Dr. Renee Thompson: Conflict is Not Bullying

This post is part of a series of posts on nurse bullying and conflict in the workplace written by Dr. Renee Thompson, DNP, RN, CMSRN. Dr. Thompson is one of the top professional development and anti-bullying thought leaders in nursing.

We tend to label all perceived negative behavior directed towards others or ourselves as bullying. However, not all bad behavior meets the criteria for bullying (target, harmful, repeated). Sometimes the behavior is really incivility (rude, inconsiderate, low level). Other times employees perceive that the manager is bullying them but really, the manager is just holding employees accountable for their performance.

Sometimes what we think and label as bullying is really conflict between two or more people.

What is conflict?

Conflict occurs when at least two people see things differently, think differently, and have different expectations of the same situation. Conflict is birthed from human interactions. Think about all the human interactions we experience in healthcare.

Conflict is inevitable. Without conflict, organizations would fail to grow, societies would fail to expand and populations would fail to adapt. However, not all conflict is made the same.

There are two types of conflict: healthy conflict and destructive conflict. Both can initially appear similar, however successful individuals and organizations are able to distinguish between the two types. They learn how to encourage and embrace healthy conflict while resolving and eliminating destructive conflict. Successful organizations establish an expectation that employees have the smaller, more frequent conversations early rather than waiting and having the big, ugly, volatile ones.

Steps to take for conflict resolution

Step 1: Distinguish between true and false conflict.

Before you get involved in conflict, ask yourself the question, “Does this need to be resolved?” Distinguishing between true conflict versus false conflict can prevent you from getting sucked into situations that do not need your involvement, leaving the time and energy you need to confront the important issues.

False conflict: False conflict can initially appear as true conflict especially when emotions are involved. However, false conflict typically involves the following:

  • Differences of opinion – your political views are the polar opposite of your colleague’s views. You’re a member of PETA and your coworker shows pictures during hunting season of the deer he shot.
  • Little or no control – you believe that the State Board of Nursing mandate to complete 30 hours of continuing education every two years is ludicrous, but your colleague whole-heartedly supports it and even offers to do an in-service on the details. Your hospital has finally adopted an electronic health record and is training all staff on how to document in the computer. You’d rather insert an IV in a hungry lion than chart in the computer.

In each of these situations, you have either no control or it’s just a difference of opinion. What do we never talk about at work? Religion, politics, sexual orientation, etc. Why? Because it’s false conflict and will only destroy relationships.

True conflict: True conflict occurs when the situation may have a negative impact on patients, the organization or the individual. Examples of true conflict:

  • Poor practice – you witness a physician about to insert a central line without using the protective barriers, or walk into an isolation room without a gown.
  • Poor behavior – you witness an experienced, senior nurse yelling at your orientee in the middle of the hallway, in front of patients’ rooms. The unit secretary drops the f-bomb while sitting at the desk in the nurses’ station.
  • Issues with processes – the nurses complain that they are never able to get their medications on time from Pharmacy. Pharmacy claims that the nurses do not enter the orders in correctly, therefore causing the delay. This is true conflict due to a process issue.
  • Issues with staff relationships – the relationship between the nurses and nursing assistants is getting worse. Call lights aren’t being answered, the fall rates are up and nobody is working together.

If you realize you are dealing with false conflict, the solution is to just let it go. If you realize you are dealing with true conflict, then you need to take action.

Step 2: Separate the person from the behavior. Beat up problems – not people.

Step 3: Fact finding. The more information you have, the better. Data doesn’t lie. When you gather as much information about the problem, it’s easier to identify a solution.

Step 4: Create common goals. Creating common goals ensures that everyone is in alignment. As the late Steve Jobs said, “It’s okay to spend a lot of time arguing about how to get to San Francisco when everyone wants to end up there…but a lot of time gets wasted when if one person wants to go to San Francisco when another secretly wants to go to San Diego.”

Step 5: Brainstorm solutions. Identify every option for a potential solution, even the ones you don’t support. The key is to brainstorm – don’t limit.

Step 6: Seek consensus. For this step to occur, everyone needs to leave his or her ego at home. We all have to make decisions based on what’s best for our patients and for our organizations – not ourselves. Seeking consensus will test your ability to agree to a solution that you might not 100 percent support. That’s okay. The key is to acknowledge that no matter what the ultimate decision is, you will commit.

What is bullying?

Bullying is the repeated patterns of destructive behavior with the conscious or unconscious attempt to do harm. For a behavior to be considered bullying there must be a target, the behavior has to be harmful, and must be repeated over time.

Conflict is a necessary condition that can lead to growth, innovation, and improvements.

Bullying should never exist in this world, let alone in healthcare.

By knowing and understanding the difference, you can embrace and resolve conflict and do your part to eliminate bullying. 

Thanks for reading, take care and stay connected.