Managing conflict: Nursing

Nurse Matt works on a medical surgical unit at a hospital and is caring for a client who requires a sterile, moist-to-dry dressing change. As Nurse Matt gathers the materials for the dressing change, a travel nurse named Monica approaches him and says, “You’re grabbing the wrong supplies, Matt. In the hospital I come from, we change the dressings differently and everyone here seems to be doing it wrong!” Nurse Matt is aware that Nurse Monica has upset several staff members by telling them to complete dressing changes the way she has been taught. Nurse Matt recognizes this difference in opinion has caused a conflict on the unit and decides to speak directly to Nurse Monica about this. He will use conflict resolution techniques to determine the best course of action.

A conflict occurs when a person experiences a disagreement in values or beliefs within themselves or with other people. Conflicts can occur between any member of the healthcare team, such as nurses, nursing students, and physicians, as well as clients and their family members.

In today’s complex healthcare environment, resolving conflicts, such as the one between Nurse Matt and Nurse Monica, is important in order to provide optimal client care and facilitate healthcare team performance.

Alright, conflict can be categorized into three main types: intrapersonal, interpersonal, and organizational. Intrapersonal conflict occurs within oneself and is a result of a person being confronted with ways of thinking which are different from what they are used to. An example of intrapersonal conflict would be a nurse having conflicting feelings when asked to work an extra shift. The nurse must balance feeling obligated to help the unit and also the need for self-care and rest.

Interpersonal conflict happens when two or more individuals disagree about a topic. This is what is happening between Nurse Matt and Nurse Monica and is the most common type of conflict.

Lastly, organizational conflict is when there are disagreements throughout a team or large organization, like a hospital. These can arise due to certain policies, procedures, or patterns of communication. An example would be if funds to purchase new equipment became available at a hospital and one group believed that new laboratory equipment was needed most but another group believed new physical therapy equipment was most important.

Now, conflict can happen for a variety of reasons and it is helpful for you to understand these sources of conflict in order to help resolve them. Conflicts arise from discrepancies in four main areas: facts, values, goals, and approaches.

Fact-based conflicts occur due to a disagreement over information that can be proven factually, such as a nurse disagreeing with the pharmacy technician over a medication dose. By reading the healthcare provider’s order, the discrepancy can easily be resolved.

Values-based conflicts occur when individuals have a difference in beliefs and opinions regarding a topic. Unlike fact-based conflict, this is not so easily resolved since both parties are passionate about their stances. An example of this is when a client who is diagnosed with stage IV cancer wants to enter hospice care, but their spouse wants them to aggressively treat the cancer instead.

There are also goal-based conflicts that happen as a result of competing priorities, such as the nurse wanting to allow the client to have uninterrupted rest time, but also needing to turn the client every two hours to prevent a pressure injury.

Finally, approach-based conflicts arise when individuals agree on a common goal, but don’t agree on how to achieve it. An example of this conflict is occurring between Nurse Matt and Nurse Monica. Both nurses want to complete the dressing change, but do not agree with how to approach the task.

Now, most conflicts go through four main stages: frustration, conceptualization, action, and outcomes. First, there is frustration, which happens due to the intense emotions experienced by the individuals involved in the conflict. For example, Nurse Matt feels frustrated when Nurse Monica tells him that his dressing change method isn’t right.

The next stage is conceptualization, where different interpretations of the situation come to light. For example, Nurse Monica may believe that this conflict stems from Nurse Matt’s inability to perform the dressing change, whereas Nurse Matt may believe that Nurse Monica is battling for control.

The third stage of conflict is action, which is when a behavioral response to the conflict occurs, like when Nurse Matt speaks to Nurse Monica about the conflict.

Lastly, the outcomes stage is where positive or negative consequences can result, depending on the type of conflict resolution used by the nurse.