Conflict Resolution Nursing Handout

Online Continuing Education for Nurses
Linking Learning to Performance
CONFLICT RESOLUTION IN NURSING

INSIDE THIS COURSE
1.5 Contact Hours
CONFLICT & COMMUNICATION ..... 1
TYPES OF CONFLICT....................... 2 This continuing education course is intended to help nurses identify
CONFLICT IN NURSING ................... 3 conflict, understand various types of conflict, implement strategies
CONFLICT M ANAGEMENT to effectively manage conflict, and understand how to minimize
STRATEGIES ..................................... 3
conflict and prevent escalation of conflict situations in the nursing
CASE SCENARIO ............................. 4
COMMUNICATION SKILLS............... 5 environment.
ART OF NEGOTIATION .................... 5
ORGANIZATIONAL TACTICS ........... 6
CONCLUSION & REFERENCES ...... 7
CE EXAM .......................................... 8 Course Objectives
EVALUATION ..................................10
REGISTRATION FORM ...................13  Define conflict and effective communication skills.
 Identify four general types of conflict.
 List the four primary types of conflict in nursing.
 Describe five strategies used to manage conflict.
 Identify four components of effective communication skills.
 List three rules for effective negotiation.
 Explain four organizational tactics for preventing and resolving
conflict.
CONFLICT AND EFFECTIVE COMMUNICATION

Conflict resolution skills are essential, not just for nursing leadership, but for all nurses. Nurses, in general,
have been found to lack conflict resolution skills and often use avoidance or withdrawal when confronted
with conflict. In order for conflict to be managed successfully, effective communication skills are necessary.
Effective communication skills are skills that stress resolution and a positive outcome, allow for the
discussion of the issue without blame, and include the ability to clearly express oneself to avoid
misunderstandings and miscommunication.
Conflict can be defined as a state of disharmony that occurs within a group of people with differing
viewpoints, opinions, values, or priorities. Nurses need to be able to recognize and accommodate
differences in the workplace while striving to minimize conflict. Conflict is not always a negative thing.
When handled effectively, a little conflict can promote organizational and personal growth. Conflict left
unchecked, however, can paralyze a group and interfere with quality patient care. Continued conflict further
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Page 2 Conflict Resolution in Nursing
leads to higher staff turnover rates, increased healthcare costs, patient dissatisfaction and an overall
decrease in organizational morale.
Quality and safe patient care depends on a collaborative work environment that stresses teamwork and
communication. The Joint Commission developed a leadership standard, effective January 1, 2009, to
address issues of conflict in the workplace. This standard calls for an organizational code of conduct that
defines acceptable versus disruptive or inappropriate behaviors. The standard also calls for leaders to
create and implement processes to effectively manage conflict in the workplace. The Joint Commission
report also identifies two main factors involved in healthcare workplace conflict:
 Personal Factors: The Joint Commission reports that the stress involved when dealing with high-
emotion situations, especially when coupled with fatigue can lead to intimidating or disruptive
individual behavior. Healthcare professionals who possess characteristics such as self-
centeredness, immaturity or defensiveness are more prone to these types of behavior and often
lack interpersonal, coping, or conflict management skills.
 Organizational Factors: The same report also points out how the uniqueness of the healthcare
cultural environment can create challenges for interpersonal communication and trust issues
between team members. The healthcare environment is marked by productivity demands, cost-
containment issues, embedded hierarchies and the ever-present fear and stress caused by the
possibility of litigation. A continual flux of change is present in healthcare, further contributing to an
environment where conflict can be expected and must be dealt with effectively for positive
outcomes.
GENERAL TYPES OF CONFLICT

In order to effectively assess a conflict situation, it is important to understand the main types of conflict.
Each type of conflict requires a different approach for effective management.
 Intrapersonal Conflict: This type of conflict occurs within a person when confronted with a
situation that causes discomfort. Intrapersonal conflict can affect others working with the nurse who
is experiencing this type of conflict and lead to the next type of conflict. An example of intrapersonal
conflict is a nurse who is working a shift that interferes with her family schedule and is creating
conflicting emotions in that nurse.
 Interpersonal Conflict: This type of conflict occurs between two or more people who disagree on
an issue due to factors such as differing goals, values, ethics, or priorities. This is the most common
type of workplace conflict. An example of interpersonal conflict is a situation where a family member
is angry with a nurse over a treatment or medication change.
 Intergroup Conflict: This type of conflict is similar in nature to interpersonal conflict, but occurs
between two or more groups of people. An example is a disagreement between two units about the
best way to transfer a patient and provide a handoff report.
 Organizational Conflict: This type of conflict occurs when there is a disagreement between staff
and the organization over issues including policies and procedures, changes occurring on the unit,
or organizational standards. An example is an organizational change in documentation the nurses
feel is unnecessary or redundant.

PRIMARY TYPES OF CONFLICT IN NURSING

 Nurse-to-Nurse Conflict: This type of conflict occurs when
nurses clash over philosophies, experience, or collusion.
Nurse-to-nurse conflict can escalate to incivility which may
result in bullying or lateral workplace violence. Lateral
violence refers to hostile acts between workplace colleagues.
Examples of this type of violence include covert or overt acts
of verbal or nonverbal aggression and may lead to bullying
behavior. Because this type of conflict can escalate quickly
and directly affect patient care, it is important that it is quickly
recognized and resolved.
 Nurse-to-Physician Conflict: This type of conflict arises as
a difference in power or perception of power. Communication
can become condescending, critical, or patronizing. This type
of conflict can affect all members of the staff and inhibit
patient care by interfering with interprofessional
collaboration. Steps must be taken to improve nurse and physician communication which stresses
the shared goal of patient-centered care.
 Nurse-to-Patient Conflict: Patient and family members who do not feel they are being heard or are
not part of the decision-making process may lead to conflict situations. Patients may feel a nurse is
not answering their call bells promptly, ignoring their pain, not giving their medications on time, or
are speaking to them in a condescending or abrasive manner.
Nurses who can remain mindful and not become defensive are able to communicate more
effectively with the patient or family members and discuss issues as they arise, thus preventing
further frustration or escalation. Care must be taken to ensure that patients and/or family members
are actively engaged in the decision-making process.
 Staffing Conflicts: Staffing and scheduling issues are common sources of both internal and
external conflicts. The process of nurse staffing requires the balancing of quality patient care with
the number and needs of staff nurses. Because of the ever-present change that is part of the
process, conflict can arise over this issue that affects nursing staff, patients, and other team
members.
Ideally, staffing should include the input of the nurses to work together in a collaborative process to
create a fair and balanced schedule as much as possible. However, no matter how staffing
schedules are determined, transparency is key to minimizing conflict and promoting safety, a sense
of community, and overall job satisfaction among staff members.
CONFLICT MANAGEMENT STRATEGIES

There are five main types of strategies used to manage conflict. Not all types are effective in all conflict
situations. Often, a combination of the following strategies can be used to effectively deal with conflict in the
workplace.
 Avoiding: This strategy is the least effective method of dealing with conflict because nothing is
resolved, only postponed. However, in a volatile situation sometimes using the avoidance strategy
to walk away and clear your head may be the best strategy to use.
 Accommodation: This strategy is also considered largely ineffective because it often results in
future conflict. Accommodation involves putting someone else’s needs or goals ahead of someone

else’s (often your own) at a sacrifice. This strategy may temporarily resolve the conflict, but leads to
a build-up of frustration and resentment.
 Competing: This strategy involves someone pursuing their own goals, needs or desires at the
expense of others. While some competition may benefit the workplace, using competing as a
strategy to management conflict leads to aggression and anger and is often found in power
struggles.
 Compromising: This is considered an effective strategy to deal with conflict. In this method, both
parties are willing to give something up in order to gain something. This strategy is only effective if
both parties feel their trade-offs are fair and equal.
 Collaborating: This strategy is considered the best method for effective conflict management. Both
parties identify shared goals and work together in a fashion where both parties are satisfied with the
outcome.
CASE SCENARIO
Nurse R arrives for her 12-hour shift in the emergency room department and finds that her assignment is
quite heavy. She has been assigned seven patients, including two who are currently unstable. She notices
that Nurse M has a light assignment with only five patients, all of whom are scheduled to be discharged to
home during the shift. She feels frustrated because her patient load exceeds the ER guidelines regarding
patient number and acuity. She knows Nurse M often receives lighter assignments because she is known
to be intimidating and aggressive. She decides to address the issue with her charge nurse who tells her
she is busy and “it is what it is.” Increasingly frustrated, Nurse R decides it is time to approach the unit
manager about this ongoing issue.
What are some ways the nurse manager can address the issue and manage this conflict situation
effectively?
A. Avoidance: The nurse manager can choose to avoid the situation and say nothing or tell Nurse
R she is too busy to address the situation.
Results: Nurse R walks away feeling more frustrated and powerless over the situation.
B. Competing: The nurse manager can become dominating and tell the charge nurse the
assignment is unacceptable and needs changed immediately.
Results: The charge nurse is upset and angry at both Nurse R and the manager. The manager
later feels regret that she handled the conflict in this manner and has caused more stress and
discord on the unit. Nurse R gets the results she wanted, but now is at odds with her charge
nurse and the other nurse on the unit.
C. Compromise: The nurse manager can discuss Nurse R’s concerns with the charge nurse and
engage her assistance to find a speedy solution that will make both nurses happy.
Results: By engaging the charge nurse and asking for her help, the manager can address the
situation without escalating it. If they can work together to find a solution that works for both
nurses, this approach may result in a positive outcome.
D. Collaboration: The manager can have an informal meeting with both nurses and the charge
nurse where they can discuss ways they can all come to an acceptable solution.

Results: Each party can give input and feel their opinion is important and heard by
management. With all involved parties included, each will be more willing to compromise for the
overall benefit of everyone on the unit including other staff members and patients. This solution
offers the best way for a speedy resolution while also improving patient care and patient
outcomes.
Collaboration is considered the most effective method of conflict management.
EFFECTIVE COMMUNICATION SKILLS FOR CONFLICT MANAGEMENT

The first step in managing any conflict is to develop communication skills that are effective and produce
positive results. Some points to remember for effective communication during conflict management include
the following four strategies:
 Mutual Respect: Both parties must remain respectful towards the other party and keep the focus
on the issue and not resort to personal attacks.
 Needs Versus Wants: Each party should examine whether their issue is a need or a want, as well
as seek to understand the other party and their needs and wants. Clarifying this point can improve
collaboration and compromise during a conflict.
 Compassion and Empathy: Both parties must act with compassion and empathy to the other party
if conflict is to be managed effectively. Both parties must be willing to actively listen to the other
party with an open mind and without becoming defensive.
 Stay in the “I”: Each party needs to stay focused on “I” statements and not fall into the habit of
using accusatory “you” statements which often lead to an increase in conflict and create an
environment of blame.
THE ART OF NEGOTIATION

A critical communication skill during conflict situations is the ability to effectively negotiate. Negotiation
involves controlling reactions during the conflict, seeking to actively listen and understand the other party’s
issues, identifying the unmet need, and being able to compromise and collaborate to come to a positive
solution. There are three rules to remember when using negotiation to solve a conflict:
1. Do not take negative comments or information presented personally. Instead, listen to the other
party with an open mind while trying to determine the core of the actual problem. While it may
be a normal reaction to become angry and defensive when faced with criticism, effective
communication and negotiation requires both parties seek to understand the other party and
collaborate to find an effective solution.
2. The second rule involves identifying the need being expressed by the other party. Is the need a
personal need, an institutional need, or a patient need? By staying in control of your own
emotions and identifying the unmet need, you can move on to the third rule in successful
negotiating, which is finding a solution.

3. The third rule focuses on finding a positive solution for all the parties involved. To accomplish
this, each party must be willing to give something up, or to compromise. Although it may be
difficult to give something up in the immediate short-term, by keeping long-term goals in mind, it
becomes easier to negotiate conflict situations as they arise.
Three Rules of Negotation
1. Don’t take it personally.

2. Identify the need.
3. Focus on a solution.
ORGANIZATIONAL TACTICS FOR PREVENTING AND RESOLVING CONFLICT

Conflict in the workplace can also be seen as a disagreement where one or more parties perceives a threat
to their needs, wants, or concerns. Organizational leaders can do much to prevent or resolve conflict and to
promote a company culture where collaboration and cooperation are the norm. These four steps can assist
nurse managers and leaders in their role to prevent or resolve conflict:
 Engage in Dialogue: The organization and management need to be willing to engage in dialogue.
Nurses should have the opportunity to speak at councils or meetings and give their perceptive and
concerns on issues that are currently creating conflict or have the potential to create conflict. This
important step will often be enough to prevent the conflict from continuing or escalating.
 Debriefing and Education: Staff conflict needs to be identified as an opportunity for dialogue and
communication skills training. Nonpunitive debriefing after a conflict situation allows everyone to
reflect on the incident and seek ways to learn from it. Role-playing and the use of case scenarios
can be helpful in preventing or minimizing conflict by teaching effective communication skills and
providing a non-threatening environment to practice these skills. This allows nurses to feel better
prepared and more confident in real-life conflict situations.
 Identify Potential Conflict: Organizational leaders can help identify potential areas for conflict and
develop policies and procedures to handle conflict that may occur. Conflict is inevitable in the
workplace, especially in fast-paced healthcare settings with various disciplines working together in
high-stress situations. By becoming aware of where potential conflict situations are likely to occur,
the organization can prepare the staff and provide tools and guidance to handle the situation
effectively.
 Recognize Conflict Early: If conflict is not managed effectively, it often continues to grow and
escalate. Nurse managers and other organizational leaders must receive the necessary training to
recognize conflict in the early stages and be prepared to act as a guide towards successful
resolution. This step produces a workplace that focuses on cooperation and collaboration.

CONCLUSION
Conflict is an inevitable part of any healthcare workplace environment. Although conflict can cause stress
and fear, with the right tools, conflict can be seen as an opportunity for growth. Effective communication
skills, role-playing, and case scenarios can be used by nurses to manage conflict in a way that results in a
positive outcome for each party.
REFERENCES
Cardilla, D. (2017). Seven strategies for managing conflict. The Iowa Nurse Reporter, pp.8-10.
Dahlkemper, T. (2017). Nursing leadership, management, and professional practice for the lpn/lvn, 6e.
(2017). Retrieved from https://ebookcentral-proquest-com.libproxy.uncg.edu.
Johansen, M. (2012). Keeping the peace. Nursing Management (Springhouse), 43(2), pp.50-54.
Jointcommission.org. (2017). Available at: https://www.jointcommission.org/assets/1/18/SEA_40.PDF

[Accessed 4 Nov. 2017].
Mahon, M.; Nicotera, A. (2011). Nursing and conflict communication: avoidance as preferred strategy.
Nursing Administration Quarterly, ISSN: 1550-5103, Vol: 35, Issue: 2, Page: 152-63.

CE EXAM
1. Conflict can be defined as a state of disharmony that occurs within a group of people with differing
viewpoints, opinions, values, or priorities.
A. True
B. False
2. This type of conflict occurs between two or more people who disagree on an issue due to factors such
as differing goals, values, ethics, or priorities. This type of conflict is the most common type of
workplace conflict.
A. Intrapersonal conflict
B. Interpersonal conflict
C. Intergroup conflict
D. Organizational conflict
3. This type of conflict occurs when nurses clash over philosophies, experiences, or collusion.
A. Staffing conflict
B. Nurse-to-Nurse conflict
C. Nurse-to-Physician conflict
D. Nurse-Patient conflict
4. Lateral workplace violence does not include covert or overt acts of verbal aggression.
A. True
B. False
5. This conflict management strategy is considered the least effective method of dealing with conflict
because nothing is really resolved, only postponed.
A. Avoiding
B. Competing
C. Compromising
D. Collaborating

6. Successfully being able to negotiate in a conflict situation requires the ability to define unmet needs of
the other party.
A. True
B. False
7. This type of conflict occurs in the healthcare workplace when there is a difference in power or
perceptions of power.
A. Staffing conflict
B. Nurse-to-Nurse conflict
C. Nurse-to-Physician conflict
D. Nurse-Patient conflict
8. The Joint Commission report identifies two main factors involved in healthcare workplace conflict as
personal and organizational factors.
A. True
B. False
9. This conflict management strategy involves someone pursuing their own goals, needs, or desires at
the expense of others.
A. Avoiding
B. Competing
C. Compromise
D. Collaborating
10. Role-playing and the use of case scenarios can be helpful in teaching effective communication skills,
but are also a source of conflict and tension.
A. True
B. False

EVALUATION
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1. The activity met the stated learning objectives. 5 4 3 2 1
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The teaching/learning methods, strategies, and

3. 5 4 3 2 1
slides were effective in helping me learn.
4. The material was clearly explained. 5 4 3 2 1
The answers to the post-test questions were

5. 5 4 3 2 1
appropriately covered in the activity.
OVERALL ACTIVITY
The online course/download supported the

6. 5 4 3 2 1
achievement of the stated learning objectives.
The material was relevant to my professional

7. 5 4 3 2 1
development.
Overall, I am pleased with this activity and

8. Yes No
would recommend it to others.
The content was presented free of commercial

9. Yes No
bias.*
Did the material presented increase your

10. Yes No NA
knowledge and/or understanding of this topic?**
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What are the four primary types of conflict in nursing?

What are the four primary types of conflict in nursing?

What are five strategies used to manage conflict?

What are five strategies used to manage conflict?

Online Continuing Education for Nurses

Linking Learning to Performance

CONFLICT RESOLUTION IN NURSING

CONFLICT AND EFFECTIVE COMMUNICATION

© Corexcel. All Rights Reserved. www.corexcel.com

GENERAL TYPES OF CONFLICT

© Corexcel. All Rights Reserved. www.corexcel.com

PRIMARY TYPES OF CONFLICT IN NURSING

CONFLICT MANAGEMENT STRATEGIES

© Corexcel. All Rights Reserved. www.corexcel.com

© Corexcel. All Rights Reserved. www.corexcel.com

Collaboration is considered the most effective method of conflict management.

EFFECTIVE COMMUNICATION SKILLS FOR CONFLICT MANAGEMENT

THE ART OF NEGOTIATION

© Corexcel. All Rights Reserved. www.corexcel.com

Three Rules of Negotation

1. Don’t take it personally.

ORGANIZATIONAL TACTICS FOR PREVENTING AND RESOLVING CONFLICT

© Corexcel. All Rights Reserved. www.corexcel.com

Jointcommission.org. (2017). Available at: https://www.jointcommission.org/assets/1/18/SEA_40.PDF

© Corexcel. All Rights Reserved. www.corexcel.com

CONFLICT RESOLUTION IN NURSING

© Corexcel. All Rights Reserved. www.corexcel.com

© Corexcel. All Rights Reserved. www.corexcel.com

CONFLICT RESOLUTION IN NURSING

COURSE OBJECTIVES & CONTENT

1. The activity met the stated learning objectives. 5 4 3 2 1

2. The content was up to date. 5 4 3 2 1

The teaching/learning methods, strategies, and

4. The material was clearly explained. 5 4 3 2 1

The answers to the post-test questions were

The online course/download supported the

The material was relevant to my professional

Overall, I am pleased with this activity and

The content was presented free of commercial

Did the material presented increase your

Continued on Next Page

© Corexcel. All Rights Reserved. www.corexcel.com

* If you responded “No” to question 9, please explain why:

© Corexcel. All Rights Reserved. www.corexcel.com

201 Webster Building

HOW TO GET YOUR CONTINUING EDUCATION CREDIT

Corexcel is accredited as a provider of continuing education in nursing by the American Nurses

Take Conflict Resolution in Nursing Online

© Corexcel. All Rights Reserved. www.corexcel.com

201 Webster Building

WRITTEN PROGRAM REGISTRATION FORM

Name & Title:

City: State: Zip:

License No. (Required for Florida):

(W): (H): (F):

Have you registered with us before? Yes No

Course # Title Amount

Shipping and Handling 8.95

Paying By: Check Credit Card Money Order Cash

Credit Card Number: Exp. Date: