Nursing Strategies: Interaction Guidelines for Painless Conflict Resolution

Part 3 of a 4-part series

This is Part Three of a multi-part series on conflict in the health care setting. Part One explored the causes and hidden costs of conflict. Part Two detailed the five styles of managing conflict.

Last week we looked at the five different styles, or tactics, that people use to manage conflict in their lives: accommodating, compromising, collaborating, avoiding, and competing. Each of the five styles comes with its own set of advantages and disadvantages, and when applied to the wrong situation can delay or derail an effective resolution. (Remember, unresolved conflicts in health care have been linked to poorer patient outcomes!)[1],[2]

An American Journal of Nursing article (June 2009) titled “Conflict in the Workplace” states that:

Conflict is common to all workplaces. But in nursing, studies have shown it’s a particular source of job stress and dissatisfaction.

Although the terms used to discuss conflict management vary, experts agree that unresolved workplace conflict contributes to occupational stress, poor morale, job dissatisfaction, and turnover. This is especially so w2hen conflict is managed by confrontation, avoidance, or withdrawal. Burnout is reduced when workers are able to resolve conflicts through collaboration.

Collaboration is generally regarded as the best way to resolve conflict because it reduces competition and avoidance without excessive accommodation or collaboration. However, studies have shown that nurses most often use withdrawal.

How you interact with others is key

It’s crucial that nurses begin to step forward and feel empowered to speak up. Rather than avoiding a confrontation, you can state your case effectively and confidently by using a set of interaction guidelines developed by Development Dimensions International, a consulting firm with a specialty in heath care practice.

This recommended interaction process consists of five steps: open, clarify, develop, agree, close. Once you’re comfortable with them, you can use this model to facilitate a conversation about any difficult situation that needs a resolution.

Here is a breakdown of the steps:

  • Open. In this step you make sure the discussion has a clear purpose and a clear goal – that you’re all talking about the same thing. (It may seem obvious, but others may have a very different idea of what’s going on!) If you’ve initiated the discussion, you can clearly state your purpose. If someone else initiates the discussion, ask them to define their purpose. For example, you might start your response with, “Let me be sure I understand – you want to talk about…”
  • Clarify. This is a fact-finding step, in which you’ll want to explore every side of the issue, and every stakeholder’s concerns. (Remember that people’s feelings about the situation are also valid information!) This is an especially important step in group discussions, where every member might bring different insights and facts to the table.
  • Develop. This is the point at which ideas are presented for resolving the conflict. Even though you’ll have your own solutions in mind, be sure to involve others and listen to alternative approaches. Getting people involved helps to spark creative energy and build commitment for turning ideas into action! Be sure to discuss any additional resources or support that might be needed in order to follow through on each suggested solution.
  • Agree. At this point, the group will decide on a plan of action, including the ways in which they’ll support those who must take action. You’ll also want to agree on what follow-up actions are necessary, whether it’s another meeting or a series of monthly reports to track progress.
  • Close. Summarize the plan for resolution and check that everyone is clear on what needs to be done!

Next week: Specific tips for positive interactions, along with examples of difficult situations and possible responses!

Demonstrating conflict resolution skills is just one sign that a nurse is a leader. Learn how you can empower yourself with an online RN to BSN or RN to MSN degree.

[1] Knaus WA, et al. An evaluation of outcome from intensive care in major medical centers. Ann Intern Med 1986;104(3):410-8.

[2] Institute for Safe Medication Practices. Survey shows workplace intimidation adversely affects patient safety [press release]. 2004 Mar 31. http://www.ismp.org/pressroom/ pr20040331.pdf.

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