Conflict and Resolution
A sources of conflict that I witnessed occurred one day when a nurse was taking care of a patient when I first started working and was still in orientation. This patient had a stroke and was unable to get up. The patient had gone to the bathroom and had been calling the nursing assistance to change her. The family members were in the room. The conflict involved the family members getting angry because the assistance told the patient serval times she was going to change her and kept leaving the room. Family members of the patient complained to charge nurse that the “nurse” provided inadequate care. As it turned out, many of these complaints were presented to the charge nurse as “Mynurse didn’t change me”. As the nurse walked into the room with the charge nurse after being told her patient was unhappy with her, things were clarified. The patient explained that it was not the nurse and that she was speaking about the assistant.
These types of complaints often led to noticeable conflict between the nurses and the nursing assistant. When the supervisors gets involved it is usually because the family has had to complain multiple times. While the complaints bother the assistant, it is something as a nurse she had to correct. Leaving the patient dirty can cause bed sores and further infection for the patients. The supervisor of course took the complaints very seriously and informed the assistant to change the working conditions she is in and if anything was missing to prevent her from doing her job in the proper matter to contact her. This was resolved for a few hours but the assistant continued to do the same thing when it came to simple things like getting water. The nursing assistant states all the nurses are against her and don’t help her when she ask for it. From the perspective of the nurse, however, the changes in working conditions were unfavorable because it created tension in her work place with her colleague and nothing was solved.
Resentment seemed to build from the nursing assistance towards their supervisors, the nurse, family members and most important the patient. It seemed the frustration that the assistance was feeling, were showing with her other patients as well (Stage one, feeling).
This led to disciplinary action and is considered an outlier in the recurrent conflict caused by such complaints. In this certain case, patients care were negatively impacted. In general, such conflict likely had minimal impact on patient care as this was the nursing assistant having a lack of caring attitude. The conflict can best be described as being interpersonal. The conflict was clearly between one assistant and the nurse. The supervisor was involved but the nurse is the one that will continue to deal directly with the assistant. Although I did not witness any arguments between the nurse and the assistant, some of the nurses indicated that they showed their frustrations to their supervisor. There were communication efforts to address the conflict and its source directly to resolve this matter.
In our textbook Finkelman it identifies four stages of conflict. Latent conflict, Perceived conflict, Felt conflict and Manifest conflict. Applying these stages to the conflict between the nurse and the nursing assistant is useful in understanding how this conflict developed and how it can be resolved effectively without further issue. The first stage of conflict involves significant levels of discontent. Here the individual (nursing assistant) are not yet engaged in conflict, though the conditions conducive to actual conflict are developing (lacking to do her job). The nursing assistant was slowly building up, leaving things undone that would soon cause a problem.
The building starts to happen and it leads to feelings of conflict. When the person perceive that there is conflict and have feelings associated with it, the second stage of conflict occurs. During this stage, the person feels mild or strong negative emotions because of their outlook of conflict. Followed by the third stage, the conflict manifests and comes out through behavior. In this stage the person starts acting in such a way that suggests that there is conflict or confirms there is conflict going on. Here the person begins to attempt to resolve or diminish as much conflict as possible.
“Conflict is a multidimensional construct with both detrimental and beneficial effects. Most definitions agree that conflict is a process involving two or more people, where a person perceives the opposition of the other. Antecedents stem from individual characteristics, interpersonal factors, and organizational factors. Individual effects, interpersonal relationships, and organizational effects are the main consequences of conflict” (Almost, 2006).
Behavior is something that can be controlled and de-escalated. There are certain things that can be done to resolve or help the problem. Communication with others is key to resolve any conflict. Some people remove themselves from the situation but in this case that would not help or solve the problem going on. Getting a third party if there is not understanding between the two people having the problem could be a good idea.
After we have the fourth and last stage of conflict which is the raft after the conflict itself. In the four stage, the conflict has already been understood or diminished. This leaves changes in perceptions, emotions, and behaviors. After all, the source of the conflict must be changed or avoided in order for the conflict to be resolved. During the fourth stage, conditions for conflict may come back up to the surface, causing a cycle of conflict. This would restart the first stage of conflict making this a circle of problems. “Conflict can never be eliminated in organizations; however, conflict can be managed” (Singh, 2012).
With these four stages of conflict, it is a helpful way to realistically try to resolvewhat happened with the nursing assistant and the nurse. There was some neglecting of patient care with the nursing assistant. The family members of the patient led to the antecedent conditions for conflict with all there right. Without the reporting of lack of patient care by the family members, there would be no conflict between the nurse and the nursing assistant causing tension. Before this repeats itself the nursing assistant should be kept an eye on, not only by the nurse that was having the problem but all that are in her team that shift and future shifts.
To ensured that no mistreatment due to her bad attitudeor lack of patient care was taking place. The supervisors at least recognizedthe issue that had occurred. By the supervisor getting in the problem more tension was created between the nursing assistant and the nurse but needed to happen for the outcome of the patient. This caused a conflict in the work place but for a proper reason.Although the nursing assistant states that no one was helping her, there is no reason to take your frustration out on other patients. That is the cycle of conflict. It can lead to more conflict with other patients or staff members. Negative feelings fall under the second stage of conflict and may or may not have affected their performance. Which in this case it did, the negative feelings were so strong that they rubbed off on other patients that could tell.
“Effective resolution of conflict requires an understanding of the cause of the conflict; however, some conflicts may have more than one cause. It is easy to jump to conclusions without doing a thorough assessment. Some of the typical causes of conflict between individuals and between groups are whether resources are shared equitably; insufficient explanation of expectations, leading to performance being questioned” (Finkelman, 2012).
Now the other side of the story would be the nursing assistant, understanding why she continued to walk out of the room and tell the family she was coming back, or had a bad attitude. An assessment must be done to understand her side as well. Maybe they were short of staff in this case she should request/state that their working conditions is causing this issue. The conflict like in stage 1 is a feeling. The feeling of being overwhelmed got to this assistant.
The supervisor and the charge nurse helped with the conflict by mediating. As the charge nurse went inside the room to calm the family members that were upset and alleviate the conflict. The supervisor spoke to the nursing assistant and provide methods to do her job correctly, although the conflict with the nurse has not been resolved and there is tension. She is providing support from higher positioned staff. She and the nurse are able to discus and explain each store to the supervisor. The supervisor acknowledging covert conflict is not easy. The staff will have different perceptions of the conflict. When conversation takes place it is easier to come up with an agreement of conflict. By doing so this might have caused the supervisors to feel the need to make changes to the working conditions of the nursing assistant, all though this may be the manifestation of behavior.
In this case I believe the fourth stage was reached because the nursing assistant continued to be frustrated. Although the charge nurse and the supervisor let the assistant know, that if there was a problem or something missing to inform her, she held the bad mood inside. Causing mistreatment to family members and patient. Behaviors expressed by the nursing assistant in this cases did not resolve the issue, as the nurse likely still felt strong negative feelings towards her, because of the conflict.
conclusion, the stages of conflict were seen in this case in order. As the
nursing assistant started feeling conflict to the aftermath that was
experienced. With what I have learned from the conflict stages, I feel that in
the future when I encounter a problem I will be able to recognize and hopefully
stop it before it gets any further. Talking about it when the feelings start to
happen (stage one). The conflict stages are essential in a workplace, keeping
the patients and the people to work with tension free is a relief. “Conflict
resolution is an essential element of a healthy work environment because a
breakdown in communication and collaboration can lead to increased patient
errors” (Mary, 2012).
The conflict stages and the reading I have done during this course will guide
me to deescalate situations that can manifest into something bigger.
Almost, J. (2006). Conflict within nursing work environments: concept analysis. Journal of Advanced Nursing Volume 53, Issue 4, 444-453.
Mary, J. (2012). Keeping the peace: Conflict Management strategies for nurse managers. Nursing Management Vol. 43, 50-54.
Finkelman, A. (2012). Leadership and management for nurses: Core competencies for quality care. Pearson.
Singh, K. (2012, September 12). What are the different stages in a conflict? Retrieved July 20, 2016, from http://www.mbaofficial.com/mba-courses/human-resource-management/management-of-conflict/what-are-the-different-stages-in-a-conflict/