CENTRAL LUZON DOCTORS’ HOSPITAL

EDUCATIONAL INSTITUTION, INC.

Romulo Highway, San Pablo, Tarlac City
' (045) 982-5019/982-5052/982-0264 7 (045) 982-0780/982-2757
Department of Graduate Studies

COURSE TITLE:  NURSING ADMINISTRATION

PREPARED BY: MARY GRACE D. MORALES, MSN 1C
COURSE CONTENT: ROLES AND FUNCTIONS IN DIRECTING

C. Effective Conflict Resolution and Negotiation

 History of Conflict Management
 Categories of Conflict
 Conflict Process
 Conflict Management

HISTORY OF CONFLICT MANAGEMENT

A systematic application of conflict management was initiated in the 19th century and Great
Britain is known to be the home of collective bargaining. The need for this arose due to
industrial conflicts leading to trade union movements.

In India, to regulate labour management relations in the textilc industry in Ahemedabaf

(Gujarat), the first collective bargaining agreement came into existence under thc leadership of
Mahatma Gandhi. Organized trade union movement are known in India from the time of first
world war.

The words like 'Labour Court', Associations, Councils, Tradc Unions etc. are known to be
concerned for collective bargaining procedures for conflict resolution.

Hospital workers 'Union and Nurses' Union are also involved many times in conflict
management process. Sometimes a collective approach is seen where the Union and Association
come to an agreement for achieving a common goal of the team or profession.

The conflict management should always aim for bringing improvement to the organisation
through solving the grievances of individuals working in and for the organisation.

CATEGORIES OF CONFLICT

1. Intrapersonal Conflict occurs within an individual.

Example:
When an employee needs a degree to advance his/her career yet has neither resources
nor the time to go to school.

A frequently occurring intrapersonal conflict for healthcare providers is deciding how

to allocate time with patients. This requires prioritizing and using time effectively to
meet the needs of all patients. It also requires the ability to delegate effectively. 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.
Example
 A staff member wants to take care of patients on a specific team. Staff might not like
their assignments and interpersonal conflicts might occur;
 Assignments may be heavier for the person who has been floated. This individual might
confront the person making the assignment, causing more conflicts;
 A patient becomes non-compliant with her treatment and resists the physician's orders;
 Some staff members want to work twelve hour shifts and single parents or staff with
young children want eight hour shifts;
 Pre-scheduling to be off on holidays has created anger between employees who have
seniority and those who made their request months in advance;
  A nurse and a doctor disagree on giving specific medications to a patient with end- stage
liver disease.

3. Organizational Conflict

A. Intragroup Conflict occurs between individuals within a specific group.

 Intragroup conflicts are most common in workplaces that divide employees into specific
teams or departments.
 These conflicts arise from objective differences of interest, and are aggravated by
antagonistic or controlling behaviors and attitudes.
 Individuals may strive for power, position, economic incentives, value differences, or
differences in gratification of personal needs.
 Often there is a mixture of all of these and these incompatibilities may develop into
intragroup conflicts.

Some signs of intragroup conflict are:

 Talking about another team member behind her/his back in a negative manner o A team
member saying they are too busy to help another member
 A team member ignoring another member when asked a question
 Failing to provide safe quality care
 Not completing work on-time o Passive/aggressive behavior

B. Intergroup conflict is defined as an incompatibility of goals, beliefs, attitudes or

behaviors between groups.

 Intergroup conflict occurs between two competing or distinct groups.

 Intergroup relations between two or more groups and their respective members are often
necessary to complete the work required to operate a business.
 Many times, groups inter-relate to accomplish the organization's goals and objectives. If
these goals or objectives are not mutually compatible conflict can occur. Example:
 Members of the hospital marketing group debating with the fiscal department about the
best way to launch a new service. If the marketing group felt that advertising the new
service on the internet was best but the fiscal department felt strongly that newspapers
ads were best, this would be intergroup conflict. Some examples of intergroup conflict
are listed below.
Other Examples:
 Nurse Managers perceive that certain policy and procedures are not up to date and do not
meet the needs that change has incurred, and administration is not concerned
 Emergency room nurses feel that the lab is not working with them in providing lab
results in a timely manner
 The shared governance group perceives that the organization is more concerned about
the fiscal bottom line than providing the needed equipment to help prevent falls
 The nursing team on a dementia unit perceive that Nurse Managers are not supportive of
their actions when dealing with patients who are non-compliant, possibly confused, and
disrespectful

CONFLICT PROCESS

Stage 1: Potential Opposition or Incompatibility

The first step in the conflict process is the presence of conditions that create opportunities for
conflict to develop. These cause or create opportunities for organizational conflict to rise.
These three conditions causes conflict:
A. Communication
 Different words connotations, jargon insufficient exchange of information and noise in
communication channel are all antecedent conditions to conflict.
 Too much communication as well as too little communication can lay the foundation for
conflict.
B. Structure
 Include variables such as size, degree of specialization in the tasks assigned to group
members, jurisdictional clarity, members/ goal compatibility, leadership styles, reward
systems and the degree of dependence between groups.
 The size and specialization act as forces to stimulate conflict.
 The larger the group and the more specialized its activities, the greater the likelihood of
conflict
  The potential for conflicts tends to be greatest when group members are younger and
when turnover is high.
C. Personal Variables
 Certain personality types- for example individuals who are highly authoritarian and
dogmatic- lead to potential conflict.
 Difference in value systems - Value differences are the best explanations of diverse
issues such as prejudice disagreements over one’s contribution to the group and rewards
one deserves.

Stage 2: Cognition and Personalization

 Conflict must be perceived by the parties to it whether or not conflict exists is a

perception issue.
 If no one is aware of a conflict, then it is generally agreed that no conflict exists. Because
conflict is perceives does not mean that is personalized.

Example:
A may be aware that B and A are in serious disagreements but it may not make A tense or
nations and it may have no effect whatsoever on A’s affection towards B” It is the felt level ,
when individuals become emotionally involved that parties experience anxiety , tension or
hostility. Stage2 is the place in the process where the parties decide what the conflict is about
and emotions plays a major role in shaping perception.

Perceived Conflict
 This is the stage at which members become aware of a problem.
 Incompatibility of needs is perceived and tension begins as the parties begin to worry
about what will happen.
 Sometimes conflict may be perceived when latent conditions are not in existence in the
system. Such a situation arises when one party perceives the other to be likely to thwart
or frustrate his/her goal.

Felt Conflict
 “Emotional involvement in a conflict creating anxiety tenseness, frustration and hostility
is known as felt conflict.”
 It is that stage when the conflict is not only perceived but actually felt and cognized.
 Parties to the conflict feel that they have some conflict among themselves.
 Parties become emotionally involved and begin to focus on differences of opinion and
opposing interest – sharpening perceived conflict.
 Internal tensions and frustration begin to crystallized around specific, define issues and
people begin to build and emotional commitment to their position.

Stage 3. Intentions
 Intentions intervene among people’s perceptions and emotions and overt behaviors.
 These intentions are decisions to act in a given way.
 Intentions are separated out as a distinct stage because you have to infer the other’s intent
to know how to respond to that other’s behavior.
 A lot of conflicts are escalated merely by one party attributing the wrong intentions to
the other party.

Stage 4: Behavior
 This stage is where conflicts become visible.
 The behavior stage includes the statements, actions, and reactions made by the
conflicting parties.
 These conflict behaviors are usually overt attempts to implement each party’s intentions,
but they have a stimulus quality that is separate from intentions.
 As a result of miscalculations or unskilled enactments, overt behaviors sometimes
deviate from original intentions.
 This stage is a dynamic process of interaction.
Ex: you make a demand on me; I respond by arguing; you threaten me; I threaten you
back; and so on
 Conflict intensities escalate as they move upward along the continuum until they become
highly destructive.
Ex: Strikes, riots, and wars
Stage 5: Outcomes
 The action–reaction interplay among the conflicting parties results in consequences.
 May be:
 Functional - in that the conflict results in an improvement in the group’s
performance
 Dysfunctional - in that it hinders group performance.

Conflict is constructive when it:

■ improves the quality of decisions,
■ stimulates creativity and innovation,
■ encourages interest and curiosity among group members,
■ provides the medium through which problems can be aired and tensions released, and fosters
an environment of self-evaluation and change.

CONFLICT MANAGEMENT

Nurse Managers, department heads, Charge Nurses, and Team Leaders have to develop
managerial actions and structures to minimize conflicts, and they must handle conflicts in a
constructive manner and with a positive attitude, using effective communication and listening
skills.

WIN-LOSE
 Win-lose scenarios often times involve groups and intragroup conflicts.
 When the group votes on an issue and majority rules there is a winner and a loser.
 This can erode the cohesiveness of a group and may diminish the group leader's
authority.
 Another scenario could involve a nurse who has 30 years of seniority and wants a
specific holiday off and another new employee also requested the same holiday off.
The senior nurse refuses to give in and wants to win this argument.

LOSE-LOSE
 Lose-lose scenarios involve losses to both parties.
 This is often is the case when a union arbitrator in union contract negotiations gives
 something to both parties and yet neither party gets what it wants.

WIN-WIN
 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 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 is no voting or other traditional dispute
measurement: only the true group consensus counts.
 Everyone involved usually feels good about the outcome.
 This is seen when Nurse Managers and Nursing Supervisor work together to staff a
unit that is constantly needing help to cover their close observation or 1:1 patients
while meeting their own unit needs.