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Conflict Resolution


David Thompson, DNSc, MS, RN Jill Marsteller, PhD, MPP Conflict Resolution * * Powerlessness can lead to self esteem issues, question our ability to work effectively ... – PowerPoint PPT presentation

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Title: Conflict Resolution

Conflict Resolution
  • David Thompson, DNSc, MS, RN
  • Jill Marsteller, PhD, MPP

What is Conflict?
  • Perception of mutual interference
  • A process that begins when goals of one party are
    frustrated by another
  • Requires interdependence/interaction

Views of Conflict
  • Conflict Good (interactionist view) G
  • Conflict Natural (human relations view) N
  • Conflict Bad (traditional view) B
  • Conflict must be managed

Sources of Conflict
  • Conflict arises from resource scarcity
  • Goals of parties are incompatible
  • Other structural factors (size, routinization,
    specialization, reward systems)
  • Conflicting perceptions, ideas, or beliefs
  • Differences between people
  • Conflicting thoughts/needs within an individual
  • Lack of communication (maybe)

Types of Conflict
  • Task Content conflict (differing opinions
    related to the task) G
  • Emotional or Relationship conflict
    (interpersonal conflict--dislike, negative
    emotions) B
  • Administrative or Process conflict (disagreement
    on how to get the task completede.g., duties,
    decision-making technique) B to N

Goal of Conflict Resolution
  • Confront problems, communicate openly and
    respectfully with someone of opposing opinion to
    provide optimal patient care.

Why address Conflict Resolution?
  • Inevitable in dynamic environments
  • Conflict can lead to feelings of powerlessness
  • Conflict can cause anyone especially subordinates
    to view administrators, attending physicians as
    adversaries and creates conflict and divided
    loyalties in the workplace

Assertion IS
  • Being appropriately assertive means
  • Organized in thought and communication
  • Technically and socially competent
  • Disavowing perfection while looking for
    clarification / common understanding
  • Being owned by the entire team (this is not just
    a subordinate skill-set, and it must be valued
    by the receiver to work)

Assertion Is NOT
  • NOT
  • Aggressive
  • Hostile
  • Confrontational
  • Ambiguous
  • Demeaning
  • Condescending

The Assertion Model
  • Model to guide and improve assertion in the
    interest of patient safety

Helpful Hints in ApplyingThe Assertion Model
  • Focus on the common goal quality care, the
    welfare of the patient, safety its hard to
    disagree with safe, high quality care
  • Avoid the issue of whos right and whos wrong
    Patient Centered care concentrate on doing the
    right thing
  • De-personalize the conversation
  • Actively avoid being perceived as judgmental
  • Be hard on the problem, not the people

Strategies for Conflict Resolution
  1. Withdrawallittle or no significance to either
    party (lose-lose)
  2. Forcingforce outcome regardless of the desire of
    one party (win-lose)
  3. Conciliationgiving in to preserve relationship
    with other party (lose-win)
  4. Compromiseconcerned with both outcome and
    relationship (?-?)
  5. CONFRONTATIONmeet the problem head on (win-win)

Confrontation is an Assertive means ofConflict
  • Respectful negotiation
  • Effective Conflict resolution is what is right
    not who is right.
  • Never Aggressive. Use to explain perspectives. If
    handled appropriately may be an opportunity to
    educate the other party involved.

Two Attempt Rule
  • Using the elements of assertion make 2 attempts
    to reach a common goal.
  • If your viewpoint is disregarded, Traditionally
    continue up the chain of command or escalate to
    achieve resolution.
  • Charge nurse
  • Nurse Manager
  • Fellow
  • Attending

Conservative Response
  • Non-confrontational method to gain agreement
    among 2 or more team members
  • Used to ensure disagreement does not escalate to
    confrontation by seeking input and advice from
    another team member or outside consultant

DESC Script
  • What is it?
  • A structured, assertive, communication approach
    for managing and resolving conflict.
  • D Describe the specific situation
  • E Express your concerns about the action
  • S Suggest other alternatives
  • C Consequences should be stated
  • Ultimately, consensus shall be reached.
  • When to use it?
  • Whenever you have a personal conflict with
    another health team member that threatens your
    ability to perform your job well
  • Key Points
  • Have timely discussion

DESC Example
  • D- When you scream at me in front of my
    co-workers about the delay in care, youre making
    it personal.
  • E- This reduces my credibility with the patients
    and undermines my authority with staff. I feel
    you dont respect me.
  • S- If you are upset about delays or other patient
    care issues, pull me aside and I will address
    your concerns.
  • C- If your outbursts continue we wont have a
    working relationship, and patient care will

LEEN--A Model for Conflict Resolution
  • L- Listen
  • E- Empathize
  • E- Explain
  • N- Negotiate

Conflict with Patients/Families
  • L- Can you help me understand why you are upset.
  • E- That is understandable, I can see why you
    are upset.
  • E- The reason we wanted to do this was because
  • N- Lets agree on a path forward.

Conflict with Clinicians
  • L- Can you help me understand how you see the
    situation, how you are weighing the risks and
  • E- I can see how you see it that way.
  • E- Let me explain how I see things.
  • N- Lets put the patient first and agree on a