Avoiding

Normally an ineffective conflict management approach, avoiding can nevertheless be appropriate when the outcome of the conflict doesn’t matter to you. You may feel it’s trivial, so you simply withdraw. However, when you feel there is something at stake, avoidance becomes a poor strategy. The other party may be unaware of your concern, which can leave you feeling powerless.

Compromising

Compromising can be an effective approach if the outcome is satisfactory to all parties. As a starting point, compromise can foster creativity and teamwork, which can be positive approaches to a solution. Conversely, compromising will be unsatisfying if one or more of the parties are unhappy with the compromise. In these cases, the parties have settled merely to avoid further conflict.

Collaborating

Collaboration is the optimal approach in most cases. It involves seeking the input of all parties involved in the conflict, which makes everyone feel validated. It incorporates the positive aspects of compromising because it encourages developing a broad range of potential solutions, through teamwork and creativity. Although irrational parties may never agree to a reasonable solution, this approach uses problem-solving to implement solutions even over the objection of irrational parties, in the interests of a higher goal such as patient safety.

If you tend to be a problem-solver, try not to get pigeon-holed. You’ll wear yourself out if you become the “go-to” person for conflicts, and you could even be perceived as controlling or interfering. Encourage others to take the lead.

Accommodating

Accommodation takes compromise one step further by addressing the concerns of the other party rather than your own. Although this approach pays off if the other party possesses the optimal solution, be careful not to be too accommodating. If you always accommodate the needs of others before considering your own, people may see you as indecisive or easily manipulated. This perception can prevent you from advancing or achieving your goals.

Competing

Competing is not a productive conflict management approach because its aim is control rather than progress. Sometimes competitive people have no idea what they want, just that they want to win. Although being assertive can help you reach your goals, blind assertiveness that lacks cooperation is detrimental. Don’t forget that providing health care is a team effort and that your colleagues have valuable wisdom to share.

Four Generations at Work

As seen in Chapter 2, four distinct generations now share the workplace for the first time in history, bringing different sets of values, norms, and expectations to the job. In health care, where teamwork is so important, members of different generations might clash from time to time. In fact, a generational tidal wave is hitting the workplace with a force not seen since Baby Boomers arrived at their desks in the early 1970s. Plus, the Millennials, born after 1980, challenge the workplace like never before.

Although they are becoming less numerous due to retirement, members of the “Great Generation” who came of age during World War II tend to occupy positions of importance and authority. These “traditional” workers value hard work and may be less flexible than their younger colleagues. Still, they are a great source of wisdom, which provides a valuable perspective when solving problems. Younger generations should treat these senior colleagues with respect, if not deference. In fact, part of their value in the workplace is in the maturity they demand of younger workers.

Baby Boomers were born between 1946 and 1964 and often work 60 hours a week to succeed and advance in their professions. They are loyal to their employers, often building a career at the same company until retirement.

Generation X workers were born between 1965 and 1980 and may feel left out of the 21st century workplace as many Baby Boomers earn available promotions. This generation also seeks flexibility in their workplace in order to gain a better balance between work and personal life.

Generation Y workers, or Millennials, share many of the same attitudes as their Baby Boomer parents, with whom they typically have close relationships. They are comfortable navigating technology and prefer working in groups. Figure 5-2 shows generations working together to achieve a common goal.

These generations are also discussed in Chapter 7.

Stressful Economic Conditions

Today’s stressful economic realities are intruding into the workplace. Even though the health industry offers incredible growth opportunities for health professionals, this progress is stop-and-start. Although an aging population of Baby Boomers will demand excellent health care, and medical research is proceeding at an incredible pace, the financing of health care remains uncertain. As a result, some health professionals are competing with one another to avoid layoffs.

Health care facilities are also undergoing unprecedented consolidation through mergers and acquisitions as health care transitions from nonprofit to for-profit entities. Suddenly, there is a new emphasis on cost-cutting, productivity gains, and efficiencies through automation, such as electronic health records. All this change, often unwanted by workers, can lead to conflicts.

Difficult Personalities

Difficult co-workers and patients add stress and conflict to any workplace, and health care is no exception. Develop skills and strategies to combat these sources of conflict.

In a customer-oriented environment like health care, conflict arises among co-workers when someone fails to act because he or she believes a task is not their responsibility—a response seldom acceptable when it comes to patient care. Patients and their families are the reason your employer exists, and their care is the focus of your work. Patients and their loved ones are often in personal crisis or acute stress, and their behavior can lead to conflict with the health professionals they encounter. Working collaboratively, you and your colleagues are in the business of managing and resolving these conflicts. In health care, customer satisfaction is everyone’s job, although people can be difficult at times.

Additional factors that contribute to or intensify conflict are listed in Box 5-1.

Reframe to Eliminate Conflicts

The first step of conflict resolution is to focus on things that are within your control. This choice will divert your attention from the negatives and give you something positive to focus on.

Finding Common Ground

Conflict is centered on disagreements. Therefore, take a moment to review what people in the dispute do agree on. This helps create a context in which the disagreement seems a little smaller in scope and importance. For instance, a dispute might arise in the waiting room as to who arrived first. Assure everyone that they will see the doctor shortly. The dispute has not been resolved, but the common ground makes it seem less important.

Setting a Positive Example

You can exercise leadership simply by holding your own behavior to a higher level. Suppose two other nursing assistants are standing outside of a patient’s room, arguing over whose turn it is to clean the room. “I’ll help,” you say, going into the room. The conflict is likely to dissipate because of your positive example.

Facilitating the Exchange of Ideas

You can elevate a negative, ego-controlled conflict into a positive and productive conflict by refocusing the discussion on the issues rather than the people. Andy wants to sterilize the instruments at the beginning of the day, but Susan wants to do it at the end of the day when she has more time. “Has anybody asked Dr. Day what she prefers? How long does the sterilization take? Does it matter how recently the instruments were sterilized?” By asking questions about the process and best practices, you have introduced new considerations that may help remove egos from the discussion.

Consulting Evidence and Documentation

The same resolution process can be facilitated by referencing documentation. By referring to an objective source, ego-based positions can be abandoned more readily. If the conflict has to do with infection control practices, you might suggest that everyone examine the latest Universal Precautions issued by the Centers for Disease Control and Prevention to determine whether the issue is covered.

Collaborating to Analyze

Finally, try an open-minded approach by listening to the other person’s viewpoint objectively. Then consider all the factors to either adjust your own viewpoint or support your point of view.

For instance, let’s say you have a co-worker who objects to the holiday work schedule. Christmas falls on a Saturday this year, so the following Monday will be an observed holiday. You have Christmas off, but will have to come in on Monday. Your co-worker is scheduled to work Christmas, but wants to be off too. You point out that since Christmas is on a Saturday, he’ll get Sunday and Monday off without it counting toward his holidays. In some ways, then, he is getting the better end of the deal.