All of us experience conflicts in some shape, form, or fashion at various points in our career. Sometimes it is a disagreement with a co-worker, supervisor, employee, resident, or family member. Conflict is a natural outcome of being in the people business. As people, we all bring different ideas, thoughts, perceptions, and opinions to a situation. When those are different, which they often are, the result is conflict. When conflict is not resolved, it can result in hurt feelings, low morale, divisive teams, and poor-quality outcomes for residents. You can probably think of a time when a family member had a differing opinion than the IDT about a loved one’s care. Most likely there were some highly charged feelings expressed during care conferences or visits. Or maybe you remember a time when two employees disagreed on a subject and you found yourself needed to mediate a tense situation that was negatively impacting the work environment. Conflict is inherent in high-stress work environments. Learning to navigate the waters of conflict is essential for the nurse leader.
As I travel around the country I find an increased amount of conflict among teams and a void in the skills needed to resolve them. Thinking back on my nursing career, I don’t remember anyone ever teaching me specific skills for conflict resolution. There were occasions when it sure would have been helpful. Humans tend to avoid conflict, putting it off until something must be done. This is often at the point where feelings are hurt, tensions are high, critical thinking is lost, and the conversations aren’t going well.
Here is a step-by-step process, known as the Relationship Model, that can help anyone anytime work through a conflict with another person or assist employees to work through a disagreement.
- Identify what type of working relationship is needed to move forward. Are you on the same team? Will you pass each other in the hall? Will you be discussing resident care together?
- What are the facts of the disagreement? This is an area where our brain wants to confuse what has really happened with the emotions involved in the story. For example, what specifically has the person said that was rude or inappropriate? Our brain wants us to start labeling people—she is so rude, he doesn’t care about the residents, she is so selfish, that daughter is always complaining, etc. Those stories are not necessarily based on facts. If we actually counted how many times we heard someone being rude, we might realize that it was only twice. We are making assumptions about a daughter when we say she is always complaining; in fact, she has brought only three issues to our attention and, in hindsight, it’s clear that those issues needed to be addressed.
- What is the story? This is where you get to talk about how the conflict makes you feel: angry, hurt, resentful, scared, intimidated, and so on. Conflict always generates enormous amounts of negative energy. Our brain wants to put us into a fight-or-flight reaction. During fight-or-flight, our blood moves to our arms and legs so that we can fight or run—leaving no blood in the brain for rational thinking! If the situation has been going on for a long time or emotions are high, you may need a third party to help you sort out the facts from the story. Our brain wants to justify our position. Usually there are two sides to every disagreement and the truth is somewhere in the middle.
- Find agreement. You and the other person must mutually agree on how you can work together better. If it is a co-worker, maybe you agree to not make statements about each other in front of the team; if a family member, maybe you give her your cell phone number so that if there is a problem she can call you directly rather than upsetting the entire team.
- Check-in time. Identify a time, possibly weekly or bi-weekly, for the two of you to meet. How is it going? Are you both living up to the agreement? Have other issues arisen? As nurse leaders are incredibly busy, this check-in time can be missed. But it is essential to be diligent in following up, at least in the short term, until the conflict has been resolved.
Here are some final tips for success in conflict resolution:
- Conflict will happen. Build the skills for resolving conflict and teach others how to do so. It will save a nurse leader a lot of time and energy when staff are able to resolve their own problems.
- You are a role model. Staff are watching you to see how you handle conflict. Do it well.
- In particularly challenging situations, practice with a trusted colleague before having a difficult conversation with another person. It will help you be more articulate with your words and lower the temperature of your emotions.
- Start small. If there are easy conflicts to be resolved, start with them. Build your skills before confronting the bigger ones. Those have generally been going on much longer and will take time.
- Say words of affirmation to yourself. We tend to be our own worst enemy when it comes to conflict. Identify a positive mantra that you can say to yourself.
- Don’t have the conversation late in the day. We do our best thinking, talking, and processing of information before noon. Schedule difficult conversations as early in the day as possible. By the end of the day our stress tends to naturally be higher and we are at greater risk for an emotional hijacking.
What conflict can you think of that needs to be resolved? Try this model and see what positive outcomes you can create for your team and, most importantly, for your residents.