By Rose O. Sherman, EdD, RN, NEA, BC, FAAN
Helping staff to navigate their conflicts with one another has always been challenging for nurse leaders. In recent McKinsey research on the nurse manager role, nurse managers indicated that managing conflict and performance issues are the top frustrations in their role and areas where they need additional training. The issues surrounding conflict management have intensified. Consider the following story, a leader recently discussed in a workshop:
I have been a leader for a considerable amount of time. Managing conflict has always been hard, but today, it is almost impossible. Staff don’t want to talk to other team members. They come into my office and behave as if it is my responsibility to make it go away. I am mediating more and more conflicts, and it has become exhausting. Our youngest generation of nurses lacks skills in this area. They have grown up in a world where you defriend or block those with whom you disagree – essentially, you remove them from your world. You can’t do this in healthcare – we rely heavily on teamwork. I don’t expect them to be friends, but they do have to work together. Informally, I am being told by my charge nurses that a significant percentage of call-ins on my unit are related to conflict management issues – i.e., people who don’t want to work together.
This leader is not alone. I have heard similar stories repeatedly from both nurse managers and charge nurses. Sometimes managers are even called at home in the evening or on the weekends to weigh in on a conflict when they have charge nurses and administrative supervisors there to support the staff.
These managers are not alone in grappling with helping younger staff manage conflict. This past weekend, The Wall Street Journal published a fascinating article titled “College Students Are Using ‘No Contact Orders’ to Block Each Other in Real Life.” It is a story about how no contact orders (similar to restraining orders), which were once almost exclusively used in sexual harassment cases are now routinely requested by both students and their parents. NCOs ,contend college administrators, have become the go-to solution for a generation uncomfortable with face-to face conflict.
Over the past 10 years, the circumstances under which a student might request an NCO have expanded considerably. Their quiet use for other purposes—roommate disputes, ruptures between friends, relationship issues that don’t rise to the level of sexual harassment— is so secretive, traumatizing and potentially damaging that most students and administrators interviewed for the Wall Street Journal story would only speak anonymously. College administrators acknowledge that few requests are denied. One professor whose scholarly area is conflict resolution noted that “We generally know that students are increasingly fragile and conflict-averse, which leads to an increased desire to request a no contact order.”
Given what was reported in this story, it is not surprising that nurse leaders are struggling. New graduates leave academic environments and enter healthcare with the set of expectations that the support of conflict avoidance will continue.
But healthcare settings are different than college. There is an expectation of strong teamwork and we know from the work of Patrick Lencioni that teams that can’t successfully navigate conflict become dysfunctional. I always reinforce to leaders that learning to successfully manage conflict is a professional expectation. It is non-negotiable in healthcare environments because an inability to manage conflict is a patient safety issue. That is the framework to use when discussing it with nurses.
Given what we know and the challenges presented in this article and others, it becomes clear that not every new nurse will start practice with the needed conflict management skills. They will need to be intentionally taught as part of residency programs and nursing orientation. Nurse managers should not be expected to do this alone.
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