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When nurses don't wanna go there: resolving conflicts.

Every conflict we face in life is rich with positive and negative potential. It can be a source of inspiration, enlightenment, learning, transformation, and growth--or rage, fear, shame, entrapment, and resistance. The choice is not up to our opponents, but to us, and our willingness to face and work through them. (Cloke, Goldsmith, 2000) (i).

Asking for a raise. Shift to shift relationships. Giving a critical performance review. Saying no to a co-worker in need. Confronting disrespectful or inappropriate behavior. Disagreements during staff meetings. Sometimes nurses just don't wanna go there. This begs the question, why do well-intentioned and intelligent people often fail to create the cultures of resolving conflicts through collaboration. Even though we have seen a revolution in new communication and collaborative technologies, resolving conflicts through collaboration on nursing teams often remains an aspiration rather than a reality. If we could calculate the total amount of time, energy, money, and resources wasted on unresolved conflicts--the relationships we destroy, the decreased productivity from time spent in gossip, absenteeism, illness and poor morale the total would be staggering. The following statistics recently caught my attention for more than a few minutes.

* Research shows that 60-80% of all difficulties in organizations stem from strained relationships between employees, not from deficits in individual employee skill or motivation. Daniel Dana, Managing Differences: How to Build Better Relationships at Work and Home (2005, 4th ed) .

* The typical manager spends 25-40% of his/her time dealing with workplace conflicts. That's one to two days of every work week.

Washington Business Journal, May 2005.

* Ernst & Young reports that the cost of losing and replacing an employee may be as high as 150% of the departing employee's annual salary. Workforce . com.

Conflict is an unavoidable part of our daily lives, an inevitable result of our highly complex, competitive and often litigious society. Actions that employees cite as causes for workplace conflict range from poor communication; not being involved in decision-making; disagreements about "who does what;" stress from working with inadequate resources; leadership problems, including inconsistent, missing, too strong or uninformed; avoiding conflict by "passing the buck" with little or no follow-through on decisions; seeing the same conflicts/ problems over and over. On the upside, conflict is often needed because it helps to raise and address problems; it energizes work to be focused on the most appropriate issues; makes it easier for people to "be real" motivating them to participate; and improves the learning process of recognizing and benefiting from differences.

Each of us has our own ideas, opinions, and needs, on how we manage our differences. As nurses our ability to resolve conflicts is essential to our effectiveness with our peers and healthcare consumers. Every nurse is faced with the possibility of conversations that make them feel uncomfortable, particularly when people feel strongly about what is being discussed or about the people discussing it, or when self-worth is on the line. While situations may be different for every person, the dilemma remains the same: How to solve these conflicts in ways that reduce anxiety and increase the likelihood of success.

Annette Simmons author of A Safe Place for Dangerous Truths (ii) says that when a group fails to address difficult issues, something has affected its members' willingness to see and tell the truth. It could be a turf war, an ego battle, a tyrannical hierarchy, old fears of retribution, or learned helplessness translated into apathy. When coworkers will only speak privately about the "real problem," then dialogue has become taboo in the larger group. The "real problem" is code speak for the one thing that needs to be fixed, yet everyone is too scared to mention it for fear of retribution, losing personal ground, or being lashed out at for being the bearer of bad news. The "real problem" is the one that everyone either pretends isn't there or ineffectively addresses the same old solutions that didn't work last time. In other words, when nurses don't wanna go there.

Oliver Wendell Holmes said that the great thing in this world is not so much where we stand, as in what direction we are moving. We have to stop avoiding the real problems and move as Holmes suggest in a new direction because it is possible it may contain the seeds of a unique opportunity. To discover this possibility, we need to change how we think about ourselves, our organizations, and the people with whom we are in conflict. We need to dramatically shift the way we approach organizational conflicts, and the way we behave and participate when we are in them. It is often difficult for us to do so because we are so preoccupied with what it will cost us to resolve our disagreements that we fail to consider the cost of not resolving them.

In the 1970s Kenneth Thomas and Ralph Kilmann identified five main styles of dealing with conflict. As people work to improve their conflict resolution abilities, one of the most important preparation tasks is to look inside themselves to gain a better understanding of their own tendencies, patterns, and beliefs. This need not be a threatening or self-critical task. It is meant to help people in challenging situations to be able to move away from not wanting to go there. The styles are:

Competitive: People who tend towards a competitive style take a firm stand, and know what they want. They usually operate from a position of power, drawn from things like position, rank, expertise, or persuasive ability. This style can be useful when there is an emergency and a decision needs to be make fast; when the decision is unpopular; or when defending against someone who is trying to exploit the situation selfishly. However it can leave people feeling bruised, unsatisfied and resentful when used in less urgent situations. (Win/Lose)

Compromising: People who prefer a compromising style try to find a solution that will at least partially satisfy everyone. Everyone is expected to give up something and the compromiser him- or herself also expects to relinquish something. Compromise is useful when the cost of conflict is higher than the cost of losing ground, when equal strength opponents are at a standstill and when there is a deadline looming. (Mini-Win/Mini-Lose)

Accommodating: This style indicates a willingness to meet the needs of others at the expense of the person's own needs. The accommodator often knows when to give in to others, but can be persuaded to surrender a position even when it is not warranted. This person is not assertive but is highly cooperative. Accommodation is appropriate when the issues matter more to the other party, when peace is more valuable than winning, or when you want to be in a position to collect on this "favor" you gave. However people may not return favors, and overall this approach is unlikely to give the best outcomes. (Yield-Lose/Win)

Avoiding: People tending towards this style seek to evade the conflict entirely. This style is typified by delegating controversial decisions, accepting default decisions, and not wanting to hurt anyone's feelings. It can be appropriate when victory is impossible, when the controversy is trivial, or when someone else is in a better position to solve the problem. However in many situations this is a weak and ineffective approach to take. (Lose/ Lose)

Collaborative: People tending towards a collaborative style try to meet the needs of all people involved. These people can be highly assertive but unlike the competitor, they cooperate effectively and acknowledge that everyone is important. This style is useful when you need to bring together a variety of viewpoints to get the best solution; when there have been previous conflicts in the group; or when the situation is too important for a simple trade-off. (Win/Win)

Nurses are faced with an unending array of options about what to say or do, how to behave in the face of conflict, and what style to choose. The collaborative approach to conflict, also called mutual gains, argues for the possibility of solutions that all sides find acceptable. It embodies the notion of "win-win." Collaboration is about identifying a common, shared, or joint goal and developing a process to achieve it. It is a process in which both parties exchange information openly, define their common problems, and create options to solve these problems (Van Slyke, 1999) (iii).

Every nurse has to deal with workplace disputes, turf issues, and hidden agendas. They're forever simmering under the surface, sometimes boiling over in nasty explosions whispering and in some cases screaming, "You don't wanna go there." But while conflicts are inescapable, they are solvable. If team members focus on the results they want, and take the active steps of collaboration to groom productive trusting relationships, then there are no such things as turf issues and hidden agendas. Instead, everyone's self-interests are legitimized, put on the table for discussion, and conflicts become the source of honest dialogue among team members.

The truth is that our finest moments are most likely to occur when we are feeling deeply uncomfortable, unhappy, or unfulfilled. For it is only in such moments, propelled by our discomfort, that we are likely to step out of our ruts and start searching for different ways or truer answers. M. Scott Peck.


(i) Cloke, K., Goldsmith, J., (2000), Resolving Conflicts at Work, Jossey-Bass, Inc., San Francisco, CA

(ii) Simmons, A., (2000), A Safe Place for Dangerous Truths, AMACOM, New York, NY

(iii) Van Slyke, E., (1999), Listening to Conflict, AMACOM, New York, NY

Priscilla Smith-Trudeau RN MSM BSN CRRN CCM is a healthcare management consultant specializing in workforce development. She is the President of Wealth in Diversity Consulting and certified in conflict management. The web is
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Title Annotation:Personal & Financial Health
Author:Smith-Trudeau, Priscilla
Publication:Vermont Nurse Connection
Date:Jun 21, 2011
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