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Book Excerpt: Conflict Management


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This is an excerpt from The Charge Nurse Leader Program Builder: A Competency-Based Approach for Developing Frontline Leaders.

The better able team members are to engage, speak, listen, hear, interpret, and respond constructively, the more likely their teams are to leverage conflict rather than be labeled by it. – Runde and Flanagan

Much like problems, conflict is inevitable though not always negative. Charge nurse leaders encounter diversity and differences in opinions, ideas, methods, values, cultures, language, perceived and real needs, ethics, and beliefs, for example, which sometimes lead to intense disagreements. Negative conflict occurs when differences, concerns, and disagreements are ignored or poorly managed, resulting in increased stress, decreased productivity, loss of relevant information not shared, disrupted decision-making processes and broken relationships, decreased patient safety and satisfaction, and wasted time and energy.

Conflict properly handled can have positive outcomes and impact when it becomes the first step to facilitating innovative change and risk-taking. It can pull team members together to work toward mutual goas, interchanges of differing ideas, styles, methods, an approaches to providing patient-centered care, for example. Positive conflict encourages teamwork and productivity, initiative, innovation, and risk taking to improve quality, safety, and practice outcomes.

Charge nurse leaders are often called to manage conflict and turn it into productive problem solving. They may not be able to resolve conflicts among team members or between staff and patients, for example, but they may be able to help them work through their disagreements. They do have several responsibilities in managing conflicts:

  • Identify real or potential conflict situations
  • Deal with conflict in its earliest stage
  • Get issues, concerns, or needs out in the open
  • Listen to but do not agree with each person’s point of view
  • Help people focus on constructive problem solving; redirect blaming or complaining
  • Work with people to help them resolve their own conflicts, develop their own solutions, and take action to reduce or eliminate future conflict
  • If the situation remains conflictual, engage the chain of command as appropriate, e.g., call the nurse manager or physician of record to address the remaining concerns or issues

The challenge in handling conflicts for charge nurse leaders lies in trying to meet the personal and practical needs that are part of every interaction. The practical need is to resolve the conflict and the problems driving it. Generally, this is only possible if personal needs are first met: for person to feel valued and respected, to be heard and understood, and to contribute to the discussion and solution. By attending to these practical and personal needs in managing conflict, the charge nurse leader facilitates more engaged and productive work teams.

To be successful, charge nurse leaders must know how to manage conflict constructively and how to handle lateral and positional violence. Too often they learn about dealing with bullying and horizontal or lateral violence among staff members, patients, and others. A critical part of the charge nurse leader program must address the potential and real lateral or positional violence, incivility, and bullying experienced by many charge nurse leaders with marginal or non-existent nurse manager or team support for decisions made when managing unit operations, schedules, and staff assignments.