Topic: Conflict Management and Negotiation

Presenter: Kristine R. Tria

Reference: https://ceufast.com/course/conflict-management

A. Outcome
The purpose of this activity is to enable the learner to recognize conflict, understand the
different types of conflict and learn how to resolve conflict.

B. Objectives
This course is designed so that the healthcare professional will be able to:
1. Define conflict;
2. Define when conflict is needed;
3. Identify four types of conflict;
4. Describe five basic strategies for managing conflict;
5. List five modes of conflict resolution;
6. Describe four types of managerial actions that cause workplace conflicts;
7. Identify four key managerial actions and structures to minimize conflicts;
8. List three key factors organizations need for resolving disputes.

C. Definition
In a field like nursing, where passions and tensions run high, learning to handle conflict
effectively is a critical safety skill.  Conflict occurs when two or more values, perspectives and
opinions are contradictory in nature and have not been aligned or agreed upon. Conflict will
always be present in the workplace and is an inevitable condition that is essential for change.
Stress can be defined as the harmful physical and emotional responses that occur when the
requirements of the job do not match the capabilities, resources or needs of the worker. Conflict
exists in all work environments and has positive aspects, as it usually precedes change. Conflict
occurs when individuals or groups have disagreements on goals, ideas, values, beliefs, attitudes,
feelings, perceptions, opinions, or actions for issues of importance. The challenge is identifying
the cause of conflict and working through the modes of conflict resolution in a constructive and
healthy way.
 Stress is the natural and normal reaction to events that are unfamiliar and infrequent. When a
person fails to control stress or cope with it, the individual may experience distress. Healthcare
professionals must learn to cope with stress by understanding how to manage stress and to utilize
time management techniques.

D. Types of Conflict
1. Intrapersonal conflict occurs within an individual and is not always easy to identify, but it
can become apparent when mood swings are present, or depression is evident. Intrapersonal
conflict is also apparent when a person has trouble choosing between two or more goals.
Example: When an employee needs a degree to advance his/her career yet has neither resources
nor the time to go school. A frequently occurring intrapersonal conflict for healthcare workers is
deciding how to allocate time with patients. This type of conflict requires prioritization skills.
This employee has an internal fight between what the heart wants to do and what the brain says
to do.

2. Interpersonal conflict is seen when two or more people do not agree on issues or the best
way to manage a specific problem.
Examples:
 A staff member wants to take care of patients on a specific team due to a small workload;
 Pre-scheduling to be off on holidays has created anger between employees who have
seniority and those who made their request months in advance;
 An employee is upset with an “unfair evaluation.”

3. Intragroup conflict occurs between individuals within a specific group. Departmental

harmony is essential to help maintain productivity and workplace morale. When two or more
people do not get along together, that personal battle can affect everyone.
Signs of intragroup  conflict:
 A team member refuses to answer another’s call light, stating that is “not my patient.”
 Talking about another team member in a negative way
 Failing to provide safe, quality care
  Not completing work on time
 Complaining
 Finger pointing
 Frequent absenteeism
 Hostility
 Not attending required meetings
 Filing grievances
4. Intergroup conflict is defined as an incompatibility of goals, beliefs, attitudes or behaviors
between groups. This conflict occurs between two or more competing or distinct groups.
Perceived differences in status and different group goals can fuel intergroup conflict. Often,
this leads to miscommunication or even no communication, affecting the team’s ability to
function.
Examples:

 Shared governance groups feel that the administration is not listening to their concerns
about the quality of care given to specific groups; 
 Nurse Managers perceive that certain policy and procedures are not up to date and do not
meet the needs of changing conditions, and administration is not concerned.

E. Managing Conflict

Managing conflict is a team effort with nurse leaders, department heads and charge nurses
working together to develop managerial actions and structures to minimize conflicts. They have
an obligation to handle conflict in a constructive manner and with a positive attitude, using
effective communication and listening skills.

3 Strategies in Managing Conflict

1. Win-lose scenarios often involve groups and intragroup conflicts. When the group votes on an
issue and majority rules, there is a winner and a loser. This scenario can erode the
cohesiveness of a group and may diminish the group leader's authority.
2. Lose-lose scenarios involve losses to both parties. This scenario is often the case when a
union arbitrator in union contract negotiations gives something to both parties and yet neither
party gets what it wants.
3. Win-win scenarios involve collaboration: all groups or parties work together to meet the goals
and objectives of all involved. Group consensus is reached after a careful investigation of the
situation, specified needs of the group are understood by all, and a workable solution is
reached. In this type of win-win scenario, there are no voting or other traditional dispute
measurements: only the true group. Some of the advantages of collaborating include solving
the actual problem, it reinforces mutual trust and respect, builds a foundation for effective
collaboration in the future and shared responsibility of the outcome

F. Modes of Conflict Resolution

Modes of conflict resolution come from the TKI or Thomas-Kilmann Conflict Mode Instrument.
The TKI is a questionnaire designed to measure how an individual tends to handle inter-personal
conflict. "Conflict Situations" are situations in which the concerns of two people appear to be
incompatible. In such situations, a person's behavior is described along two basis dimensions:
1. Assertiveness - This is the degree to which an individual try to satisfy their own concerns
when faced with a conflict.
2. Cooperativeness - The extent to which an individual try to satisfy the other person's
concerns when faced with a conflict.
1. Avoiding - This is unassertive and uncooperative which involves avoiding or withdrawing
and not dealing with the conflict. The individual does not pursue his/her concerns, or those of
the other person, and the conflict is not addressed.
2. Accommodating - The exact opposite of competing, accommodating is unassertive and
highly cooperative. The individual might neglect their own concerns to satisfy the concerns of
another person. This mode to conflict resolution could be self-sacrificing, but it can also
represent selfless generosity or charity or obeying orders when one would prefer otherwise..
3. Competing - This mode is considered to be very assertive and very uncooperative.
Sometimes the term power-oriented is associated with this mode. It can be represented by an
 individual who pursues his/her beliefs at another person's expense, using whatever power is
appropriate to win his or her position.
4. Compromising or Negotiating - This mode to conflict resolution involves a give and take
from both parties. It is the middle ground regarding assertiveness and cooperativeness. Parties
find a mutual solution that partially satisfies both parties.
5. Collaborating - This is assertive and cooperative, it is the opposite of avoiding. This method
is the most creative form of conflict resolution. An individual attempts to work with the other
person to find a solution that satisfies both parties' concerns.

G. Workplace Conflicts Reasons

1. Poor or no communications
a. Employees not understanding reasons for decisions which affected them.
b. Employees experiencing continuous changes, new programs and decisions they
were not informed of or involved in making.
c. The "rumor mill" seemed to be the only means of communication.
2. Insufficient resources for all shifts.
a. Stress from working with inadequate resources.
b. Disagreement about assignments and who should be doing what.
c. The alignment of resources is inadequate.
3. Conflicting values or actions among managers and employees
a. Strong personalities do not match.
b. Dislike in others what they do not like in themselves.
c. Lack of trust.
4. Leadership problems, e.g., inconsistency, perceived or actual lack of leadership, an
autocratic leadership style, or a bureaucratic or uniformed leadership.
a. Employees see limited or no changes in workplace issues
b. Avoiding the conflict with little follow-through on decisions that affect everyone,
including customers
c. Supervisors do not understand the responsibilities and jobs of their subordinates
d. Lack of support from management when dealing with nurse-patient issues.
H. Key Managerial Actions
1. Implement "Shared Governance." Get employees involved in decisions that affect them
and obtain their support.
2. On a regular basis hold management and employee meetings to communicate new
initiatives and the status of current programs.
3. Regularly review job descriptions and get employees' input. Job descriptions must be
clearly defined including dates. Ensure the job roles do not conflict with each other and
no tasks are left undone.
4. Intentionally build relationships with all subordinates and work on building a trusting
relationship.
5. Get regular written status reports.
6. Conduct training sessions.
7. Include Employees' input in developing procedures for routine tasks.
8. Have an anonymous suggestion box in an accessible area.
9. Set up an incentive program for positive suggestions to improve patient care, safety, and
organizational productivity.

I. Factors in Developing Dispute Resolution Process

1. A leadership group committed to the process of conflict resolution;
2. A leadership group who perceive this process as in their best interest and in the best
interests of the people they serve;
3. Strategic cooperation among historical competitors.
4. Satisfactory and realistic outcome.
5. Setting a limit on negative conflict - seeking behaviors.

J. Managing Intrapersonal Conflicts

1. Identifying the conflict: include what you want and are not getting.
2. Writing thoughts down to come to a workable conclusion.
3. Having someone you trust for consultation and assistance. Consider how important the
issue is, does the issue seem worse when you are tired or angry at something else, and
what exactly is the role you play in this issue.
4. Deciding if you want to take this issue as your problem or if it should belong to someone
else.
5. Chose one thing you can do about the conflict.
6. Give yourself a cooling-off period prior to doing anything about the conflict and then
take action.
7. Set a tentative date in which you will act again if there has been no improvement in the
situation.

K. Managing Interpersonal Conflicts

1. Being in control of yourself and your actions towards others who are demonstrating
negative behaviors.
a. Stay in control and establishing eye contact.
b. Listen and show you are interested in what the other person says and feels.
c. Speak in a moderated tone and nod your head as you listen.
d. Give the person time to vent and do not interrupt them or judge them.
e. Prevent blaming the person and look at the process.
2. When an individual is speaking with you about their concerns, verify that you understood
what they have said once they have finished speaking. 
a. Ask the person if it is permissible to rephrase what you are hearing from them.
b. Ask open-ended questions and avoid asking "why" questions to prevent them
from becoming defensive.
3. Ask the individual to verify if what you said is accurate and avoid the words "You" and
instead use the word "I." Speak in terms related to the present and mention your feelings.
4. Acknowledge where you disagree and where you agree.
5. Discuss the issue or the process, not the individual. Get the individual's suggestions on
how to fix the problem. Keep focusing on the issue and what can be done.
6. Identify one action that can be done by you and the individual.
a. Ask the person if the action chosen is agreeable.
b. If not, ask for a "cooling off period" and then work on an alternative solution.
c. Thank the individual for their input and for sharing his/her perspective on the
issue at hand.
 d. Help the individual to feel appreciated and valued.
7. If the situation remains in conflict, conclude whether or not the individual's behavior
conflicts with current policies and procedures. Consult with your superior to discuss the
issues presented. Decide whether to agree or disagree with the individual who has the
issue.
8. Consider whether or not a third party is needed to be a mediator.

L. Conclusion
Training and education in conflict resolution can provide healthcare professionals with the
skills and expertise to help them deal with workplace conflicts. Conflict resolution provides a
safer and more satisfying environment for everyone.
Conflict is an inevitable aspect of life. In healthcare organizations, if the conflict is not dealt
with effectively, the end result affects customers/patient care, employee's satisfaction, and the
desire to do the best job possible and provide a safe and progressive environment. If the process
of conflict resolution is viewed as an opportunity for growth and change in a work environment,
the potential for a positive outcome is great.
On an individual level, the ability to solve problems and manage change plays a vital role
in one's success. In the same way, the overall ability of a company - whether it is a healthcare
organization or not - in solving problems through collaborative efforts, has a strong impact on
the organization's bottom line and overall success.