educate and coach staff how behaviors that are improper among peers and other healthcare team members.
Secondly, Finkelman (2016) asserts that instead of using avoidance methods, nurse leaders should focus on techniques that mentor professionalism, respect, and personal growth. As such, he says that nurse leaders should access the ability level of their departments to handle conflicts through learns, meetings, and lunch. Teaching staffs the skills required to confront and resolve conflict in an effective manner. This will help enhance collaboration between team members since they will be able to handle conflict through a healthy technique.
Thirdly, to have a clear understanding of every discipline concerning physicians and nurses- because of the changes in health care delivery, there is a need for good working relationships between physicians and nurses for the delivery of high quality and safe care. However, friction often occurs between two disciplines because of differing job roles of each discipline, and lack of roles understanding. Physicians usually have a different patient care approach than nurses, leading to a difference of plan of care opinions. Therefore, to improve this relationship, each party must better understand the discipline of one another. One way of improving the physician-nurse relationship is through conscious leadership teaching, which may be effective in improving the collaborative relationship between physicians and nurses. Through the conscious leadership training, roles of nurses are recognized, and the nurses are also involved in input and discussions regarding the outcome of patients. As such, each discipline has a huddle of daily review of the schedule of patients and care delivery. This technique has been proven effective in minimizing conflict between physicians and nurses (Finkelman, 2016).
Fourth is negotiation- through negotiation, questioning is done to all parties involved in the conflict to enable clarification of the situation involved. Afterward, a clear resolution guideline is established by the manager, which is presented to staff in the form of writing. For negotiation to be effective, a manager must choose a good time; when emotions have deescalated before the conflict is addressed. Also, a manager must take the following approaches for effective negotiations: the manager should maintain good eye contact, listen attentively, should have knowledge of procedures and policies, shut down outbursts of emotions, and build trust (Finkelman, 2016).
Recommendations
Almost et al (2016) recommend the following initiative to assist individuals to manage and mitigate conflicts in the workplace. The initiative is to provide inter-professional education where professionals engage together in a learning process. This learning is likely to foster positive relations and stereotypes, which may, in turn, improve the promotion practices that are collaborative. This interaction or learning is a significant factor in preventing barrier creation which may negatively impact professional teamwork and collaboration. The joint clinical and classroom training opportunities allow staff members and new members to discourse historical stereotypes, enable them to exchange various theoretical perspectives, develop leadership and communication skills which are essential to clinical teams that are highly functioning in the clinical setting. As such, teamwork and better professional understanding are improved (Almost et al., 2016).
Conflict is unavoidable in any organization including healthcare. The best way to benefit from conflict is through establishing strategies of managing or handling conflict resolution whenever it occurs. From the discussion, it is evident that formulating strategies for preventing, managing or handling conflict resolution accrues some benefits to healthcare organizations such improved quality of patient care outcome and enhanced interpersonal relationships which enhance collaboration among staff. It is therefore essential for leaders or managers in healthcare settings to implement the above strategies and recommendations to enjoy the benefits which will improve the growth of their organization.
References
Almost, J., Wolff, A. C., Stewart‐Pyne, A., McCormick, L. G., Strachan, D., & D'souza, C. (2016). Managing and mitigating conflict in healthcare teams: an integrative review. Journal of advanced nursing , 72 (7), 1490-1505.
Dodge, A. (2017, September 30). Types of Conflict in Nursing. azcentral . Retrieved March 1, 2018 from https://healthyliving.azcentral.com/types-of-conflicts-in-nursing-12238357.html
Finkelman, A. (2016). Leadership and management for nurses (3rd ed.). Boston, MA: Pearson
Mills, M. E. C. (2012). Conflict in health care organizations. J. Health Care L. & Pol'y , 5 , 502.
Spagnol, C. A., Santiago, G. R., Campos, B. M. D. O., Badaró, M. T. M., Vieira, J. S., & Silveira, A. P. D. O. (2010). Conflict situations experienced at hospital: the view of nursing technicians and auxiliaries. Revista da Escola de Enfermagem da USP , 44 (3), 803-811.
