Chapter 23

Conflict: The Cutting Edge of Change

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Objectives

Determine the nature and sources of perceived and actual conflict.

Assess preferred approaches to conflict. Determine effective approaches to conflict. Identify conflict management techniques that

will prevent lateral violence and bullying.

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Conflict

Disagreement in values or beliefs within oneself or between people that causes harm or the potential to cause harm

Conflict is a catalyst for change and has the ability to stimulate either detrimental or beneficial effects.

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Types of Conflict

Intrapersonal Interpersonal Organizational

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Better Understanding of Stress and Conflict

Important factors to consider Context (e.g., particular work environment) Extent to which leaders respect staff concerns Cultures that condone “shame and blame” Use of compromise to avoid dealing with the

conflict Understanding that unresolved stress leads to

poor patient outcomes

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The Stages of Conflict

Frustration Conceptualization Action Outcomes

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Modes of Conflict Resolution

Avoiding Accommodating Competing Compromising Collaborating

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Self-Assessment: Avoidance

If you tend to use avoidance often, ask yourself: Do people have difficulty getting my input and

understanding my view? Do I block cooperative efforts to resolve issues? Am I distancing myself from significant others? Are important issues being left unidentified and

unresolved?

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Self-Assessment: Avoidance (Cont.)

If you seldom use avoidance, ask yourself: Do I find myself overwhelmed by a large number

of conflicts and a need to say “no”? Do I assert myself even when things do not matter

that much? Do others view me as an aggressor? Do I lack a clear view of what my priorities are? Do I stir up conflicts and fights?

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Self-Assessment: Accommodation

If you use accommodation often, ask yourself: Do I feel that my needs, goals, concerns, and

ideas are not being considered by others? Am I depriving myself of influence, recognition,

and respect? When I am in charge, is “discipline” lax? Do I think people are using me?

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Self-Assessment: Accommodation (Cont.)

If you seldom use accommodation, ask yourself: Am I building goodwill with others during conflict? Do I admit when I’ve made a mistake? Do I know when to give in, or do I assert myself at

all costs? Am I viewed as unreasonable or insensitive?

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Self-Assessment: Competing

If you use competing often, ask yourself: Am I surrounded by people who agree with me all

the time? Do people avoid confronting me? Are others afraid to share themselves and their

needs for growth with me? Am I out to win at all costs? What are others saying about me?

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Self-Assessment: Competing (Cont.)

If you use seldom use competing, ask yourself: How often do I avoid taking a strong stand and

then feel powerless? Do I avoid taking a stand to escape risk? Am I fearful and unassertive to the point that

important decisions are delayed and people suffer?

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Self-Assessment:Negotiation/Compromise

If you use negotiation often, ask yourself: Do I ignore large, important issues while trying to

work out creative, practical compromise? Is “gamesmanship” a part of my negotiations? Am I sincerely committed to compromise or

negotiated solutions?

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Self-Assessment:Negotiation/Compromise (Cont.)

If you seldom use negotiation, ask yourself: Do I find it difficult to make concessions? Am I often engaged in strong disagreements, or

do I withdraw when I see no way to get out? Do I feel embarrassed, sensitive, self-conscious,

or pressured to negotiate, compromise, and bargain?

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Benefits of Compromise

Supports a balance of power between self and others in the workplace

May require mediation Involves an impartial helper Both sides must acknowledge disparities Not about winning or losing Key: What works best in this situation?

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Steps to Resolving Conflict

Name the conflict (identify the problem) Identify your reaction to it Search for cause Identify a common goal Generate solutions Select and plan innovative solution Implement Evaluate Repeat as needed

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Guidelines for Confrontation

I.D. need for confrontation Timing Clearly I.D. problem I.D. behavior required Establish credibility Remain empathic Avoid personal attacks Use genuine humor if appropriate

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Managing Lateral Violence and Bullying

Lateral violence: Aggressive and destructive behavior or psychological harassment of nurses against each other.

Bullying: Real or perceived power differential between the instigator and recipient must be present in bullying.

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Self-Assessment: Collaboration

If you tend to collaborate often, ask yourself: Do I spend valuable group time and energy on

issues that do not warrant or deserve it? Do I postpone needed action to get consensus

and avoid making key decisions? When I initiate collaboration, do others respond in

a genuine way? Does the group exhibit hidden agendas, unspoken

hostilities, and/or manipulation?

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Self-Assessment: Collaboration (Cont.)

If you seldom use collaboration, ask yourself: Do I ignore opportunities to cooperate, take risks,

and creatively confront conflict? Do I tend to be pessimistic, distrusting,

withdrawing, and/or competitive? Am I involving others in important decisions,

eliciting commitment, and empowering them?

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Assessing the Degree of Conflict Resolution

Quality of decisions Quality of relationships

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Exercise 23-3

Consider a conflict you would describe as “ongoing” in a clinical setting. Talk to some people who have been around for a while to get their historical perspective on this issue. Then consider the following questions: What are their positions and years of experience? How are resources, time, and personnel wasted on

mismanaging this issue? What blocks the effective management of this issue? What currently aids in its management? What new things and actions would improve its management

in the future?

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