Nursing

From the staff development bookshelf: Training charge nurses to manage conflicts

Staff Development Weekly: Insight on Evidence-Based Practice in Education, March 23, 2012

According to a hospital survey of nurses, nurses tend to use avoidance as a primary strategy to resolve conflict, and the next choices were compromise and accommodation (Rollins, 2004). The reality is that these strategies for conflict resolution all involve losing at some level. So what does that mean to you and what does that tell you? It demonstrates that we as leaders have not mentored our team members to manage conflict and that our frontline nurses are choosing the most comfortable strategies. And if that is the case, then we know that when we promote our nurses to a charge nurse position, we need to teach them techniques to use in situations of conflict. Charge nurses need to be assertive and manage conflict in a professional manner in order to effectively lead and provide for the delivery of safe patient care.

What strategies are out there when we talk about conflict resolution? There are five different methods that are often used; some are effective, and some are not. But each method may be more appropriate to certain situations. Let us review the five strategies for conflict management:

1. Avoidance: A lose-lose strategy whereby a nurse may avoid dealing with a conflict situation. It is important to evaluate the use of avoidance because in some cases avoiding the conflict may be the best approach. For example, two nurses on the unit are having a heated discussion. Either nurses or one nurse may choose to walk away and avoid the situation until both parties have allowed emotions to cool down, at which point each can revisit the situation in a more positive and respectful way. In this example, avoidance is simply utilized as a time-out period. However, if avoidance is utilized so situations of conflict are never revisited or addressed, this strategy can lead to employee dissatisfaction.
2. Competition: A win-lose approach. In some cases competition is necessary, such as when attempting to change a work environment in order to meet or sustain continuous regulatory compliance. For example, in an emergency situation, such as a cardiac arrest on the patient care unit, there is often no time for negotiation between team members, and as a result someone will need to take charge and direct the others. However, if competition is used as an approach to intimidate and win in their approach, then it is considered unprofessional and disruptive behavior for the work environment.
3. Accommodation: A lose-win situation. This technique often is utilized in situations where you want to preserve a relationship. In other words, you are really not that passionate about getting your needs met and are willing to allow the other individual to get what he or she needs. An example would be when a charge nurse is asked to help out another colleague with a task and the charge nurse has not even completed her own tasks. This is a form of accommodation where a leader puts his or her own needs aside to help a colleague first.
4. Compromise: A win-lose/lose-win situation. This is best utilized to achieve a solution that partially meets the needs of both parties. For example, a nurse on your unit needs to leave early that day because of a personal matter. So the charge nurse schedules another nurse from the night shift to come in early to relieve the day nurse, with the understanding that the day nurse will come one hour earlier the next day relieve the night nurse.
5. Collaboration: A win-win approach. This is best used to meet the goal for the whole team and not just for the best interest of the minority. Collaboration is an interdisciplinary strategy that explores all nurses' opinions and needs and creates the solution as a team approach. As a charge nurse, this is the best approach to use as time allows.

Book excerpt adapted from
Charge Nurse Program Builder: Tools for Developing Unit Leaders by Tammy L. Berbarie, BA, RN, RN-BC.

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