Interpersonal conflict between stakeholders - Essay Example

Interpersonal conflict between stakeholders Introduction Conflict among the nurses appeared to be the biggest issue that could but should never occur in the health care system. This was what I decided when I had to see two junior nurses shouting at each other over a patient’s management. Both had been responsible for the patient in different duties. The day nurse was a conscientious worker who believed in doing her duty well with close interpersonal relationship with the other nurses and the patients. The patient who was recovering from stroke had to be turned over every two hours as per instruction. The day nurse was strictly conforming to instruction while the night nurse was a little lazy and made the excuse that the patient was sleeping and she did not want to disturb her. Seeing the pink rashes on the skin in the sacral region, the day nurse had asked the patient about the matter. She questioned the day nurse about it and this sparked the conflict between them. They had already been arguing over various matters recently. When they argued loudly, there were people taking sides: other health staff, families who heard the argument and the medical officers on daily rounds. The incident was shocking as it happened in the full view of so many spectators. Conflict was defined as the involvement of 2 people in perceived opposition (Almost, 2006). The verbal abuse and the humiliation of creating a scene went down badly with the onlookers. The psychological feeling of harassment and hostility that were evoked produced a shameful situation which could have been averted long before it had reached these proportions (McKenna et al, 2003). Nurses could even feel like leaving the profession (Wheeler, 2001). The shortage of nurses could be attributed to the discontent with the work environment. The undervaluing by other nurses and the feeling that learning was not easy with so much ill-will could influence the decision to change professions (Whitworth, 2008). Rudeness and critical treatment could affect them. Three per cent of nurses reported verbal threats (Whitworth, 2008). Distress was experienced by 66%. Females were the main perpetrators. Conflict had been described as a social behavior between individuals who attempted to gain something both could not have (Moss, 2002). Nursing conflicts had been termed as role conflict (Cooper, 2003), burnout (Poncet, 2007), horizontal violence (Abu Alrub, 2004) and intergenerational conflict (Swearingen & Liberman, 2004). Reflection and the impact on work practices and stakeholders Conflict constituted most of the management problems in nursing. The hospital environment or primary care or community centers worked well and efficiently partially due to the efficacy of conflict management. The variety of people with diverse “perceptions, personalities and behaviors” could ignite a problem at any moment (Sikes, 2010). The common goals were what brought them together. Barriers were inevitable but efforts to prevent conflicts needed to come from the right quarters. The idea was not to totally prevent the conflict but to manage it well so that a creative style with classic decision-making produced improved outcomes. Cohesion of the group was ensured through the efficient management of conflict. Too much conflict was conducive to frequent sparring and a decrease in performance; group cohesion suffered in the long run. Conflicts could arise between any of the stakeholders in a health environment: between nurses, nurses and doctors, nurses and patients, nurses and the patients’ families, doctors and patients’ families, nurse manager and staff nurses, staff of different categories and between policy makers and the hospital industry. The nursing profession needed to handle conflicts with confidence and evoke the best results. The resolution of the conflict The nurse manager had to use her skills of communication and interpersonal skills to identify the main problem of the conflict by interaction with the nurses. They were allowed to speak singly to convey the reason for their outburst. The real reason was to be made evident through questioning both of them. The conflict was over the deficient management of a stroke patient. Using charisma, communication skills and good interpersonal skills, the nurse manager could evaluate the situation. She could also ask them to help find the best solution through collaboration. Three skills of a nurse manager to manage conflicts The ability to provide conflict coaching was a commendable skill where conflict management was the issue. The nurse manager could use her communication skills to impart appropriate methods of handling conflict issues in the hospital. Good interpersonal relationship needed to be developed among the nurses; the nurse manager could cultivate a healthy relationship and team cohesiveness with the nurses through interactional justice, lifting the unit morale and perceptions of fairness. The skill of practicing the agreeable style of conflict management was the third required ability to maintain a peaceful atmosphere in the workplace. Skills required to address the conflict- a critical review of literature Conflict coaching was a method of improving the communication competencies and skills of nurse leaders and managers (Brinkert, 2010). It was a supervisory intervention where challenges posed by conflicts could be prevented or managed as the situation merited. Stress could be handled better with strategies of practical management (Haraway and Haraway, 2005). Nurses could understand conflict better and practice interaction strategies and skills proactively or reactively (Brinkert, 2006). The narrative structure of the coaching model included the beginning conversation and four stages backed up by a continuous stage which was a parallel process. As the nurse manager, I could first “discover the story” (Brinkert, 2010). I could then use “identity, emotion and power” to evaluate the conflict situation (Brinkert, 2010). Using my “appreciative” approach, I could convey the message that a best-future outcome must be elicited from the conflict and allow the 2 nurses to make the story end well. Sharpening the nurse’s communication skills and strategies, I could enable the nurse to apply her best conflict styles, negotiate and resolve the issue (Brinkert, 2010). Alleyne et al have described executive coaching as a method of communication of the nurse manager with other nurses (2008). The nurse manager and the organisation she worked for both benefited. Three types of coaching had been identified: feedback, in-depth development and content (Alleyne, 2008). The first two were concerned with the development of the nurse manager and the third, content management, concerned the others. Collaboration was another skillful technique to handle nursing conflicts (Vivar, 2006). This method required a long time to reach resolution but it could help nurses who were together for a lengthy duration. The capacity to resolve depended on the skills of the nurse leaders and managers (Vivar, 2006). Self-evaluation and core beliefs of one’s own disposition with four personality characteristics of self-esteem, self-efficacy, locus of control and smaller extent of neuroticism were sufficient to provide a positive environment for the reduction of conflicts (Almost, 2010). Conflict management could be excellent if the core evaluation of oneself were associated with autonomy, efficacious nursing model, sound leadership and shrewd collaboration (Siu et al, 2008). For good conflict managements, the nurse manager needed to possess a few interpersonal characteristics while dealing with the nurses. Interactional justice from the nurse manager was expected by the nurses (Almost, 2010). A healthy and positive relationship, without receiving demeaning judgments, drew the nurses closer to their nurse manager and they could refrain from making responses which triggered conflicts. Perceptions of fairness were received well (Laschinger and Finegan 2005). Being treated with dignity helped the nurses trust their leader. This also evoked positive responses to work issues and thereby lesser conflicts (Almost, 2010). Team cohesiveness and morale were essential for the strong bonding in interpersonal relationships. Unit morale if low could ignite conflicts (Almost, 2010). Affection reduced and commitment became less. The feeling of mutual dislike provoked the team members to be frustrated, uneasy and withdrawn from the others physically and psychologically. The agreeable style of conflict management enabled the involved persons to collaborate with their leader and resolve the issues in the work environment (Almost, 2010). Over time, their environment evolved into a conflict-free zone. The disagreeable style was conducive to a strained conflict-laden work environment. Health care teams could be cohesive only if they had the necessary characteristics (Grumbach and Bodenheimer, 2004). The goals had to be precise and able to produce measurable outcomes. The team needed to have systems of administrative and clinical overview. Labor was to be divided. Team members had to be trained and communication skills were to be honed. The greater cohesiveness was associated with the better outcomes and an exalted level of patient satisfaction (Grumbach and Bodenheimer, 2004). Keith Kreit emphasized negotiation skills among interpersonal skills for conflict management (2008). The ability to negotiate anything and anyone could be the scoring point for management of conflicts. Negotiating skills had many factors associated for success (Salacuse, 2004).. The attitude of win-win enabled a collaborative effort at solving problems. The style of negotiation involved the manner of dressing, the titles used, manner of speaking and type of interactions could be formal or informal (Salacuse, 2004). The informal style was more in conformity with nursing conflicts. Communication needed to be direct in the nursing environment. Transformational leaders were previously believed to be able to provide a high performance, good satisfaction in the job, commitment to the organization and calm behavior (Koslowsky and Stashevsky, 2005). The picture had slightly changed. Compliance was seen more with transformational leadership even in conflicts. This leader was never judged as negative, rather he was understood to be forced to perform harsh actions. Power strategy was related to the charismatic and task-oriented leadership (Koslowsky and Stashevsky, 2005). Plan outline The aim of the plan was to resolve the conflict between the two nurses. The nurse manager needed to address the nurses and the others at the scenario itself. Convincing the onlookers that a misunderstanding had occurred between the two conscientious nurses and that necessary arrangements were being made to prevent such issues in the future and that the present issue would soon be resolved, the nurse manager must provide the impression that everything was under control. The calm composure and confidence of the nurse manager must reflect in the situation, the nurses and onlookers. The crowd if any must be dispersed with this speech after recognizing the power of the person who said these words. Arrangements could be made to speak to the two nurses together after they had conveyed their opinions in writing to the nurse manager. A collaborative effort would be made to resolve the issue. The two nurses could be encouraged to find areas of agreement and identify the areas of disagreement with the nurse manager in attendance. A solution that combined the perspectives of both nurses could be attempted. The best outcome for the conflict would be attempted by introducing the nurses in the incident to conflict management. Conclusion Conflict among nurses had become a common issue that needed plenty of research. Conflict was defined as involvement of 2 people in perceived opposition. The psychological feeling of harassment and hostility that were evoked produced a shameful situation which could have been averted long before it reached big proportions. The shortage of nurses could be attributed to the discontent with the work environment. Nursing conflicts had been termed as role conflict (Cooper, 2003), burnout (Poncet, 2007), horizontal violence (Abu Alrub, 2004) and intergenerational conflict (Swearingen & Liberman, 2004). Conflict constituted most of the management problems in nursing. The nurse manager needed to use her skills of communication, interpersonal skills and the agreeable style to identify the main problem of the conflict by interaction with the nurses. The ability to provide conflict coaching was a commendable skill where conflict management was the issue. The nurse manager could cultivate good interpersonal relationship with her nurses with the aim of producing team cohesiveness through interactional justice, lifting the unit morale and perceptions of fairness. Conflict coaching was a supervisory intervention where challenges posed by conflicts could be prevented or managed as the situation merited (Brinkert, 2010). Collaboration was another skillful technique to handle nursing conflicts (Vivar, 2006). Alleyne et al had described executive coaching as a method of communication of the nurse manager with other nurses (2008). Self-evaluation and core beliefs of one’s own disposition with four personality characteristics of self-esteem, self-efficacy, locus of control and smaller extent of neuroticism were sufficient to provide a positive environment for the reduction of conflicts (Almost, 2010). The ability to negotiate anything and anyone could be the scoring point for management of conflicts (Kreit, 2008). References: Abu, AlRub R. (2004) Job stress, job performance and social support among hospital nurses. Journal of Nursing Scholarship 36 (1), 73–78. Alleyne, J. and Jumaa, M.O. (2007). 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