Chapter 23
Conflict: The Cutting Edge of Change
Copyright 2011 by Mosby, Inc., an affiliate of Elsevier Inc.
Objectives
Determine the nature and sources of perceived and actual conflict. Assess preferred approaches to conflict. Determine effective approaches to conflict. Identify conflict management techniques that will prevent lateral violence from occurring.
Copyright 2011 by Mosby, Inc., an affiliate of Elsevier Inc.
Conflict
Disagreement in values or beliefs within oneself or between people that causes harm or the potential to cause harm
Copyright 2011 by Mosby, Inc., an affiliate of Elsevier Inc.
Types of Conflict
Intrapersonal Organizational
Copyright 2011 by Mosby, Inc., an affiliate of Elsevier Inc.
Better Understanding of Stress and Conflict
Important factors to consider
Context (e.g., particular work environment) Extent to which leaders respect staff concerns Cultures that condone shame and blame Use of compromise to avoid dealing with the conflict Understanding that stress equals poor patient outcomes
Copyright 2011 by Mosby, Inc., an affiliate of Elsevier Inc.
The Conflict Process
Frustration Conceptualization Action Outcomes
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Modes of Conflict Resolution
Avoiding Accommodating Competing Compromising Collaborating
Copyright 2011 by Mosby, Inc., an affiliate of Elsevier Inc.
Self-Assessment: Avoidance
If you tend to use avoidance often, ask yourself:
Do people have difficulty getting my input and understanding my view? Do I block cooperative efforts to resolve issues? Am I distancing myself from significant others? Are important issues being left unidentified and unresolved?
Copyright 2011 by Mosby, Inc., an affiliate of Elsevier Inc.
Self-Assessment: Avoidance
(contd)
If you seldom use avoidance, ask yourself:
Do I find myself overwhelmed by a large number of conflicts and a need to say no? Do I assert myself even when things do not matter that much? Do others view me as an aggressor? Do I lack a clear view of what my priorities are? Do I stir up conflicts and fights?
Copyright 2011 by Mosby, Inc., an affiliate of Elsevier Inc.
Self-Assessment: Accommodation
If you use accommodation often, ask yourself:
Do I feel that my needs, goals, concerns, and ideas are not being considered by others? Am I depriving myself of influence, recognition, and respect? When I am in charge, is discipline lax? Do I think people are using me?
Copyright 2011 by Mosby, Inc., an affiliate of Elsevier Inc.
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Self-Assessment: Accommodation
(contd)
If you seldom use accommodation, ask yourself:
Am I building goodwill with others during conflict? Do I admit when Ive made a mistake? Do I know when to give in, or do I assert myself at all costs? Am I viewed as unreasonable or insensitive?
Copyright 2011 by Mosby, Inc., an affiliate of Elsevier Inc.
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Self-Assessment: Competing
If you use competing often, ask yourself:
Am I surrounded by people who agree with me all the time? Do people avoid confronting me? Are others afraid to share themselves and their needs for growth with me? Am I out to win at all costs? What are others saying about me?
Copyright 2011 by Mosby, Inc., an affiliate of Elsevier Inc.
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Self-Assessment: Competing
(contd)
If you use seldom use competing, ask yourself:
How often do I avoid taking a strong stand and then feel powerless? Do I avoid taking a stand to escape risk? Am I fearful and unassertive to the point that important decisions are delayed and people suffer?
Copyright 2011 by Mosby, Inc., an affiliate of Elsevier Inc.
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Self-Assessment: Negotiation/Compromise
If you use negotiation often, ask yourself:
Do I ignore large, important issues while trying to work out creative, practical compromise? Is gamesmanship a part of my negotiations? Am I sincerely committed to compromise or negotiated solutions?
Copyright 2011 by Mosby, Inc., an affiliate of Elsevier Inc.
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Self-Assessment: Negotiation/Compromise (contd)
If you seldom use negotiation, ask yourself:
Do I find it difficult to make concessions? Am I often engaged in strong disagreements, or do I withdraw when I see no way to get out? Do I feel embarrassed, sensitive, self-conscious, or pressured to negotiate, compromise, and bargain?
Copyright 2011 by Mosby, Inc., an affiliate of Elsevier Inc.
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Compromise Supports a Balance of Power Between Self and Others in the Workplace
Mediation: a learned skill Involves an impartial helper Both sides must acknowledge disparities Not about winning or losing Key: What works best in this situation?
Copyright 2011 by Mosby, Inc., an affiliate of Elsevier Inc.
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Self-Assessment: Collaboration
If you tend to collaborate often, ask yourself:
Do I spend valuable group time and energy on issues that do not warrant or deserve it? Do I postpone needed action to get consensus and avoid making key decisions? When I initiate collaboration, do others respond in a genuine way? Does the group exhibit hidden agendas, unspoken hostilities, and/or manipulation?
Copyright 2011 by Mosby, Inc., an affiliate of Elsevier Inc.
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Self-Assessment: Collaboration
(contd)
If you seldom use collaboration, ask yourself:
Do I ignore opportunities to cooperate, take risks, and creatively confront conflict? Do I tend to be pessimistic, distrusting, withdrawing, and/or competitive? Am I involving others in important decisions, eliciting commitment, and empowering them?
Copyright 2011 by Mosby, Inc., an affiliate of Elsevier Inc.
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Assessing the Degree of Conflict Resolution
Quality of decisions Quality of relationships
Copyright 2011 by Mosby, Inc., an affiliate of Elsevier Inc.
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Exercise 23-3
Consider a conflict you would describe as ongoing in a clinical setting. Talk to some people who have been around for a while to get their historical perspective on this issue. Then consider the following questions: What are their positions and years of experience? How are resources, time, and personnel wasted on mismanaging this issue? What blocks the effective management of this issue? What currently aids in its management? What new things and actions would add to its management in the future?
Copyright 2011 by Mosby, Inc., an affiliate of Elsevier Inc. 20
Managing Lateral Violence and Bullying
Lateral violence: Aggressive and destructive behavior or psychological harassment of nurses against each other. Bullying: Real or perceived power differential between the instigator and recipient must be present in bullying.
Copyright 2011 by Mosby, Inc., an affiliate of Elsevier Inc.
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