The healthcare set up is faced with various challenges and conflict forms one of the major problems at work. Conflict frequently occurs at work due to several reasons and management of the healthcare problems is sometimes challenging. The nursing sector is affected by conflicts in the United States, and measures have been taken to solve the problem. The Affordable Care Act (ACA) has also tried to promote working in the healthcare sector through health insurance exchange and advocacy for unity thus ending the problem. Allocation of duties and shifts in the nursing profession is challenging, and sometimes problems arise due to, duty allocation or delegation. I observed a conflict between a nurse in charge and a staff member the other day, and being the supervisor I had to take action. The issue revolved around duty delegation. The staff nurse had refused to be pulled to a different unit during allocation of work, and there was a conflict between the two sides.
Allocation of duties in the nursing profession is one of the functions of a nurse in-charge and in some cases, adjustments are required when necessary. As a nursing supervisor, I was approached by upset charge nurse complaining about staff nurse A refusal to be pulled to the different unit then where she usually works. Charge nurse stated that that nurse A in the middle of the nurse’s station in front of both day and night shift and patients family members refused to listen to the reasoning that for continuity of patient care tonight she will be pulled. The nurse B that was her turn to be pulled already had full patient assignment last night in this unit. Nurse A ignored Charge nurse and went directly to Nurse B and asked her to check whose turn it was to be pulled. Nurse B to avoid even bigger problems left the home unit to the one that nurse A was avoiding to be pulled.
Conflicts between staff at work are a common occurrence, and as a supervisor, the first step is performing an investigation to determine the root of the problem and planning the course of action. After the information from the nurse in charge, I observed the behavior of the parties involved and noticed that there was an existing problem. Communication between the parties was impaired, and further investigation indicated that an intervention was needed. The exchange of words that occurred also raised concerns from other nurses during the shift and it was a bad picture to the relatives and the patients that nurses could show their differences in front of everyone.
Identification of conflicts in the healthcare organization is a managerial function, and the managers or supervisors use different approaches depending on the type of conflict identified (Finkelman, 2016). After assessing the disagreement between the workers in the department, I categorize the problem as interpersonal conflict. Interpersonal conflict exists between two primary individuals, and it can extend to third parties in an organization if not well managed. Most of the time, interpersonal conflicts occur due to the nature of people. People are different, and disagreements occur all the time at work due to personality differences. The primary conflict in our case was between the nurse in charge and the staff nurse. Although the conflict extended to nurse B, the reaction did not seem to cause more problems. Categorically, the conflict is classified as insubordination because it involved decline of duty delegation from the in charge.
Stages of Conflict
Recognition of a conflict is an essential step towards conflict management in an organization. A conflict is manifested through different stages, and once they are observed in the conflicting parties, it becomes easy to solve the issue. The Latent stage represents events that occur between conflicting individuals without their knowledge (Finkelman, 2016). Sometimes the stage is avoided because the conflict does not begin from the latent stage. Relating the latent stage with the healthcare problem observed, it represents the initial phase where the nurse manager decided to delegate the duty to the staff nurse expecting a positive response as usual. The staff nurse also was attending the shift without knowledge that a different delegation was underneath.
Perceived conflict is the most prominent stage that arises even when the latent stage is not present. At this stage, the parties become fully aware that there is a misunderstanding and it is easily observed (Dorn et al., 2013). The stage can be manifested through argument, throwing words or sometimes physical violence. In the healthcare setup, the management identifies the perceived conflict stage and interventions are made immediately to calm down the situation. A perceived conflict was observed between nurse A and the in charge nurse when the staff nurse disobeyed the orders. The staff nurse also extended the conflict to nurse B, and it is observed that nurse A bullied the other staff nurse to look at the duty roster. The incident shows that there was a misunderstanding between the parties and intervention was needed.
The felt stage follows the perceived phase, and it is observed that the stress and anxiety dominate the stage (Finkelman, 2016). The individuals feel the pressure because of managerial involvement and the process of investigation. Personalization of the problem is observed in some individuals when the whole personality is involved in the process. The conflict between nurse A and the in charge nurse is seen to have caused tension and discomfort in the unit. The manifest stage comes in when the affected parties engage in open aggression and sabotage. However, there was no aggression because the matter was reported to the senior nurse for further management. At the same time, nurse B left the home unit and took over the place avoided by nurse A thus minimizing further problems.
All conflicts end with the aftermath stage which represents the resolution of the problem. The stage has either positive or negative consequences on the organization depending on how it is handled. When the problem is genuinely resolved, satisfaction is reached, and the conflicting parties restore their relationship. Conflict aftermath is likely to occur when a problem is not solved correctly either due to poor judgment or lack of satisfaction from one party. The phase is manifested in the healthcare conflict of interest because as the supervisor, I listened to the two sides and found out that the staff nurse had a mistake. After counseling the nurse, the mistake was realized, and she realized her mistake. The intervention was good because the conflict was resolved effectively.
Strategies
Conflicts do occur every day, but the problem is not the misunderstanding but the management part of the problem. Effective conflict management strategies are required in the healthcare setting when dealing with interpersonal problems. Dealing with the conflict directly solves the problem rather than avoiding it (Finkelman, 2016). According to research, ignoring conflicts leads to stress and unresolved anger. People become happier and healthier when they face their problems effectively (Dorn et al., 2013). Conflict cannot be avoided in the hospital set up, but it can be managed. Experts agree that various skills are needed to solve conflicts, and conflict competence is among the key issue. Competency describes the ability of an individual to use cognitive, emotional and behavioral skills in managing conflicts. The managers can use the strategy to solve problems between workers in an organization.
Effective communication is a strategy that is used to prevent escalation of conflicts in the hospital set up. A research conducted on the effect of communication on conflict resolution indicates teaching communication skills in organizations resulted in a 10% improvement in confrontational habits (Overton and Lowry, 2016). The CPP global report also indicates that improved communication leads to a 30% increase in productivity. Overton and Lowry researched to determine the impact of communication and causes of difficult conversations in people (2013). The results of the study show that training in communication skills and conflict resolution improves productivity and patient satisfaction.
The use of mediation forms a better method and strategy for solving conflicts in the workplace (Finkelman, 2013). A third party such as a supervisor is needed when conflict arises in the healthcare setting. I used this method in resolving the conflict between the nurse in- charge and the staff nurse. The in-Charge nurse followed the chain of command and brought the unresolved conflict to me the nursing supervisor. I listened to both parties individually. I let them express their point of view before making the judgment. I did not find any inappropriate behavior by the in-charge nurse. I pointed out to the Nurse A that she was inappropriate and unprofessional. Yelling at the nurse’s station is unacceptable behavior. Since she ignored the in- charge nurse, it was insubordination. Then she bullied Nurse B to leave their unit. I allowed Nurse A to think about the situation and I asked her how she would feel if someone treated her like she did both nurses. She started to cry. Moreover, she apologized for her behavior. I asked her, in the future, if she does not agree with the in-charge nurse’s decision to discuss that professionally. I added that I was to notify her manager about the incident. I told her to learn from her mistakes to avoid future mistakes as the one committed.
Conflict management in an organization is not an easy task because relevant skills are required to solve the problem. The conflict between the in-charge nurse and the staff nurse is an example of how healthcare professionals disagree in the hospital. I am pleased with the way I handled the conflict to see the two parties at ease. It is observed that conflict management requires skills and the most critical skill required is communication. A good language promotes understanding and respect in an organization. Conflict resolution should also focus on alleviating the problem rather than preventing the issue. Conflicts can never stop to happen, but the way the managers handle the conflicts dictates the success of the programme. In future, I would like to deal with conflicts cautiously by conducting investigations before judgment. I will also venture in educational programmes on communication skills and effective ways of dealing with misunderstandings in the healthcare organization.
References
Overton, A. R., & Lowry, A. C. (2013). Conflict management: difficult conversations with difficult people. Clinics in colon and rectal surgery, 26(4), 259.
Dorn, B., Marcus, L., & McNulty, E. (October, 2013). Four Steps to Resolving Conflicts in Health Care. Havard business review, 51(8), 04.
Finkelman (2016), Chapter 13: Improving Teamwork: Collaboration, Coordination, and Conflict Resolution, section on Negotiation and Conflict Resolution, pp. 324-333.
