Conflict is a daily reality, yet many of us do our best to avoid it, dreading the time when we will have to navigate interpersonal disputes. Many nurse leaders are similarly uncomfortable with or do not feel competent to manage conflict. Unfortunately, avoidance typically compounds the problem, further complicating matters when the choice is finally made to deal with it. Poorly handling conflict damages relationships, interferes with employee performance, and, in turn, hurts the entire organization. However, when conflict is handled well, problems are resolved smoothly and everyone benefits in some way. This article suggests that the best approach to conflict resolution for nurse leaders is the collaborative approach, which creates a “win-win” situation for all involved. By taking this approach, nurse leaders can reframe their perspective from treating conflict as a problem to be avoided and instead handle conflict as an opportunity for beneficial outcomes for all.
Collaboration versus compromise
The father of modern conflict management theory, Morton Deutsch, transformed the field when he introduced the collaborative approach, which seeks to find a mutually beneficial resolution for all parties in a dispute. The collaborative approach is often referred to as “win-win” because both parties gain from the resolution. Outcomes the collaborative approach generates often sound something like, “Both of us will gain from this.” The collaborative approach contrasts to compromising, in which both parties give up something to resolve the conflict; it often sounds something like, “I’ll give up this, if you give up that.” Because the collaborative approach can enhance the relationship of the involved parties rather than create feelings of animosity towards each other because of what was lost, it is ideal for nurse leaders to use when managing disputes.
Discovering what the involved parties want
The pursuit of the win-win hinges upon the involved parties being honest about what they truly want. Do they want to win the conflict by proving a point without regard for the consequences? Or are the parties motivated to resolve the conflict in a manner that produces a win for everyone involved? As a conflict manager, the nurse leader must listen for what the involved parties want and block out the noise of denials and blame they may place on the other. Uncovering the real desires of the involved parties may require private discussions that probe into what is motivating them. In the book, Crucial Conversations: Tools for Talking When Stakes Are High, Patterson et al. (2012) recommend uncovering personal motivations.
To do so, the nurse leader can ask the parties:
- What do you really want for yourself?
- What do you really want for others?
- What do you really want for this relationship?
If the involved parties only want to win to advance their own agenda, then a collaborative approach will not be productive. However, most of the time, the nurse leader will discover that both parties want to see a mutually beneficial resolution for all involved, because they usually share the goal of ensuring that the resident receives the best care.
Initially, the nurse leader may find that the involved parties struggle to articulate what they really want because they are so upset by the conflict, and emotion is clouding their ability to reason. This emotional state creates assumptions and beliefs, which can often be misguided or even completely inaccurate. Consider the following example:
Certified nurse aide (CNA) A becomes upset that CNA B never helps to care for Mr. S, who is very challenging to assist. CNA A assumes that CNA B is lazy and uncaring and is very angry. CNA A tells the nurse leader “What I really want is for you to fire CNA B because they never help me with Mr. S because they are lazy and don’t care if he gets out of bed.”
When emotions drive assumptions about others’ motivations, thus influencing the other party’s own motivations, the nurse leader can ask everyone to take a deep breath and gain perspective by asking “Why would a normal person behave like this?” Let’s return to the example to see how this is applies in a realistic situation.
The DNS responds to CNA A by saying, “I’m sorry you didn’t get the help you needed to care for Mr. S. What would make CNA B, who helps you with all the other residents, not help you with Mr. S? Mr. S can use foul language and say indecent things to women. Do you think it’s possible he said or did something that would make CNA B uncomfortable?” CNA A responds to the DNS “Maybe. I didn’t think about that, but I still need help.”
CNA A is still upset and remains steadfast that she still needs help from CNA B, but a new perspective has been introduced for her to consider. Because of it, she has reconsidered her initial assumption that CNA B is simply lazy and doesn’t want to be helpful.
Creating a common goal and resolution
Gathering facts will provide the clarity and context the nurse leader needs to sort through the conflict and help the parties discover a common goal. Exploring such shared interests leads to a win-win for all. This process is not about finding blame; it is about understanding the conflict from multiple perspectives to share this information in a way that enlightens everyone involved.
Using the example case, the DNS would first confirm that CNA B helps care for all residents except for Mr. S. Next, the DNS would speak with CNA B to ask why she avoids caring for this resident when she does such a great job caring for other residents. When asked for her perspective, CNA B shares she is very uncomfortable around Mr. S and does not know how to respond when he makes crude remarks to her.
Once the facts are known, the DNS can facilitate discussion between the involved parties and help them see that they do indeed have a common goal. Sometimes, the nurse leader will have to start with a broad common goal, such as providing excellent care to all residents, but it cannot be communicated as an empty platitude. Rather, it must be something real and meaningful to the involved parties. Sharing the common goal in a way that reinforces the ongoing relationship they have to each other can help to reframe the conversation around what each really wants. This creates the opportunity to collaborate with each other. Applying this to the example could sound something like:
The DNS says, “I’ve talked with both of you, and I understand that both of you want the best for all the residents, including Mr. S. CNA A, you need help to properly care for Mr. S and you’re depending upon your teammate CNA B to give you that help. CNA B wants to help you and Mr. S, but Mr. S has said some inappropriate things to CNA B, and she’s uncertain how to care for him when he says these things. Are we agreed that we want to work as a team so that we can be there for each other and help Mr. S in a way that is safe for everyone involved?
Once the common goal is identified, the nurse leader can facilitate problem solving and help the involved parties identify how they can contribute to the resolution. Returning to the example, problem solving could sound something like:
The DNS says, “CNA B, I would like to provide some additional training to you on how to deal with inappropriate resident behaviors so that you feel more competent using your skills. CNA A, you need help today caring for Mr. S, so please either reach out to me or your charge nurse, and one of us will go in with you to help him. What else can be done over the next few days to ensure that each of you have what you need to care for Mr. S?”
Nurse leaders must be able to manage conflict and help facilitate conflict resolution. The collaborative approach, pursuing a win-win, is an example of how looking at conflict as an opportunity to strengthen relationships can lead to positive results. Implementing this approach properly should have the result of not only resolving the conflict at hand but doing so in a way that benefits staff and the broader team environment.
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