Managing and Mitigating Conflict in Healthcare Teams


Conflict resolution is a vital aspect in healthcare systems due to the strong interpersonal and complex professional relationships that occur within all areas of care, ranging from treatment to administrative tasks. Medical professionals are called upon to understand and practice conflict resolution techniques to resolve any situations that may arise which disturb the workflow or quality of care for patients.

Conflict

The observed conflict occurred in a large hospital setting in Miami in one of the wards. It occurred between nurses. One of the nurses, who was a single mother, was continuously late to her shifts because of scheduling conflicts of taking care of her child. As a result, this led to several negative consequences. First, the nurse’s late arrival always delayed the smooth transition of shifts in the ward of the nursing staff, which in turn complicated schedules in terms of treatments, consultations, medication adherence, and other potentially time-sensitive procedures. This potentially endangered the safety of patients and caused problems in interprofessional collaboration on treatments.

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The core conflict itself occurred between the late nurse and her co-workers and supervisor. At the same time, the rest of the nursing staff attempted to be understanding initially, considering the nurse’s difficult life situation and often covered for her tardiness or absences. Eventually, it became a chronic issue. When the co-workers and eventually the supervisor attempted to speak calmly to the nurse at issue in order to determine a solution, they faced backlash and threats of legal action if she was to be let go, citing unfair treatment to her as a single mother.

Overall, it has soured relationships between the nurses in the ward and has created unnecessary tensions. The conflict is unresolved since the problem continues to persist, and interpersonal tensions are evident, which has visibly impacted the atmosphere in the ward and potentially the quality of care. This conflict fits two distinct categories as both an intragroup relationship conflict and a task-related conflict. Intragroup conflict defines a conflict occurring within a group that affects several individuals. A task-related conflict is one that is common in workplaces regarding concrete issues on work assignments and division about policies or expectations (Shonk, 2019).

Four Stages

The latent stage of the conflict has not yet begun, but there is potential for it, the parties involved and circumstances are set up, and depending on the emotional aspects of individuals, the latent stage can be quick or be ongoing for a while.

In this case, the latent stage began when the nurse started to demonstrate a pattern of tardiness which slowly affected workflow in the ward. The perceived stage is when the involved parties gain awareness of the situation and attempt to potentially clarify the issues. In the observed situation, the perceived stage occurred when the co-workers and the shift manager attempted to speak to the tardy nurse to determine what was going on and how the problem can be fixed.

The felt stage is evident when the conflict begins affecting the involved parties and organizational culture. Individuals begin to feel tension and anxiety surrounding the issue. In this case, after the attempted discussion, the nurse felt judged and threatened, perhaps not welcome anymore as part of the collective. Meanwhile, others felt misunderstood and potentially used, feeling it was unfair for this pattern to continue. Finally, the manifest stage is the direct demonstration of conflict among the parties with the purpose of evoking a response from each other. This can be seen through aggressive behavior, apathy, disobedience, or withdrawal (Eshghi & Ray, 2019).

In this case, the conflict erupted when the nurse directly contradicted her co-workers, began to aggressively talk to them, and threaten legal action against the hospital. On the other hand, her co-workers began to treat her with resentment and showed withdrawal from social contact. This conflict does not seem to be a delegation issue as workload and schedules are made fairly, even giving flexibility to the nurse in the center of the conflict. However, delegation can be potentially used to resolve the problems underlying the conflict.

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Strategies for Resolution

One of the most common strategies for conflict resolution in healthcare settings, according to a meta-analysis done by Labrague, Al Hamdan, and McEnroe-Petitte (2018), is integration and collaboration. Essentially integration focuses on an active search of information about the values and interests of involved parties with the motivation to find mutually satisfactory agreements. Collaboration is then used to work as a team to determine potential solutions to the conflict.

Structures in healthcare that foster collaborative relationships and equitable input into decision-making have helped to mitigate conflict. Meanwhile, on an interpersonal level, clear and good communication, including by the manager, are necessary. Communication requires accountability of individuals to contributing to the conflict and establish trust that is necessary to avoid misinterpreting behavior and jumping to conclusions. Conflict resolution must occur in a manner that does not disrupt workflow and helps everyone to maintain a mutually beneficial relationship going forward (Almost et al., 2016).

Collaboration is most often employed by nurse leaders, while staff nurses choose avoidance as the primary method of conflict management. This is not healthy in the long-term, and therefore, the presence of a nurse leader is vital during this process to oversee the process and entice collaboration to resolve the conflict at hand (Labrague et al., 2018). In the observed scenario, working with a nurse leader, perhaps someone more influential than the shift manager, can be beneficial to oversee the process. The nurse leader will likely have more experience and insight on how to approach the situation without worsening the conflict.

Applying integration, the nurse leader can meet with the problematic nurse to determine the causes of her tardiness and show how her behavior pattern is negatively influencing workflow while relaying to other nurses the reasons for this incidence. Following, a collaborative approach can be used to find to mitigate the issue by potentially placing the nurse on more comfortable shift rotations, establish a better communication system among co-workers to let each other know when there is a problem with getting to a shift on time.

Potentially, an interdepartmental approach can be used with HR helping the nurse to find a better fitting position in the organization or social workers helping to find better childcare so that the nurse can be on time. Overall, these strategies focus strongly on communication and establishing trust and openness rather than defensive mechanisms and emotional outbursts, which exacerbated the conflict in the first place.

Conclusion

This observational experience that conflict can take place in healthcare environments, and it is critical to resolving it as it has profound impacts on organizational workflow and quality of care, which is critical as the safety and health of patients is at risk. Analyzing the observed conflict, it became evident that the four theoretical stages of conflict are relevant in practical, real-life situations.

It also means that every conflict has initial latent and perceived stages during which it can be addressed before erupting into critical manifestations. Using this knowledge and relevant conflict-resolution techniques, potential conflicts can be prevented or mitigated early with mutual benefit to involved parties and the health organization. It also requires understanding, communication, and collaboration among nurses, leaders, and human resources to ensure the best outcomes.

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References

Almost, J., Wolff, A. C., Stewart-Pyne, A., McCormick, L. G., Strachan, D., & D’Souza, C. (2016). Managing and mitigating conflict in healthcare teams: An integrative review. Journal of Advanced Nursing, 72(7), 1490-1505. Web.

Eshghi, K., & Ray, S. (2019). Chapter 7: Managing channel conflict: Insights from the current literature. In C. A. Ingene, J. R. Brown, & R. P. Dant (Eds.), Handbook of research on distribution channels (pp. 130-160). Cheltenham, UK: Edward Elgar Publishing.

Labrague, L. J., Al Hamdan, Z., & McEnroe-Petitte, D. M. (2018). An integrative review on conflict management styles among nursing professionals: implications for nursing management. Journal of Nursing Management, 26(8), 1-16. Web.

Shonk, K. (2019). 3 types of conflict and how to address them. Web.

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