De-escalating Conflict in the Healthcare Setting

De-escalating Conflict in the Healthcare SettingIn any workplace, there are times when differing points of view create conflict. And unfortunately, a minor dispute can all too easily turn into a verbal argument or hostile behavior. When you’re involved in a situation like this, you always have a choice to make: you can allow your words and actions to escalate the conflict into something damaging and disruptive, or you can relinquish the false goal of “winning” the argument and focus on shared workplace goals. These shared goals usually include some element of patient safety, positive outcomes, collaborative care, and interdisciplinary teamwork.

The idea of de-escalating conflict stems from the fact that very few conflicts are entirely the fault of one person. Think back to a recent conflict that you were involved in. Was there something that made you become angry or defensive? Maybe the other person rolled his eyes, interrupted you, made a sarcastic comment, or shouted at you. In the heat of the moment, any of these things are likely to be perceived as an insult or even a threat. This perception of threat is what usually contributes to conflict escalation. So when you want to de-escalate a conflict, the idea is to make yourself non-threatening to the other person. This might include any or all of the following behaviors:

  • Listen to the other person’s concerns and accept his or her point of view without passing judgment.
  • Control your own tone of voice—it takes two to turn a conversation into a shouting match.
  • Watch your body language. Crossing your arms, rolling your eyes, or shaking your head can all put the other person on the defense.
  • Accept responsibility for anything you’ve done that has made the conflict worse, and apologize for those words or actions.
  • Don’t become defensive in the face of angry accusations or over-generalizations. When you start defending yourself instead of working toward a resolution, you’re most likely escalating the conflict.
  • Don’t make over-generalizations. Statements that begin with “you always…” or “you never…” are almost never universally true—and they’re going to be perceived as insults, which will escalate the conflict.
  • Focus on the desired end result, instead of on who is right or who is at fault. Remember that when two caregivers are in conflict, the patient is the most likely party to be harmed in some way.

Sometimes a conflict arises between a nurse and a patient, or the patient’s family members. Often these same de-escalation strategies will apply. Other times, a patient may become agitated to the point that it becomes a behavioral emergency that requires a specialized intervention. Your next steps in such an emergency depend in part on your employer’s policies. You may be required to call security or a crisis intervention specialist. But in general your primary goal will be to ensure your own safety, as well as the safety of the patient and anyone else in the area, while avoiding any actions that escalate the patient’s agitation and working toward helping the patient regain control. Current guidelines don’t recommend restraints or involuntary medication as a frontline strategy, but rather focus on verbally engaging the patient to establish a collaborative relationship.

One of the recurring themes in the American Sentinel healthcare blog is that nurses can and should build leadership skills at every stage of their careers. Here’s something to consider: leadership and conflict resolution go hand-in-hand. According to various surveys and estimates, nursing managers spend between 25 and 40 percent of their time dealing with conflict. Doesn’t it make sense that your organization would actively seek out and promote those individuals that demonstrate the ability to address conflict in productive ways? If you’re looking to advance your career, one of the best strategies you can employ is to become adept at managing and resolving conflict. Education can help. Empower yourself with knowledge through an online RN to BSN or RN to BSN/MSN degree. American Sentinel University is an innovative, accredited provider of online nursing degrees, including programs that prepare nurses for a specialty in nursing informatics, nursing management and organizational leadership, and nursing education.