Conflicts are inevitable in nursing practice settings. This is because the healthcare environment is inherently stressful, which increases the likelihood of occurrence of personal conflicts involving nurses. Conflicts in the healthcare environment can be as a result of various factors including scarce resources, different work styles, cultural diversity that might hinder communication, and differences in power and knowledge. Cases of conflict are also replete in high involvement healthcare settings that require collaboration such as the emergency department. The impacts of conflicts in the clinical practice environment are adverse such as disrupting the operations of hospitals and negatively affecting the productivity of nurses; hence, it is essential to resolve conflicts immediately they occur to avoid disastrous outcomes. This paper describes an unresolved conflict observed by the author in a healthcare setting and proposes the conflict resolution strategies that can be adopted in this case and future conflict situations.
Description of the Unresolved Conflict Observed
The unresolved conflict involved shift issues. This conflict occurred between two nurses, with one nurse taking care of the patient during the daytime shift and the other nurse caring for the same patient over the nighttime shift. The nighttime shift nurse was not satisfied with the work style the daytime nurse. Specifically, the nightshift nurse believed that the dayshift nurse was disorganized and left the workspace in chaos. For example, the nightshift nurse reported difficulties finding the patient record, which was often times left unfilled or filled incorrectly. On the other hand, the dayshift nurse insisted that daytime times are overly demanding when compared to the nightshift demands. The type of conflict identified in this case is interpersonal conflict, which occurs between people and can be attributed to a number of factors including differences, competition, personalities, and concerns regarding territory. Interpersonal differences in the practice environment can also be caused by differences in ideas, values, perceptions, responsibilities, needs, and goals between the involved nurses. Also, interpersonal conflicts in the nursing environment involve disagreements between nurses on issues. In this case, the interpersonal conflict was attributed to differences in the expectations regarding the responsibilities of the dayshift and nightshift nurses involved.
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Details of What Happened
The conflict occurred at the end of the dayshift when the nightshift nurse just assuming duty. The nighttime nurse could not trace the patient sheet because the daytime nurse had forgot to carry the patient record sheet to the place where they meet during the shift change. The dayshift nurse said that she could not remember where she last placed the patient sheet. Consequently, the nightshift nurse started complaining how the dayshift nurse was disorganized and unprofessional. Instead of having a seamless handover session, a verbal tantrum ensued, with the dayshift nurse retorting that the demands of her shift are overwhelming and that the night nurse was not understanding. She further responded by stating that the nightshift is not demanding, and the nurse can find time to trace the patient sheet. The nightshift nurse also complained that the daytime nurse had developed a habit of failing to fill the patient sheet accurately and sometimes failing to fill it completely, to which she insisted that complicated her work of caring for the patient.
The conflict between the nurses resulted in detrimental outcomes. First, during the handover session, there was a verbal confrontation between the nurses, which lasted for about 10 minutes. This means that the patient had to wait for the confrontation to end before nighttime care. The conflict also resulted in a strained relationship between the two nurses. In the subsequent handover sessions, the dayshift nurse elected not to brief the incoming nighttime nurse. Instead, she opted to leave the patient sheet at the hospitals reception and instructed the receptionist whom to give the sheet. At the same time, the nightshift nurse reported to the nurse administrator at the hospital that she was frustrated and angered and considered being reassigned to another patient. She also expressed concern that patient might be affected since she was not sure that the daytime nurse was not filling the patient correctly, which complicated her shiftwork. Such concerns led to the conflict is yet to be resolved.
Four Stages of Conflict
There are four stages of conflict, which are latent, perceived, felt, and manifest conflict stags. The latent conflict stage is characterized by anticipating the conflict. Inadequate communication and competition for limited resources are often precursors of conflict. Anticipating a conflict can result in heightened tension. In the case of the observed conflict, the predictors of observed conflict were the differences in the expectations of the nurses regarding their roles and responsibilities. For instance, the nighttime nurse was aware that the daytime nurse was disorganized while the daytime nurse argued that he shift was extremely demanding but they never showed signs of disagreement. Perhaps, the nightshift nurse thought that it was just a temporary behavior that would soon pass. The perceived conflict is the second stage, which is characterized by aware of the existence of the conflict. The perceived conflict is only felt rather than discussed. Perception plays a key role in determining whether a conflict actually exists, the known aspects regarding the conflict, and ways of addressing the conflict. The observed conflict also advanced to the perceived conflict stage, wherein the night nurse started showing signs of being frustrated with the behaviors and actions of the daytime nurse.
The felt conflict is the third stage characterized by individuals starting to have feelings emanating from the conflict such as anger or anxiety. The individuals in conflict start having stress. Using avoidance at the felt conflict stage can help stop the escalation of the conflict to the subsequent stage. Caution should be exercised when using avoidance because it might just cover the conflict rather than resolve it, which means that the conflict might recur in a more complicated manner. Trust is also crucial in addressing conflict at this stage. The described conflict escalated up to the felt stage. This was evident by the fact that the night nurse was aware that she disagreed with the manner in which the daytime nurse worked; however, this did not make the nightshift nurse anxious or tense and had no effect on her relations with the dayshift nurse. Essentially, the nightshift nurse personalized the conflict, which is consistent with Barskys descriptions of felt conflict stage – the personalization of a conflict, which makes individuals to feel the conflict. During this felt stage, there is no response from the parties who perceive to be in conflict.
The manifest conflict is the last stage characterized by the behaviors of the two conflicting individuals invoking response from one another. Conflict that has developed up to this stage can be either destructive or constructive. Constructive responses is characterized interest in identifying and solving the problem; conflicting parties showing appropriate feelings; and offering to provide assistance to the other person. On the other hand, destructive conflict is typified by ignoring the conflict, denying the existence of a conflict, avoiding another person, and publicly discussing the other person in a negative light. The identified conflict advanced to this stage and took a destructive turn as evidenced by the daytime nurse avoiding briefing and meeting the night nurse during the shift handover.
Strategies for Conflict Resolution
Conflict management seeks to decrease or eliminate an existing conflict; ensure that the needs of patient and the organization are met; and to ensure that all parties in conflict feel positive regarding the resolution to enable them work productively in the future. The identified can be resolved using a number of strategies such as empowerment and negotiation, and mediation. Empowerment can be adopted as a means to resolve the identified conflict through participative decision-making, wherein staff are provided with an opportunity for participating and influencing decisions. In this way, nurses should be involved in decisions regarding patient assignments and shiftwork scheduling among others. Even with empowerment, it is imperative to set boundaries or limits to deter the development conflict. In this case, nurse manager should describe the staff responsibilities and roles clearly. Negotiation involves letting the people in conflict discuss a resolution that is deemed both acceptable to the parties involved. This will involve maintaining an objective approach; helping the conflicting nurses to settle their differences on their own if possible instead of taking charge of the process; and encouraging staff members to adapt their behaviors. Mediation involves using a neutral party to help the conflicting nurses by guiding the discussion. In this case, another staff can act as a mediator.
The scope of the collaborative efforts with the nurse leader to resolve the conflict will include clarifying the roles and responsibilities of nursing staff; encouraging staff to respect to the contributions of others; and cultivating a culture of trust and open communication among nursing staff. The clarification of roles and responsibilities eliminates the likelihood of ambiguity, which reduces conflicts and encourages collaboration. Trust is needed to facilitate information sharing among nurses. In order for nurses to respect the contribution of others, it is crucial for them to be aware that they cannot work in isolation.
This learning experience has offered insights regarding the various stages through which conflicts progresses, which ranges from latent, perceived, felt, and manifested conflict. Understanding this stages of conflict can help address the conflict before it become destructive. From the learning experience, the author has also identified three conflict resolution strategies that can applied to resolve future conflicts, which are mediation, negotiation, and empowerment. The significance of collaboration has also been underscored in this learning experience, which requires respect, trust, open communication, and role clarification. These insights will be helpful when dealing with conflicts in future.