Report Conflict Theory Dizon Jayvee

8/2/2019 Report Conflict Theory Dizon Jayvee

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H O L Y A N G E L U N I V E R S I T Y

G r a d u a t e S c h o o l o f N u r s i n g

_________________________________________________________________________________

WRITTEN REPORT

Submitted by:

Jayvee Bartolome C. Dizon, R.N

Submiited to:

Lillibeth L. Caparas, RN, MAN

Professor, GSNANM


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STRESS MANAGEMENT

SOURCES OF STRESS

Adjustment to change is stressful. Many events in life produce individual stress

reaction. Death of a spouse or close family member, divorce, marital separation,

marriage or remarriage, and personal injury or illness is highly stressful events.

Change in the health of a family member, marital reconciliation, increased arguing

with spouse, sexual difficulties, changes in financial state, mortgages, trouble with

in-laws are stressful. Changes in living condition and personal habits also causes

stress. Even personal achievements, vacations, and holidays are stressful. These

personal stressors can affect ones job performance.

In addition to personal stressors, there are many sources of stress at work.

Dismissal and retirement are highly stressful. Business readjustments such aschanging jobs or responsibilities, and problems with the boss are stressful.

Nurses face stress with life and death situation; heavy workloads involving

physical and mental strain; knowledge of how to use numerous pieces of

equipment and consequences of equipment failure.

People often needlessly increase their stress. The difference between demands

people place on themselves or perceive from others and the resources they

perceive as available to meet the demands is a threat or stress.

STRESS RESPONSE

Stress is impossible to avoid. It is a nonspecific response of the body to any

demand. There are two types of stress: (1)eustress, a positive force that adds

excitement and challenge to life and provides a sense of well-being, and (2)

distress, a negative force cause by unrelieved tension that threatens

effectiveness. Whether one will experience eustress or distress largely depends on

the persons perceptions, physically activity or inactivity, mental activity or

inactivity, sound nutrition, and meaningful relationship.

A stressor is anything individual perceives is a threat. Stressors produce a state

of stress by disrupting homeostasis. There are three stages in the stress response(Box 2-1). First, the alarm reaction is the mobilization of resources to confront the

threat. Second, in the resistance stage, there is a large increase in energy

consumption. Once the reserve energy has been used, the body needs time to

recover and to replenish the supply. When stress continues for long periods of

time, the energy is used but not replaced and the third stage, the exhaustion,

results.

Consequently, unrelieved stress interferes with one physical and mental well

being. After the stress event the body return to a state of equilibrium. Stable

periods for bodies to restore adaptive energy allow one to meet new stressfulsituations.


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SYMPTOM OF STRESS

Numerous symptoms indicate that stress is becoming distress.

High stress levels accumulated over several months are likely to result in

physical and psychological reactions. The amount of stress necessary before onemanifests symptoms varies depending on factors such as heredity, habits,

personality, past illnesses, and previous crises and copying mechanism. Well-

educated, intelligent, creative people in management are at high risk and burnout.

They may become a workaholics but get little accomplished experience chronic

fatigue, feel they do not want to go to work, take increasing amounts of sick time,

become negative, blame and criticize others, engage in backbiting, and talk in

others backs.

STRESS CONTROL

The secret of happiness is to count your blessings while others are adding up theirtroubles

-Anonymous

Nurse managers can prevent and control burnout by setting personal and

professional goals, establishing properties, practicing good health habits and

relaxation techniques, improving their self-esteem by obtaining their skills they

need, and using support systems.

Values Clarification

Values clarification is a useful activity. Values should be chosen freely from

alternatives with thoughtful coordination to the consequences of each alternative.

They should be cherished and shared with others. The value should be integrated

in to ones lifestyle, and actions should be consistent with the values.

Goal Setting

Goals should be consistent with ones values, and one should consider goal

alternatives. To do this one considers why a goal is desired. One may want a

promotion for recognition or for economic reasons. If the promotion is not fourth

coming, one may receive recognition through community service. Money might begenerated through wise investments or fees for community services. The

achievement of the desired outcomes through different approaches increased

flexibilities and decrease stress causes by unmet goals.

Stress Avoidance and Regulation

When reappraising situations, ones should avoid troublesome transactions. Thefrequency of stress-inducing situations should be minimized. Every change takesenergy. Therefore during the high period of stress, routines and habits should bemaintained as much as possible. One should be cautious about moving and

starting a new job at the same time is getting a divorce. That also would be aparticularly poor time try to stop smoking or lose weight. Unnecessary changesshould be prevented during periods of high stress. Deliberately postponing some


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changes helps one deal with unavoidable change constructively and reduces theneed for multiple adjustments at one time. However, increasing positive sources oftension that foster growths, such as learning a sport, can help offset thedeleterious affect of negative tension.

Time BlockingTime blocking is the setting aside of specific time for to a stressor. To reduce thestress from having been promoted to a management position, you can set asidetime for reading about management or for observing a manager. This help ensurethat concerns are addressed and tasks accomplished. It decreased anxiety, timeurgency, and feeling of frustration. Define off-limit times, and set-aside time whenyou will not be interrupted by phone calls or by individuals except foremergencies. Schedule free time and exercise time, and put social events on thecalendar like you would be a business appointment.

Time ManagementTime management help control stress. Much time can be conserved when one

knows ones value system and act consistently with it, set goals, and plansstrategies for accomplishment of those goals. One can also use organizers such asto-do list and calendars to plan good uses of ones time.

AssertivenessWhen one asserts oneself, one increases self-esteem and reduces anxiety, thusreducing stress.As with time management, assertiveness involve thinking through goals andacting consistently with ones values through the uses of the effective work habitsand by setting limits on others attempts to block ones goals. It involves statingwhat one want and how one feels, making requests, taking compliments, handling,putdowns, and setting limits. An assertive person makes eye contact with other;stand straight; sit in an open, listening posture; and sits in an open, listeningposture; and speaks in a clear voice. Assertive people choose for themselves andachieve desired goals through self enhancing behavior that reduces stress.

Feeling Pauses

Feeling pauses are useful. One should take time to identify a feeling, label it,distinguish between thinking, and accept the feeling for what is rather than talkingoneself into what it should be.

Inner Shouting

Inner shouting is the process of shouting I feel. Inside ones head; the personblurts the feeling out spontaneously rather than saying it quietly. Anger should beviewed as a symptom. Pains should be focused on to help one take responsibilityfor feelings of hurt and humiliation.

Anchoring

Anchors are associated feelings that are initiated either by an event or by thememory of that event. Anchors may be sounds, lights, smells, taste or touchesthat stimulate positive or negative feelings. Birds chirping may remind one ofhappy, lazy mornings with the family. One may recall an awful accident at the

sight of blood. One might remember fall walks through the woods with a lover atthe smell of dry leaves. A taste may revive memories of Grandmas home cooking.


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A light touch to the face may remind on the earlier loving moments and cause oneto experience a sense of well-being. Our lives are filled with anchors that causeassociations. We can use anchoring in a useful way to experience desired feelings.Because touch can be inconspicuous and easy to replicate, one can associate apositive feeling with a familiar touch to the body. This may be as simple as

clasping ones hands and being reminded of soft music, beautiful colored glass,and the peaceful sanctuary of church. Exact pressure at a very specific spot makesthe anchor work most accurately and should be done when one desires to bringback a pleasurable feeling.

Sorting

Sorting is choosing the interpretation of an event. One can have an optimistic orpessimistic interpretation of events. Is the glass half full or half empty? Webecome what we think and therefore can make ourselves happy or miserable. Tobe happier and more fun loving, one should focus on the positive aspects ofsituations.

Thought Stopping

Thought stopping helps get rid of negative thinking. Excessive rehearsals in ourminds of negative past events are unhelpful thoughts that waste time, reduce ourself-esteem, and encourage maladaptive behavior patterns. To prepare for thoughtstopping, one should think of beautiful, pleasant experiences. One should alsoidentify the negative thoughts that are most bothersome. In private one can thinkabout negative thoughts momentarily and suddenly yell, Stop! while claspingones hands or hitting ones head or leg. One startles oneself, and the thoughtescapes. Immediately one should insert a pleasing thought.

Compartmentalization

Compartmentalization of thought is the deliberate decision to think negativethought at specified times of the day. During the allotted time one thinks aboutworry, guilt or jealousy. One does not allow oneself to think these thoughts atother times of the day.

Environmental Changes

Environmental Changes can be designed to reduce stress. This may be as extremeas changing job or residence or as minor as painting a room a favourite color or

adding a picture, candle, or basket. The short time inconvenience of remodellingmay be worth the long-term stress reduction. Temporary changes in jobs can addvariety and stimulation.

Humor

Humor related to an attitude toward life is most likely to reduce stress. There is acluster of qualities that characterize this frame of mind, including the flexibility,spontaneity, unconventionality, shrewdness, playfulness, humility and irony.

Centering

Centering helps reduce stress by bringing the mind and body back into balance.With left sided dominance, intuitive, aesthetic, and creative functions are reduced


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under stress. To center oneself, one is to put ones tongue on the centeringbutton, which is about one quarter of an inch behind the upper front teeth. Thisspot apparently stimulates the thymus gland, weaken the effect of stress, andbalances the cerebral hemisphere.

Nutrition

Good nutrition helps maintain the body for full functioning. Eating a balanced diet,taking vitamin supplements and drinking plenty of water are important.

Exercise

Regular, vigorous exercise can also help one withstand chronic stress. Aerobicexercise elevates the heart rate during and for a period after the exercise. Therange of elevation necessary to produce an aerobic effect is from 60% to 80% ofthe maximal heart rate the person can achieve, which is calculated at 220 minusthe persons age in years. Jogging, cycling, and swimming are particularly good

aerobic exercises. Dance allows to stretch and strengthen muscles and reducetension.

Sleep

Sleep is also important for dealing with stress. Sleep needs decrease with age, andpeople may awaken several times during the night as they grow older. This shouldnot be confused with insomnia, which is prolonged inability to sleep. There arethree types of insomnia: (1) initial, when it takes more than 15 minutes to fallasleep; (2) intermittent; with awakening during the night and difficulty returning tosleep; and (3) terminal, with early morning awakening and inability to go back tosleep.

RELAXATION

Abdominal Breathing

Numerous techniques can be used to foster relaxation. Abdominal breathing is aquick method. When stressed, people tend to breath in short, shallow breaths.Consequently, the lungs do not feel completely. The remaining air is stale, andoxidation of tissues is incomplete. Muscle tension results. Without beingconspicuous, one can take a few abdominal breaths almost everywhere at anytime.

Massage

Massage can relieve tension; provide passive form of exercise, and foster tactilecommunication. It stimulates relaxation and flexibility.

Meditation

Meditation focuses attention on an experience, helps one become aware of onesresponse, and facilitates the integration of the physical, mental, emotional, andspiritual aspects of ones life.

Visualization and Mental Imagery


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Visualization and mental imagery can be used to relax. One starts in relaxedposition and visualizes pleasant thoughts. One can meditate on a visualize coloredobjects such as blue sky, white cloud, green tree or pink flower.

Music

Soft classical music can help release feelings and emotions and bring aboutrelaxation.

Baths

Water is a relaxant. One should fill the bathtub with water that is bodytemperature and immerse oneself up to ones neck for about 15 minutes.

CONFLICT THEORY

Conflict, which is closely related to power and political issues, is inevitable and can

be constructive or destructive. It may offer an individual personal gain, provide

prestige to winner, be an incentive for for creativity, and serve as a powerful

motivator. Indeed, there seems to be an optimal level of conflict or anxiety

necessary for effective functioning. Conflict that is managed instead of avoided,

ignored, or suppressed can be used effectively. If conflict it goes beyond theinvigorating stage, it becomes debilitating. Conflict is warning in to management

that something is amiss, and it should stimulate a search for new solutions through

problem solving, the clarification of the objectives, and the determination of the

group boundaries. However, eliminating conflict is not necessary. If managers

learn the sources and types of conflict and how to manage them, they can

minimize stress on individuals and the organization and maximizes effectiveness.

SOURCE OF CONFLICT

Cultural differences may contribute to differing attitudes, values, beliefs, and

behaviours. Conflict can arise because the individuals involved do not have the

same facts. They define the problem differently, have different pieces of

information, place more or less importance on various aspects, or have divergent

views on their own power and authority. Varying goals and objectives or

contrasting procedural strategies for accomplishing mutually acceptable goals

produce conflict. Variation in personal value systems or in perceptions of ethical

responsibilities can lead to divergence in choices of both goals and methods, thus

producing conflict.

When people work together in a complex organization, there are numerous

sources of conflict. Conflict increases with both of number of organizational levelsand the number of specialities. It is greater as the degree of association increases


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and when some parties depend on others. Competition for scarce resources,

ambiguous jurisdictions, and the need for consensus all contribute to conflict.

Communication barriers impede understanding, and separations in time and space

fosters factionalism rather than the mutual cooperation. Although standardized

policies, rules, and procedure regulate behaviour, make relationships more

predictable, and decrease the number of arbitrary decisions, they impose addedcontrols over the individual. Men and women who value autonomy are likely to

resist such control. Clearly, the sources of conflict are endless, and the number of

conflicts increases with the unresolved differences.

TYPES OF CONFLICT

Structurally base conflict either vertical or horizontal .Differences between

managers and staff associates (vertical conflict) are often related to inadequate

communication, opposing interest, and lack of shared perceptions and attitudes. In

vertical situations, managers often attempt to control staff associates behaviour,and the staff associates resist, often causing managers to apply their position

power through impersonal bureaucratic rules. Line-staff conflict, which is usually

horizontal, is commonly a struggle among the domains related to activities,

expertise, and authority and is often to interdepartmental strife.

Interdepartmental differences are related to the degree of interdependence

among departments. Interdependence demands collaboration, and the later

provides the occasion for conflict. The need for the consensus, the work sequence,

and common use of shared facilities or services are areas of interdependence

aggravated by differing departmental goals. Both the personalities and the status

of the individuals involved affect attitude such as trust and cooperation, which arejust as important as the communication and interaction structures.

There are several types of role conflict. Intrasenderconflict originates in the

sender who gives conflicting instruction or expects conflicting or mutually

exclusive behavioural responses. For example, the same supervisor may demand

a higher quality of nursing care, refuse to allow the head nurse to fire equipment

help, and, in an effort to cut cost, refuse to increase an inadequate staff or to

permit overtime.

Intersenderconflict arises when an individual receives conflicting messages from

two or more sources. For example, management may implement an incentive plan

to stimulate production and peer pressures may discourage rate busting. In

university settings, the dean may expect department chairpersons to function as

administrators, and the faculty may expect them to act as their advocates. The

matrix organization that imposes project management on a functional structure

creates intersender role conflict.

Interrole conflict can occur when an individual belongs to more than one group.

Simultaneous, multiple roles within the same organization or the conflicting

expectations that result from being a member of more than one organization are

sources of such conflict. For example, a person may be expected to attend twodifferent committee meetings at the same time. Job expectations can easily


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within a limited time period. As a result, quality is sacrificed for quantity, the ego

threatened, and frustrations develop.

REACTIONS TO CONFLICT

Numerous psychological mechanisms exist for coping with ones own behavioralreactions to conflict, but such stress contribute to somatic reactions, for example,

cardiovascular diseases.lists some common reactions to conflict.

Sublimation is one of the most constructive psychological mechanisms

whereby unacceptable feelings are repressed and channelled into socially

acceptable activities. Energy from hostility and anger that would be

destructive if expressed directly is diverted with positive results into other

activities, such as jogging, tennis, or community service. Vigorous physical

activityoften reduces interpersonal aggression.

People who are displeased with the results of their behaviour may increasetheir efforts. Working longer and harder is likely to increase productivity.

Flight into activity, a defense mechanism whereby a person keeps busy to

avoid thinking about problems, provides some temporary relief but does not

solve the problems.

Identification is the practice of enhancing ones self esteem by imitating

anothers behaviour. The values and beliefs of the other person are

internalized, and both achievements and suffering experienced vicariously.

This illustrates the adage, If you cant beat them, join them. An individual

may compensate for a real or imagined inadequacy in one area bysubstituting a high degree of proficiency in another area. For example, one

who lacks social skills may excel academically.

Goals may be reinterpreted to attain an unmet goal, or the goal may be

lowered or another goal substituted. A person promoted to vice president

may decide that the vice presidency is a satisfactorily position. A rejected

applicant may find another job the applicant enjoys more.

Rationalization provides acceptable explanations for undesirable beliefs or

behaviours. Managers may find reasons to fire someone they do not like or

pad the expense account because everyone does it.

Attention getting may involve seeking highly visible jobs, engaging in loud

or excessive talking, wearing bright or sexy clothing and unusual hair styles,

or driving flashy cars. These displays are destructive only if they divert

attention from problem solving.

When individuals repress unacceptable behaviors and values and substitute

the opposite attitudes and behaviors, they are using a coping mechanism

called reaction formation. For example, an employee who was denied a

merit pay increase may defend the manager and vigorously support the

related policies.


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of-shift report in a timely way, and patients do not get the care they deserve at the

beginning of the shift. People have to tell you what you missed, and we all seem to

get off with the bad start. Dealing with personalities escalates conflict and is not

appropriate. We should separate the person from the problem. Issue expansion

includes issues form other times. We should stay focused. Bickering often makes

conflict worse unless we identify the problem causing discomfort and take aproblem-solving approach. Coalition formation gets other people involved and is a

power strategy. Constricting others and making threats escalate conflict. One of

the most difficult situations to handle is intentional hurt. That may lead to revenge.

STAGES OF CONFLICT

Conflict may be divided into four progressive stages: latent, perceived, felt, and

manifest. Latent conflictis a phase of anticipation in which antecedent conditions,

such as scarcity of resources, predict conflict behavior. When change is required,

the manager anticipates differences of opinion about the desirability of the

change, how it should be implemented, and how the consequences should be

handled.

Perceived conflict, which may or may not be discussed, indicates a cognitive

awareness of a stressful situation. Ones personal perceptions can contribute to

either an accurate or inaccurate assessment of the situation and affect the amount

of threat and potential loss the individual anticipates. Conflicts can be perceived

when antecedent conditions do not exist, such as when individuals have a limited

knowledge of the facts or do not know others opinions and values. For instance, a

manager may think there are limited resources or that someone else wants to use

the same materials when, in fact, there is plenty for everyone or no one else isinterested anyway. Personal perceptions also can help to avoid conflict. A

suppression mechanism may be used to ignore conflict that involves low potential

loss or is only minimally threatening. An attention focus mechanism helps the

individual select which conditions to change and which is to ignore.

Affective states such stress, tension, anxiety, anger and hostility are present

during the felt conflict. Feelings and attitudes may create or avoid conflict. Trust,

for example, is a significant factor in the development of a manifest conflict. If the

individuals involved possess trusting attitudes, they share information and control

and recognize their mutual vulnerability. In the absence of trust, individuals maywithhold information so it cannot be used against them or distort communications

to their advantage. They may scheme to increase their control over others and

strive to decrease others control over them. Clearly, trusting attitudes may

prevent potential conflict, and the lack of them may actually create conflict. Two

self-serving individuals are more likely to have manifest conflict than a dominant

and submissive pair.

The personalization or depersonalization of the situation affects the evolution of

conflict. When the situation is personalized, the individual is threatened or judged

negatively. With a depersonalized approach, the behavior rather than the

individual is identified as creating the problem. You are wrong is personalized,whereas your views are very different from mine is depersonalized. Personalized


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comments increase anxiety; a depersonalized approach is conducive to problem

solving.

Manifest conflict is overt behavior resulting from the latent, perceived and felt

conflict. It can be either constructive or destructive to problem solving.

Unfortunately, aggression, competition and other defenses are learnedunconsciously, whereas problem solving requires a more deliberate, conscious

effort.

CONFLICT MANAGEMENT

NATURE OF CONFLICT

Interactive processes of leadership are multifaceted, and the management of

conflict might well be the most challenging process of all. Acknowledging the dual

nature of conflict as potentially constructive or destructive and recognizing the

cues of each is the goal of managing conflict.

Anger is frequently a response to conflict. Lyon differentiates between situational

anger and chronic anger. Situational anger is energizing and constructive and

arises when realistic expectations are not likely to be met and involve the

following criteria: (1) the expectation has been clearly communicated; (2) persons

involved have the capability, knowledge, time and material resources to meet the

expectation, and (3) persons involved are willing to do what is expected.

Situational anger is empowering, and Lyon cites Florence Nightingales anger as

an example of how effective it can be in creating opportunities for nurses to

practice and improve health care. Nightingales anger was frequent, situational,

data-driven, and about matters that were changeable. She used her anger

effectively for action to correct appalling conditions in Londons hospitals. Lyon

challenges nurses today to empower themselves to change what is changeable

through Nightingale power. It can be used in variety of situations---in major

events or those of less consequence.

Where there is concern about an issue, collect data and present it, along with

suggestions on how the situation can be turned around, to enhance the nursing

practice. When nurses follow through with their concerns, they communicate to

others what nursing brings to health care that no other discipline can provide.

Keeping conflicts from getting out of control requires communication between

participants. Managers need to assure the staff that open sharing can be safe and

in their best interest as long as there is respect shown to each other. The open

communication should continue until there is consensus.

Not all conflicts are bad. Some conflicts are preventive and reduce hindrances to

goal attainment. Effective leader learn to curtail conflict on one hand and to design

or allow its influence on the other, becoming increasingly astute in determining the

need for each. Obsolete practices of entrenched groups can be shaken loose by

allowing or imposing conflict events. For example, identifying different

expectations that introduce new ideas and ways of doing things can pump newblood into stagnant, but otherwise competent, groups. Members gains new


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appreciations and readily incorporate changed expectations if the conflict event is

managed well. In the case of destructive conflict, early intervention is needed to

diffuse volatile emotions that threaten an attainment of the groups purpose.

Disarming instigators in some way through the use of various techniques is one

way of handling destructive conflicts are offered in the following section.

Collaborative conflict resolution is characterized by an approach when people

attack problems rather than each other. In order to avoid escalating conflict that

can occur when opposing forces hold different perspectives, participants should

answer some basic questions before entering into a collaborative effort. An

analytic approach includes consideration about: (1) what is essential and what can

be given up, (2) what the other person wants, (3) if either side holds false

assumption or incorrect perceptions, (4) what is the best strategy to use, (5) how

to handle hot button issues should they arise and (6) what precautions will

prevent further conflict? Preparation for collaborative conflict resolution pays

valuable dividends in terms of relationship, time, and the prevention of stress.Another technique to enhance collaboration is centering. It is a method that is

valuable in controlling stress during conflict resolution efforts. The goal of

centering is to relax the body and open the mind. It strengthens ones psycho-

physiological state and produces emptional and physical stability that affects

relationships and the environment. It allows individuals to move away from a line

of conflict and redirect negative energies.

In settings where conflict has traditionally been viewed as destructive, a new look

can broaden perspectives to consider the potential benefits that might result. A

simple question (will some change harm or help a situation?) leads to analysis,

which is the first stage of conflict management. Analysis reveals the nature of the

particular conflict, which must be considered within the context of a given

situation and point in time to determine its potential outcome.

The degree of conflict in a setting is an important factor to consider when

analyzing its effects. Situational factors influence the point at which a conflict is

good or bad. Competent groups handle conflicts differently than weak groups. The

collective strength of effective groups accommodates weaknesses among its

members. Such accommodation is not found in ineffective groups. The style and

strength of leadership operating in a specific setting influences individuals and

groups responses to disruptive events. The overall internal climate, therefore, isan important determinant of the outcome of any given conflict. It is important to

acknowledge the fluid nature of factors that contribute to the internal climate so

that frequent monitoring of the environment occurs. It cannot be assumed that the

cohesiveness of a group is constant.

Conflicts do not fall on a fixed point on a scale from beneficial and growth

producing to harmful. Multiple interactive situational factors determine the merit

of each. A conflict event might produce the cutting edge needed for growth at one

point in time and cause problems at another. For example, in times of

organizational prosperity, an announcement of no raises or cutbacks in salaries

will have a very different outcome on the workers than at that time of economic


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constraint and retrenchment that threatens job security. The same announcement

with the same individuals, but with different situational factors, produces different

consequences. The assumption that dissatisfaction can be expected from the

former situation and cooperation from the latter could be quite accurate

depending on the degree of shared information, understanding and fairness. If cuts

only affect the staff, while managers remain completely unaffected, and noexplanations are given, a perception of misuse power is likely, whether or not it is

true. Conflicts noted in misunderstanding, lack of cooperation, misuse of power,

and unfairness generally produce detrimental outcomes. At times, skilled

negotiators are needed to settle disputes when cooperative efforts within a group

fail. Differences in perceptions of events occur from time to time, and it is

important that nurses develop an appreciation of conflict as a significant force

influencing nursing practice. Failure to understand or handle conflicts

appropriately can account for serious internal professional problems.

BASIS OF CONFLICT

Conflict can be of an intra-psychic, interpersonal, or intradepartmental nature.

Nurses encounter varying degrees of each and need to develop understanding and

skill in managing them. Individuals can experience serious internal personal

conflicts that temporarily force reordering of their priorities. Personal conflicts can

put an individual at variance with work goals. In such instances, the collective

strength of effective work groups can temporarily compensate for an individuals

poor performance, but resolution is ultimately the responsibility of the individual.

Interpersonal influences, such as personality differences and conflicting ideas,

produce conflicts that can lead to either positive or negative results.Disagreements between individuals can be good or bad based on the degree of

mutual respect shared between them. The outcome of any interpersonal conflict is

related to complex, time related, situational factors surrounding the entire event.

Conflict is frequently associated with felt, unequal distribution of power, status,

and resources. It may be real or the result of inaccurate perceptions. In either

case, problems arise that must be handled swiftly if complications are to be

avoided. The outcome of these conflicts is determined by four critical forces: the

issue, power base of participants, cooperation between participants, and

communication. Selected courses of action can keep issues to manageableproportion or can escalate them. Power can be used to coerce or to compromise.

Individuals can hold onto bias or to work to dissipate it. Information can be freely

shared or withheld as means of control, and listening can become an integral part

of communication.

Clause and Bailey describe the use ofpower in two ways: directive and synergic.

Directive power shapes others for the purpose of advancing the interest of the

power wielder and is viewed as negative force. It is an example of unequal

distribution of power. Synergic power, however, incorporates group values and

cherishes other people. Synergic power is an essential element in balancing

control in competitive environments. Nursing is in a competitive environment inwhich bureaucratic goals dominate, putting professional goals and values at risk.


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Strong cohesive voices from nursing, plus intelligent and articulate nurse

representatives, are necessary to keep professional values/bureaucratic efficiency

conflicts to manageable proportions in complex organizations. In todays climate of

heath care delivery, ways must be found to conserve resources and use wisely

what is available. Professional nurses must spend their time providing professional

services rather than secretarial and hotel-typed activities that frequently consumetoo many professional nurse hours. An honest look at practices might reveal that

some nurses purposely hold on to non-nurses activities because they can provide

opportunities for closure task, which is satisfying, whereas many professional

activities leave nurses with some ambiguity more effectively.

Recognition of the basis of conflict can be helpful in managing it. Recognizing

events that are bound to be problematic can allow for effective interventions to

reduce their magnitude or to eliminate them altogether. Decisive action is

complex, and analysis of the premises from which action was formed is ongoing

and interactive.

Examples of Common Conflicts in Nursing

Nobel and Rancourt present evidence of a lack of cohesiveness in perceptions and

values among nurses, which causes major intradepartmental conflicts. They

discuss different modes of knowing and knowledge-accessing styles as causes. As

a result of the differences, nurses perceive the world of nursing and how they

conceptualize legitimate knowledge form opposing viewpoints. Educational

preparation was suggested as one factor in accounting for the differences, with

university-educated nurses being more flexible and broadminded about conflict

situations. Nurses with broader educational backgrounds were able to appreciate avariety of perceptions about a situation, whereas non-degree nurses tended to

hold on to their own perception as being correct. An unwillingness to develop

greater flexibility can lead to anger as responses to conflict.

Earlier research by Kramer and Schmalenberg has shown that commonly occurring

conflicts in nursing can be categorized according to type. Labels given to the types

of conflicts help identify the source and participants of conflict in nursing and

provide clues about interventions. Examples of classic conflicts in nursing include

professional/bureaucratic, nurse/nurse, nurse/doctor. Many nurse will be able to

see themselves in each one of these situation at one time or another. How theyare managed and what is learned from them is important. A description of each

type follows.

Professional/bureaucratic conflicts are the result of an incompatibility of

expectations produced by the system and perceived professional standards and

responsibilities. An imbalance of power is frequently at the root of such conflicts.

As such they lead to a great deal of frustration for nurses who feel helpless in a

situation.

Nurse/nurse conflicts results when directing values toward the philosophy of

nursing are held by nurses who work together. The differences interfere withteamwork. There can be ongoing problems between nurses who are consistently


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task oriented and those who wish to do holistic care. Assignment preferences of

task-oriented nurses might be based on the procedures to be performed, whereas

nurses who prefer holistic care continuity of patient care from admission to

discharge. Both approaches cannot exist on the same unit. Recently, nursing has

experienced the need for sensitivity training in order to manage staff conflicts that

arise out of multicultural issues. Martin, Wimberly, and O Keefe present a newview of multiculturalisms impact on the healthcare industry. U.S. standards

emphasize the individual, competition and accomplishment. Nurses strive to assist

patients to become more independent in healthcare matters. Western language is

considered to be low context, with many words used to make a point. In contrast,

eastern cultures are group oriented, and individual is subordinated. Harmony is

prized, and language is considered to be high context, with only a few words used

for necessary communication. Philosophical resources can become sources of

misunderstanding that can turn into conflict when planned efforts to improve

understanding are neglected.

Nurse/doctor conflicts spring from different expectations of each other in the

delivery of care. The stereotype of physicians dominating patient care has for

years submerged nursing. Some nurses continue to feel a need to compete with

doctors, and according to Cox and Sofield there remains instances of severe verbal

abuse of nurses by doctors. However, some doctors and nurses have worked

together and shown mutual respect for each others expertise and bottom-line

care outcomes. A trend toward educating doctors and nurses together for specific

areas of learning results in improved collaboration between the two groups. The

outcome promotes good practice, fosters respect for each other, and promotes

professional satisfaction. There are differences in the medical model and thenursing model. Each emphasizes different aspects of health care that

complement each other. Conflict comes about because of an imbalance of power

traditionally found in the system. Development of collegial relationships in which

there is mutual respect for each others complementary roles can prevent the

time-consuming and senseless problems that take attention away from the shared

goals of nurse and doctors. Nurses who take nursing forward through collaboration

recognize nurse and doctor contributions to health care as interdependent and

equal. They value nurses as full members of health care teams, and identify what

is essentially nursing in an overall plan of care. They recognize that incorporating

new technologies into healthcare is essential today and can be done without losingthe human element of compassion and ethical caring that meets spiritual and

emotional needs.

APPROCHES TO MANAGING CONFLICT

Some common approaches to handling conflict are avoiding, accommodating,

compromising, collaborating and competing (Box 6). Avoiding creates lose-lose

situations through unassertive and uncooperative means. The conflict is simply not

addressed. This approach may be appropriate when the other party is more

powerful, the issue is unimportant, one has no chance of meeting the goals, or the


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cost of dealing with the conflict is higher than the benefit of the resolution. It may

also be used when it is more appropriate for others to solve a problem, when more

information is needed, or when one wishes to reduce tension and gain composure.

Withdrawing from a conflict does not resolve it, and the individual who retreats

frequently harbours a gnawing anger over a situation that drains energy needed

for more constructive purposes.

Accommodating is cooperative but unassertive. It is self-sacrificing---the opposite

of competing. One neglects ones own needs to meet the goals of the other party.

It is appropriate when the opponent is right, the opponent is more powerful, or the

issue is more important to someone else. It can be used when preserving harmony

is important or when collecting social credits is necessary for later, more important

issues. By complimenting ones opponent and accentuating points of agreement,

one may smooth out an agreement or minor issues, but the real problem still have

to be dealt with.

Compromising moderates both assertiveness and cooperation. It addresses a

problem more effectively than avoidance but less than collaboration.

Compromisers are willing to yield less than accommodaters but more than

competitors as they seek expedient, mutually acceptable answers. Because both

parties feel that they sacrifice something, they are only partially satisfied, and a

lose-lose atmosphere results. Compromising is useful for reaching expedient

answers for limited periods when the goals are only moderately important and the

parties have equivalent power.

Collaborating is assertive and cooperative. It is a win-win strategy. It contributes to

effective problem solving because both parties try to find mutually satisfyingsolutions. This method integrates insights from different perspectives with the

commitment developed through participation and the resolution of hard feelings.

Problems are identified, alternatives explored, and ramifications considered until

difficulties are resolved. Unfortunately, it may take more time than the results are

worth. Generally this is a most effective method of conflict resolution. It should be

used for important issues and can be used to find creative solutions to

interpersonal problems.

Competing is a power-oriented mode that is assertive but uncooperative. In

competition one is aggressive and pursues ones own goals at anothers expense.This creates a win-lose situation. Nevertheless, it is appropriate when a quick or

unpopular decision is needed, when the person is very knowledgeable about the

situation and able to make a sound decision, or when one must protect oneself

from other aggressive people. If this strategy is used too often, colleagues may

become afraid to admit mistakes and may simply say that they think the

aggressor wants to hear. A manager can always fall back on authority and give

orders to a subordinate, but because the resolution is forced, it almost certainly

will be unsatisfactory.

A foundation of mutual trust must underlie any attempt to understand alternative

views and to actively seek solutions that will allow each party to achieve its goals.This trust creates an atmosphere conducive to successful conflict resolution.


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DEESCALATION-OF-CONFLICT TACTICS

Listening is a good way to deescalate conflict. It shows that you care about the

person by taking your time to listen to them. The other person may be able to talk

through the problem and solve it, particularly if you ask questions that lead her

through problem solving, such as the following: What is the problem? What areyour options? What will happen if you do that? What do you think is the best way

to handle this situation? What are you going to do? Showing tact and concern to

others is important. Appealing to de-escalation by saying something such as I

dont want to fight about this can help. Goodwill gestures such as Lets get a cup

of coffee and discuss this and allowing the airing of feeling are good. Our feelings

often dissipate after we talk about how we are feeling. We usually feel better after

talking about our feelings. Negative inquiry is an assertive technique of asking for

more information and trying to resolve the problem. When we are criticized, we

tend to get defensive, which escalates the conflict. Then the other person has to

work harder to get us to understand where we went wrong. When we ask for moreinformation, the criticizer may end up defending the accused.

Using metacommunications, one discusses the communication as it is occurring. I

am trying to talk to you, and you are walking away with me.It is important to

respond to all levels of communications, the facts and the feelings. I know that it

is my weekend to work, but I am angry that I have to work. Once again,

expressing the feelings helps dissipate them. Focusing on the facts helps with

reality testing and problem solving. Fractionalization breaks the problem down into

more manageable components. Position papers help move people from opposite

poles to a more middle-of-the-road stance. People will often follow flat statements

with qualifiers. Problem solving is a very effective deescalator. When all else fails,

establishment of outside criteria may be used.

STRATEGIES FOR MANAGEMENT OF CONFLICT

There are three ways of dealing with conflict: the win-lose, lose-lose, or win-win

strategy. Win-lose methods include the use of position power, mental or physical

power, failure to respond, majority rule, and railroading a minority position over

the majority. Lose-lose strategies include compromise, bribes for accomplishing

disagreeable task, arbitration by a neutral third party, and resorting to the use of

general rules instead of considering the merits of the individual cases. In win-loseand lose-lose strategies, the parties often personalize the issues by focusing on

each other instead of on the problem. Intent on their personal differences, they

avoid the more important matter of how to mutually solve their problem. Solutions

are emphasized instead of goals and values. Rather than identifying mutual needs,

planning activities for resolution, and solving the problem, the parties involved

look at the issue from their own point of view and strive for a total victor.

By contrast, win-win strategies focus on goals. They emphasize consensus and

integrative approaches to decision making. The consensus process demands a

focus on the problem, on the collection of facts, on the acceptance of useful

aspects of conflict, and on avoidance of averaging and self oriented behavior. Thusthe group decision is often better than the best individual decision.


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Problem solving strategies include indentifying both the problem and each partys

need, exploring alternatives, choosing the most acceptable alternative, planning,

defining roles, implementing, and evaluating the decision.

MEDIATION

Mediation is a friendly intervention by consent and invitation for settling

differences between parties. It is negotiation that involves a third party who is

knowledgeable about negotiation procedures can help the parties do their

bargaining. A mediator plays several roles. The mediator serves as housekeepers

who reviews the ground rules and keep the records. The mediator serves as the

ringmaster who chairs the meeting and determines when to recess, when to

adjourn, and when to have separate meetings. The mediator helps the parties

define the problems, identify the issues, and prioritize multiple issues. The

mediator is educator who facilitates the bargaining process and helps each party

consider how to achieve his/her objectives while accommodating the opponent to

create a win-win solution. The mediator is a communicator and an innovator.

Innovation can come about by making suggestions, but the suggestion should be

explored in separate meetings because the mediator should never raise questions

in the presence of both sides that could be embarrassing from either side. If one

party opposes the suggestion, it can be dropped. The mediator is a problem

explorer who helps analyzes issues from a variety of viewpoints; a resource

expander who links parties to outside resources; and an agent of reality who helps

creates a reasonable and implementable settlement. The mediator is a leader who

takes initiative to advance negotiations forward procedurally and may at times

offer suggestions for consideration. The mediator may also serve as a scapegoat

and take some responsibility and blame for an unpopular decision.

ARBITRATION

Arbitration is a structured method of dispute resolution. The arbitrator does not

interact with the parties but renders a binding decision based on a formal

presentation of information.

INTRAPERSONAL CONFLICT

Intrapersonal conflict occurs within the person and usually involves a struggle over

values, desires, or incompatible activities. The conflict is internalized. One shouldset personal goals and priorities and do problem solving. Being self aware and

working to resolve the conflict as soon as possible are important for the manager

to remain physically and psychologically well. The manager should help associates

be self aware and do problem solving too.

INTERPERSONAL CONFLICT

Interpersonal conflict is inevitable, but the manager can lessen its impact by

coaching staff associates in assertive communication and fair fighting. Engaging in

a fair fight demands that individuals with a complaint first ask their opponent for a

meeting. Once a time and place are agreed on, both parties should determinewhether their manager should be present. Moreover, a fair fight demands that


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both parties know the purpose of meeting so neither will be caught off guard---

each can be prepared. The encounter should begin with a statement of the

problem. The manager, if present, should act as a mediator, asking the complainer

to explain the perceived problem to the opponent. The opponent then should

relate her understanding of how the complainer perceives the problem. After each

has spoken, each can clarify any differences over the statement of the problem.Next, the opponent describes her perception of the problem; this description then

should be followed by the complainers repeating her understanding of how the

opponent perceives the problem. Again, there is a pause for clarification.

Helpful strategies for mediating interpersonal conflict include the following

(Loveridge and Cummings, 1996):

Do not blame anyone for the problem.

Focus on the issues, not personalities.

Protect each partys self-respect.

Facilitate open and complete discussion of the issues.

Give equal time to each party.

Encourage the expression of both positive and negative feelings.

Encourage each party to listen actively and try to understand the otherpersons point of view.

Help develop alternative solutions.

Summarize key points and plans.

Later follow up on the plans and give positive reinforcement as appropriate.

Facilitate further problem solving as necessary.

GROUP CONFLICT

Team development can help prevent and resolve conflict. Planning, goal setting,and rating goals represent the first team development. The statement of the coremission of the team is developed by brainstorming and sharing individual missionstatements.

The nominal group technique is very effective for developing team-performancegoals and priorities. First, individual group member list on separate pieces of paperwhat they think team performance goals should be.

INTERGROUP CONFLICT

Intergroup conflict is common and can be dysfunctional. As with interpersonalconflict, intergroup resistance may result from low trust, poor communications,and false assumptions.

ORGANIZATIONAL CONFLICT

Organizations in conflict display the collective symptoms of their members.Personnel feel frustrations at work. If they do not think their skills are being used,they experience loss of self-esteem and sense of powerlessness, both of whichlead to withdrawal from the situation instead of an attempt to solve the problems.

PREVENTION OF CONFLICT


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Careful development of an organizations structure, strategic, and comprehensiveplanning, management and organizational development, and careful selection andplacement of personnel help prevent organizational conflict.

1. Ann Mariner Tomey. 2004. Guide to Nursing Management and Leadership. 8 th

edition. USA. Mosby/Elsevier2. Basavanthappa.2006. Nursing Administration. New Delhi. Jaypee Publications.3. Bessie L. Marquis.2008. Leadership role and management functions in nursing.USA. J.B. Lippincott publication4. Diane. L. Huber. Leadership anManagement.3rd edition. USA. Saunders/Elseviercompany.5. Mary Allen Grohar-Murray. 2003.Leadership and Management in Nursing.Pearson Education, Inc.,

3.http:// www.authorstream.com /Presentation/sawan_17-155346-sep-bank-hrd-education-ppt-powerpoint/

4.http://www.dcswift.com/military/classes/Mentoring/negotiation.pdf

5. http://rphrm.curtin.edu.au/2005/issue2/emic.html

6.http://businessmanagement.suite101.com/article.cfm/negotiation-consensus-conflict management
http://www.authorstream.com/Presentation/sawan_17-155346-sep-bank-hrd-education-ppt-powerpoint/http://www.authorstream.com/Presentation/sawan_17-155346-sep-bank-hrd-education-ppt-powerpoint/http://rphrm.curtin.edu.au/2005/issue2/emic.htmlhttp://www.authorstream.com/Presentation/sawan_17-155346-sep-bank-hrd-education-ppt-powerpoint/http://www.authorstream.com/Presentation/sawan_17-155346-sep-bank-hrd-education-ppt-powerpoint/http://www.authorstream.com/Presentation/sawan_17-155346-sep-bank-hrd-education-ppt-powerpoint/http://www.authorstream.com/Presentation/sawan_17-155346-sep-bank-hrd-education-ppt-powerpoint/http://rphrm.curtin.edu.au/2005/issue2/emic.html

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