Module 8 Chapter 13 . Conflict is defined as the consequence of real or perceived differences in mutually exclusive goals, values, ideas, attitudes, beliefs, feelings, or actions: o Within one individual (intrapersonal conflict) Between two or more individuals (interpersonal conflict) - Example of intrapersonal conflict: . The nurse manager asks the staff nurse to work a double shift because the census is high. Although the nurse realizes the staffing for the night shift is low, the nurse has already made a family commitment for the same night. ** . Within one group (intragroup conflict) Between two or more groups (intergroup conflict) o A certain amount of conflict in an organization is helpful because: - It provides heightened sensitivity to an issue. . It acts as a stimulus for developing new ideas or solutions. . It helps people become more aware of trade-offs of a particular service or technique. . It helps people recognize legitimate differences with organizations. It motivates people to improve performance. o In competitive conflict, the goals of each side are mutually incompatible, but the emphasis is on winning, not the defeat or reduction of the opponent In disruptive conflict, the goal does not emphasize winning; the parties are engaged in activities to reduce, defeat, or eliminate the opponent. - Example of disruptive conflict: . A staff nurse has experienced disagreements with one of the medical residents about several issues, and the resident reacts to this conflict by belittling the nurse in front of colleagues*** - Due to the high stress nature of their jobs, nurses often have interprofessional conflicts with other health care professionals, administrators, or coworkers. Time is a frequently a source of conflict with other disciplines; nurses may feel that times for meetings, rounds, etc. do not consider their schedules - Conflicts between physicians and nurses dominate the problems reported by both professions. . An effective approach for resolving interprofessional conflicts is to advocate from the perspective of the client. . The DESC script from the Agency for Healthcare, Quality and Research can be helpful: . D: Describe the situation.. E: Express how the situation makes you feel (e.g., uncomfortable), and what your concerns are. - S: Suggest other alternatives and seek agreement. . C: Consequences should be stated in terms of impact on established goals; strive for consensus. . Example of consensus as a conflict management strategy: . The nurse manager presents an issue to the nursing staff for a decision. The group assesses the problem, and a decision is made meeting the needs of both the nurse manager and the nursing staff. *** . Conflict and its resolution develop according to a specific process, beginning with preexisting conditions, or antecedent conditions, which include: - Incompatible goals . Role conflicts Structural conflict Competition for resources . Values and beliefs - Differences contribute to conflict. . Distancing mechanisms (differentiation) serve to divide the group's members into small, distinct groups, increasing the chance for conflict, like a "we-they" distinction. . Example of distancing: . The day shift nurses and night shift nurses are in clear opposition regarding the responsibilities that each shift should be assigned. This opposition has created a "we- they" distinction on the unit. *** . The parties are influenced by their feelings or perceptions about the situation. Conflict behavior results from the parties' perceived or felt conflict. . Perceived conflict: each party's perception of the other's position . Felt conflict: the negative feelings between two or more parties The conflict is either resolved or suppressed, and the outcome results in new attitudes and feeling between the parties. . Resolution: mutually agreed-upon solution is arrived at and both parties commit themselves to carrying out the agreement. . Suppression: one person or group defeats the other; only the dominant side is committed to the agreement, and the loser may or may not carry out the agreement. o Conflict management is an important part of the manager's role. Involvement may occur at several levels: . Direct participants as individuals, administrators, or representatives of a unit . Confronting staff individually or collectively . Serving as mediators or judges to conflicting partiesConflict management begins with the decision if and when to intervene. . Very minor conflicts: better handled by the two people involved . Postponing intervention: allows the conflict to escalate; increased intensity can motivate participants to seek resolution . Giving participants a shared task or shared goals not directly related to the conflict: may help them understand each other better and increase their chances to resolve the conflict by themselves When a decision to intervene is made various mediation techniques can be used, deciding where, when and how the intervention will take place. Select a neutral location, free of distractions. . Allow sufficient time. . Avoid imposing positional power and making a quick solution that results in a win-lose outcome. . Runde and Flanigan model, constructive and destructive messages, and guidelines for helping two or more parties navigate conflict: Employ constructive responses: perspective taking, creating solutions, expressing emotions, reaching out, thinking reflectively, delaying response, and adapting. o Avoid destructive responses: winning at all costs, displaying anger, demeaning others, retaliating, avoiding, yielding, hiding emotions, and criticizing oneself. Protect each party's self-respect. Focus on the conflict of issues, not personalities. Avoid putting blame or responsibility for the problem on the participants. The participants are responsible for developing a solution to the problem. Allow open and complete discussion of the problem from each participant. o Maintain equity in the frequency and duration of each party's presentation. Encourage full expression of positive and negative feelings in an accepting atmosphere. . Make sure both parties listen actively to each other's words. o Identify key themes in the discussion and restate them at frequent intervals. Encourage the parties to provide frequent feedback to each other's comments. Help the participants develop alternative solutions, select a mutually agreeable one, and develop a plan to carry it out. At an agreed-upon interval, follow up on the progress of the plan. Give positive feedback to participants regarding their cooperation in solving the conflict. . There is a wide variety of conflict responses or conflict styles: . Confrontation is considered the most effective means for resolving conflicts; the goal is to achieve win-win solutions. . Example of confrontation strategy: - The nurse manager assesses that two staff nurses are engaged in a conflict that is having a negative impact on client care. The manager meets with the nurses involved and identifies the conflict. An attempt is made to resolve the conflict through knowledge and reason.***I Negotiation involves giveandtake among the parties. Its purpose is to achieve agreement even though consensus will never be reached; the best solution is not often achieved. I Example of negotiation: - The sta nurses and nursing administration are attempting to construct a method of scheduling that meets the needs of both the clients andI the nursing personnel because of prior conflict an agreeable solution is the intention.*"\"r I In collaboration, the talents of all parties are used, with a focus on solving the problem, not defeating the opponent. The goal is to satisfy both parties' concerns. I Example of collaboration problem solving: - A difference in opinion has arisen regarding methods to care for clients who are on mechanical ventilators. The nurse manager asks a group of nurses to meet and review evidence-based practice related to this client care situation. Each nurse volunteers to gather data prior to the next meeting. *\" I Compromise divides the rewards between both parties; neither gets what she or he wants. It can serve as a backup to resolve conflict when collaboration is ineffective. I Competing is the allout effort to win, regardless of the cost; it may be needed in situations involving unpopular or critical decisions. I Accommodating is an unassertive, cooperative tactic used when individuals neglect their own concerns in favor of others'. It is used to preserve harmony when one person has a vested interest in an issue that is unimportant to the other party. I In avoiding, participants never acknowledge that a conflict exists, a technique often used in highly cohesive groups. I In withdrawal, at least one party is removed, making it impossible to resolve the situation. The issue remains unresolved, and feelings about the issue may resurface inappropriately. - Smoothing is complimenting one's opponent, downplaying differences, and focusing on minor areas of agreement, as though little disagreement existed. - Forcing yields an immediate end to the conflict but leaves the cause of the conflict unresolved. It may be appropriate in Iife-or-death situations but is otherwise inappropriate. I Resistance can be positive or negative; it may mean a resistance to change or disobedience, or it may be an effective approach to handling power differences, especially verbal abuse. I Regardless of the strategy employed, managers must develop reexivity or a level of selfawareness, particularly awareness of the possible ways of understanding a conflict and one's own role in a conflict. Reexive strategies identified by Littlejohn and Dominici include: I Thinking of the conflict not as an obstacle, but as an opportunity for problemsolving 'l-ulinu-lium'l-u-nuruue .u.-f~i--lr-n..ru-dld_1l1lmin-.nn-dr-LunI-r.I'l_|ru_.-.mrwnk'immlula- Elm-n irlI'T'TDQnr'l JJ'E - Reframing the issue from emotional reaction to substantive issues I Turning the situation into an opportunity for building respect I Presenting or generate a variety of options for resolution - Shifting attention from positions to interests and then to mutual interests {such as patientcentered, high quality, safe care} I Alternative dispute resolution is often used in conicts that have the potential to lead to legal action. I Mediation is a form of ADR that involves a thirdparty mediator to help settle disputes