Charge Nurse Series Part 4 - How to Manage Conflict

By Rose O. Sherman, EdD, RN, FAAN

In research that I have done with charge nurses, conflict management has been identified as the top challenge that they confront in their roles. Charge nurses reported that they are frequently mediating conflicts that occur with physicians, other departments, among team members or sometimes with family. The generational diversity in the healthcare workforce presents new challenges for those in leadership roles. Charge nurses report significant differences among team members in values and beliefs about teamwork, loyalty, use of social networking and preferred methods of communication. Finding the time and having the skill to mediate conflict can be challenging.

Conflict is Part of the Work Environment

A conflict-free workplace would be a beautiful place. However, it’s just not possible to avoid conflict entirely especially in high stress healthcare environments. If conflict is managed effectively, it can be viewed as an opportunity for team growth. The necessity of effectively managing team conflict should be framed in terms of a patient safety issue. Root cause analysis studies done by the Joint Commission on Accreditation of Healthcare Organizations since 1995 indicate that a breakdown in communication among caregivers is the top contributor to sentinel events. Often, these breakdowns in communication are a result of unresolved conflicts.

Steps in Managing Conflict

The following steps in the conflict resolution process can be used to help staff discuss and mediate conflict that involves differences:

1. Bring the individuals in conflict together to discuss the problem.

It seems obvious that there is a need to bring individuals together who are in conflict with one another, but you may find resistence to this from those involved in the conflict. The problem is that if you allow each individual to tell their story to you individually, you risk polarizing their positions. You need to make sure that all parties concerned are participating together in the discussion. These conversations should not be a one-sided monologue.

2. Agree to ground rules for discussion that are acceptable to all parties.

As the mediator of the conflict, it will be helpful to establish some ground rules regarding the discussion. These ground rules could include topics like no interrupting, no personal attacks and no discussion of issues unrelated to this specific conflict.

3. Let the other person clarify his or her perspective and opinion on the issue.

Allow each person to tell their story from their perspective. It may be helpful to apply a time limit to the discussion. Doing so helps each person speak about the issues that really matter and reduces conversational clutter that has little bearing on the conflict.

4. Highlight some common ground that all involved in the conflict can agree on.

Common ground in conflict is important because it can serve a reference point to help bring discussion back on track. Most staff will agreee that they are there to provide the best possible care to patients as an example. When conflict escalates, you can bring the individuals back to the point of common ground.

5. Develop interventions collaboratively and agree to disagree on points of contention.

Holding desperately to a dogmatic grudge isn’t likely to yield many benefits in a workplace conflict. And presenting a conflict as a black-or-white, right-or-wrong situation heightens tension. Work to help the individuals develop interventions collaboratively. Where there are point of major contention, it may be necessary to just agree to disagree.

6. Keep the lines of communication open and respect differences in attitudes, values and behaviors.

Your goal in most conflicts will be to try to open the lines of communication and re-establish working relationships. Try not to take someone’s conflicting opinion as a negative assessment of you as a person or as a co-worker. It can help to openly acknowledge the differences in attitudes, values and beliefs.

Your overall goal in the mediation of conflict should be able to help team members work more effectively together to meet the needs of patients. Not every conflict will require intervention from you, but serious conflicts can escalate so don’t be a conflict avoider. Keep in mind that the conflict never just impacts the people involved. Your team members and every employee with whom the conflicting employees interact, is affected by the stress. To create a positive work environment, as a charge nurse, you will need to learn conflict mediation skills.

The next and last blog in our Charge Nurse series will be focused on managing difficult people. Your comments are important so please share your ideas about conflict management.

Read to Lead

Moss, M.T. (2005). The emotionally intelligent nursing leader. San Francisco: Josey-Bass.

Sherman, R.O. & Eggenberger, T. (2009). Taking Charge: What Every Charge Nurse Needs to Know Nurses First, 2(4), 6-10.