Managing team conflict assertively and responsibly

Work hard, keep the ceremonies, live peaceably, and unite your hearts.

Definition of conflict

Conflict can be a source of personal and organizational stress by the very nature of nurses’ work (Vivar, 2006). Conflict, often seen as “bad,” is a natural part of interactions and, when effectively addressed, improves interpersonal relationships and can promote organizational growth (Chadwick, 2010). A longitudinal study of 53 college student teams indicated that conflict management “has a direct, positive effect on team cohesion and moderates the relationship between relationship conflict and team cohesion as well as that between task conflict and team cohesion” (Tekleab et al, 2009, p. 170). Conflict may be viewed as a feeling, a disagreement, a real or perceived incompatibility of interests, inconsistent worldviews, or a set of behaviors (Mayer, 2000). Conflict arises when interdependency exists, and conflict resolution is necessary to build positive relationships with others as well as to meet our own needs. Whenever two people come together, there is the potential for conflict. Conflict can occupy 30% of a manager’s time (Marick and Albright, 2002). Although conflict is inevitable, it can have advantageous outcomes when it is handled in assertive and responsible ways. Conflict resolution can build interdependence and professional collaboration and help team members better address the big-picture issues.

Building positive co-worker relationships, teamwork, and collaboration supports clear communication, which has a direct impact on patient safety. The integration of communication skills and teamwork training in schools of nursing and in the workplace supports this effort (Beckett and Kipnis, 2009; Chapman, 2009; Clark, 2009; Corless et al, 2009; McKeon et al, 2009; Thomas, 2009). The Institute of Medicine’s report on medical errors concluded that “as many as 98,000 people die yearly in the United States because of preventable medical errors . . . a startling 70% of these preventable medical errors result from poor communication between healthcare providers” (Kohn et al, 2000, as cited in Lamontagne, 2010, p. 54). The Joint Center for Transforming Healthcare (Zhani, 2010) reports an “estimated 80% of serious medical errors involve miscommunication between caregivers when responsibility for patients is transferred or handed-off.” In their Hand-off Communication Project participating hospitals found that more than 37% of hand-offs were defective, preventing the receiver of the information from safely caring for the patient. After implementing targeted solutions to the hand-off communication, the result was a 52% reduction in defective hand-offs.

WIT&Wisdom

An ounce of prevention is worth a pound of cure.

Benjamin Franklin

Cushnie (1988) identifies four categories of conflict intensifying in degree of difficulty from first to last: facts, methods, goals, and values.

Conflict-resolution approaches

You know you cannot avoid conflict. What you can avoid is feeling impotent or uncomfortable when you encounter situations involving conflict. By now you are familiar with assertive and responsible communication. These approaches can help you resolve conflicts in constructive ways.

Resolving a conflict means acting in such a way that an agreement is reached that is acceptable, and even pleasing, to both parties. If both parties cannot agree on a resolution, the conflict will continue. When conflict drags out and team members do not see a hopeful resolution, then helplessness prevails. Any healthcare team that is stuck in this hopeless situation is not working at its full capacity. Harrington-Mackin (1994) advises dealing with conflicts in a timely way and suggests that most people find it difficult to openly discuss and work through conflicts. Instead, they accumulate grudges and use techniques such as procrastination and sniping to “get even.” Client care and morale suffer when conflicts remain unresolved.

You can approach conflict resolution in three ways: win–win, lose–win, or win–lose. Although win–win is preferable, there may be times when a workable compromise is the best solution to avoid having both parties lose. Throughout this book, the point has been made that assertiveness is a matter of choice. There may be times when you feel obligated to insist on your solution to a problem, such as in parenting a small child. There may be times when you choose to allow the other person to win, such as when you recognize that a colleague has been pushed to the limit and your position seems less important than their peace of mind.

The win–win approach to conflict resolution requires you to be assertive and responsible. This approach results in a solution with which you and your colleagues are happy. Not only is the outcome satisfactory, but adopting a win–win approach uses your full creativity and often results in a unique and innovative resolution.

The lose–win approach is one in which you allow your colleagues to resolve the conflict at your expense. Either you are not happy with the outcome or you permit your colleagues to walk all over you. This approach is nonassertive and irresponsible.

The win–lose approach is the opposite of the lose–win approach. You may resolve the conflict in a way that is satisfying to you, but in the process you bulldoze over the rights of your colleagues. This approach is aggressive and irresponsible.

Any win–lose/lose–win approach creates forces that aggravate the struggle and do little to discover constructive solutions acceptable to all involved. A conflict is more constructive when the outcome is satisfying to all the participants than when it is satisfying to only some. Conflict at some point is inevitable, so it helps to know how to use it as an opportunity to be constructive—because the alternatives have unpleasant consequences.

A win–win conflict management strategy covers each of the following steps (Flanagan, 1995):

1. View the problem in terms of needs (what is required) instead of solutions (what should be done) to facilitate a mutual problem-solving approach; detach yourself from biases and stay focused on the actual data.

2. Consider the problem as a mutual one to be solved, requiring the active involvement of all affected persons.

3. Describe the conflict as specifically as possible, using undistorted data.

4. Identify the differences between concerned parties before attempting to resolve the conflict.

5. See the conflict from another point of view.

6. Use brainstorming to arrive at possible solutions instead of adopting the first or most convenient idea.

7. Select the solution that best meets both parties’ needs and considers all possible consequences.

8. Reach an agreement about how the conflict is to end and not recur.

9. Plan who will do what and where and when it will be done.

10. After the plan has been implemented, evaluate the problem-solving process and review how well the solution turned out.

Table 28-1 summarizes three different approaches to conflict. The assertive, responsible attitude toward conflict and approach to conflict resolution is contrasted with the nonassertive, irresponsible approaches.

Table 28-1

Assertive/Responsible versus Nonassertive/Irresponsible Ways of Handling Team Conflict

CHARACTERISTIC WIN	WIN–WIN LOSE	LOSE WIN–WIN	WIN–LOSE
Attitude toward conflict	Assumes conflict is inevitable and occurs whenever people work together	Assumes conflicts are sent to try us	Sees conflict as a challenge to be won
	Assumes that conflict can be managed so that creative solutions are achieved	Assumes that in a conflict the other person always wins	Considers that manipulation is needed to win conflicts and that it is never ceasing and thinks fighting is required to get what you want
	Assumes that controversy involves everything in the issue and increases members’ commitment	Assume that it is a foregone conclusion that the plan to resolve the conflict will satisfy only others	Believes the other person is trying hard to win
	Assumes that conflict can be resolved in ways that are satisfying to all team members	Wonders why there must be conflict in the workplace
Approach to conflict resolution	Employs a systematic problem-solving approach	Decides in advance that the other person will win and gives up	Keeps fighting with biased information that supports his or her own viewpoint
Data collection	Examines his or her own thoughts and feelings objectively	Prematurely closes data collection	Seeks, examines, and submits only data that support his or her own desired resolution
	Listen emphatically to colleagues’ points of view	Assumes it is hopeless to collect data because of an irrational belief that others will win regardless
	Seeks relevant information from appropriate resources (literature, consultants)	Dwells on how bad things will be if the conflict is not resolved
	Shares knowledge of the conflict with all others involved	Passively participates in information sharing
	Remains objective
Assessment	Formulates an accurate definition of the conflict	Defines the conflict in terms of how it affects colleagues	Does not seek out colleagues’ assessments of the conflict
	Shares assessment with colleagues	Defines conflict from his or her own point of view	Overwhelmingly argues for his or her own assessment of the conflict
	Acknowledges colleagues’ perceptions of the conflict
Resolution generation	Considers resolutions that satisfy all involved	Contributes little to this planning because of the assumption that the winner will tell the loser what to do	Only considers or supports plans that agree with his or her own interpretation of the conflict
	Chooses resolutions that maximize the benefits and minimize the drawbacks		Sabotages plans that oppose his or her own view
Evaluation	Maintains vigilance to ensure that resolution continues to satisfy self and colleagues on the team	Complains that resolution could never be successful; disgruntled	Ignores the fact that others are not satisfied with the resolution