Conflicts are not uncommon among nursing personnel due to the challenging working conditions and the dynamic nature of the field (Kleinpell et al., 2014). However, their occurrence can be prevented or even turned into an advantage by applying proper leadership skills and techniques after the conflict is properly identified, analyzed, and assigned appropriate preventive and curative measures.
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The conflict in question was observed in the delivery care setting during the routine check of the patients. A nurse (termed nurse A for convenience) has stopped to talk to the patient who was known to have emotional instabilities. The mood deviations were not of a particularly serious kind and had been previously successfully alleviated by the simple communication at all times. That day, however, the patient displayed no signs of dismay, but since he used to talk to the nurse, he stopped him anyway. Another nurse (nurse B), who was accompanying him, reminded him of the shortage of time they were experiencing and urged to hurry. Nurse A politely excused himself and went out of the ward. However, as soon as they exited, nurse B proceeded to criticize nurse A’s behavior. His arguments were centered around the needless time spent on “chit-chat” and the constant lack of time, which restricted them from completing even the prioritized tasks. Nurse A countered that the emotional well-being of a patient was regarded as one of the areas of responsibility of nursing personnel and that his time was spent meaningfully. Throughout the course of the conversation, it became apparent that the time presumably “wasted” on the conversation was a long-standing issue, at least from the point of view of nurse B, who attributed their failures to finish routine tasks in time to this activity. In a couple of minutes, nurse B finished his monolog and said, “Now let’s go. We still have work to do” and proceeded to the next ward.
The whole conversation took no more than two to three minutes, and both participants managed to keep their voices down despite the obvious fact that both were annoyed with each other. Overall no immediate harm could be observed since the working process was largely uninterrupted, and no stress was experienced by the patients, including the one who was the reason for the dispute in the first place. However, certain negative outcomes are likely to turn up in the future in such a situation. First, the conversation was loud enough to be overheard by the patients, which may lead to an assumption that the staff lacks understanding of their tasks and responsibilities, and the establishment is poorly managed. At least two other patients experienced the discrepancy directly and could rich this conclusion. Second is the oncoming difficulties for both nurses. The conflict ended after both sides exchanged their views on the matter, but clearly, none of them agreed with the arguments against him, and the conversation was finished in an abrupt manner. This leads us to the conclusion that the conflict was clearly unresolved. The pending nature of the issue coupled with the long build-up hinted by nurse B allows us to foresee one of the two possible consequences: either the debate will resurface again (possibly more than once) and be resolved or at least one of the nurses changes his course of actions to deescalate the conflict but go against his understanding of the workplace responsibilities, which, for nurse A, prioritize emotional and psychological well-being of the patient and for nurse B focus on the streamlined and structured workflow. Either way, the efficiency of the process will be compromised, and both job satisfaction and the workplace climate will go down.
Despite the fact that the conflict in question occurred between two individuals, the reason for the misunderstanding was the difference in task prioritizing, or the lack of definitive understanding of the range of nursing responsibilities (Kleinpell et al., 2014). For this reason, the conflict can be defined as an individual (Huber, 2014). Admittedly, the field of nursing is still experiencing problems with the precise understanding of the number of resources allocated for each of the mentioned tasks. In addition, both of the nurses were reluctant to abandon their positions, perceiving their point as correct. In another setting, such determination may be viewed as positive as it aligns with the concept of empowerment, which is currently among the leading trends in nursing. However, the stubbornness and lack of cooperation demonstrated by both parties is a result of an incorrect understanding of the phenomenon and, to some extent, the sign of poor leadership values communicated by the nurse leader.
Stages of the Conflict
The conflict can be broken down into four phases.
Latent conflict. This stage is occurring when the events leading to the buildup of the conflict take place. In this case, the latent stage began when nurse A started engaging in communication with the patient.
Perceived conflict. At this stage, the discontent arises, which creates tension and results in conflict. In this example, it began when the time devoted by nurse A to the patient became interfering (or perceived as interfering) with the workflow by nurse B.
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Felt conflict. At this stage, the issue becomes recognized by one of the sides as being the cause of the disturbance or discrepancy. In this case, the conflict was felt when the delays and failures to achieve the set goals were connected by nurse B to the conversations held by the nurse A. This was likely triggered by some recent stressful event and most likely happened immediately prior to the dispute.
Manifested conflict. The overt stage where the conflict gets explicitly specified – in this case, voiced by nurse B. Interestingly, while it is tempting to classify the particular manifestation as constructive (as no hostility was displayed and the discussion was centered around professional matters), the facts that the conversation took place in public, involved criticism of professional competence, and did not lead to settlement of any kind suggest that it was destructive.
Both participants of the conflict were nurses executing their daily duties, so delegation was not an issue in this conflict. However, it should be noted that the same conflict can take place after some of the responsibilities are delegated to UAP or other staff members who either have the same poor understanding of the responsibilities or have them poorly explained during the delegation process.
Strategies for Conflict Resolution
Two strategies can be outlined based on the determined causes. First, the current issue needs to be brought up before the nurse leader and guided to the conclusion. Obviously, both nurses have a point in emphasizing patient communication and workflow integrity as crucial in the nursing profession. The task of the leader is thus to bring them together, describe the positive sides of both views, create the desire to cooperate in reaching common ground, and smooth out the difficulties in the process. Both nurses demonstrate strong determination, and directing their passion can be sufficient to produce positive results (Persily, 2013).
Second, preventive measures need to be taken to reduce the ambiguity of roles and specify the time required for the tasks. Currently, the staff clearly demonstrates the knowledge of chief aspects of their profession but lacks a clear understanding of the time frames and techniques which are involved. This is largely the administrative issue but is unlikely to be limited to rigid schedules, so a proper understanding of the concept is desirable to operate on a daily basis without disrupting the process (Grohar-Murray, DiCroce, & Langan, 2016). The same can be said about the empowerment. Both nurses demonstrated the lack of tolerance and the adherence to authoritarian approach. To improve the matters, a series of workshops can be organized to provide the personnel with the necessary communication skills, which would minimize tensions and improve the overall working conditions. An issue of tolerance, trust, and respect should be brought up as a necessary contribution to the empowerment process during the workshops (MacPhee, Skelton‐Green, Bouthillette, & Suryaprakash, 2012). Once the staff is ready to take responsibility while being open to suggestions of co-workers, such conflicts (as well as a range of bordering issues) will be prevented.
While the described conflict creates few immediate negative outcomes, it signals several inconsistencies in nursing practice which need to be addressed. Most of the issues can be averted by applying leadership skills and organizing dedicated events by the nurse leader. Both the preventive and the curative measures will not only minimize the future disruptions but create a more dynamic and proactive working environment, providing the staff with better opportunities to improve both the patient outcomes and job satisfaction.
Grohar-Murray, M. E., DiCroce, H. R., & Langan, J. C. (2016). Leadership and management in nursing. London, England: Pearson.
Huber, D. (2014). Leadership and nursing care management. Iowa, IA: Elsevier Health Sciences.
Kleinpell, R., Scanlon, A., Hibbert, D., Ganz, F., East, L., Fraser, D.,…Beauchesne, M. (2014). Addressing issues impacting advanced nursing practice worldwide. Online Journal of Issues in Nursing, 19(2), 4-6.
MacPhee, M., Skelton‐Green, J., Bouthillette, F., & Suryaprakash, N. (2012). An empowerment framework for nursing leadership development: supporting evidence. Journal of Advanced Nursing, 68(1), 159-169.
Persily, C. (2013). Team leadership and partnering in nursing and health care. New York, NY: Springer Publishing Company.