Cristina Lacerda, RN, Geriatric Specialist Nurse, Master in Health Management, Head Nurse of Oncology Department, Portuguese Institute Oncology in Lisbon, Treasure of EONS

Managing Conflict as a Leader

Review and update knowledge about conflict in Health –care organizations;

Identify how can prevent, mitigated and management aconflict;

Act according the best practices to resolve conflictshaving the knowledge, competencies and behaviours foreffective conflict management.

Objectives

What is conflict ?

In this presentation , conflict is defined as a dynamic processoccurring between interdependent individuals and/or groupsas they experience negative emotional reactions to perceiveddisagreements and interference with the attainment of theirgoals.

Baki&Hartwick,2004

Understanding, mitigating and managing conflict may result in positive outcomes such as new

ideas and initiatives

Leadership is required across all organizational and Health-care

sector levels to create environments that practice

management and mitigation of conflict.

A healthy work environment for nurses is complex and

multidimensional, comprised of numerous components and

relationships among the components

Healthy work environments for nurses are defined as practice

settings that maximize the health and well-being of the nurse, quality patient/client

outcomes, organizational performance and societal

outcomes.

Conflict at Work Setting is Inevitable

Conflict

Disagreement is thekey cognitive componentin conflict and occurswhen there is adivergence of values,needs, opinions, or goalsbetween individuals.However, disagreementby itself is notconflict.

The core process ofconflict is the behaviorwhere individuals opposeor interfere withanother’s interests orgoals.

(Barki & Hartwick 2004)

Not inherently negative, can be anopportunity for growth, learning, andchange (Almost, 2006)

Impact of Conflict in a Health-Care Teams

Job Stress

Unhealthy Workplace Practices and

Conditions

Losses for each Staff Member

Effectiveness, Moral, Employee Turnover

Sickness and Meaningful Professional Relationships

Compromised Patient Care

Cost of Time: Spent 2,8 hours/week

Cost of Money: 304 Billion Euros

Lost of productivity: 25% Absenteeism and illness

Workplace Conflit and How Business Can Harness it to Thrive, CPP, July 2008; William G Bliss-Bliss & Associates

Cost of Conflict

Factors that Interfere in Conflict

Factors that Interfere in Conflict

Health-care systems are under mounting pressure to control costs and increase productivity while responding to increasing

demands from growing and aging populations, advancing technology and more sophisticated consumerism.

Conflict is Not

But……Bullying and Harassment

These terms are used to describe behaviour thatclearly causes humiliation, offence or distress, and thatmay interfere with job performance and/or cause anunpleasant working environment.

Harassment is unwanted conduct affecting the dignity of aperson. It may be related to age, gender, race, disability,religion or belief, sexual orientation, being married or in a civilpartnership, being pregnant or having a child, nationality,political opinion, gender identity, or any personal characteristic,and may be persistent or an isolated incident. The key is thatthe actions or comments are viewed as demeaning andunacceptable by the recipient.

Unresolved Conflict in Teams

Team Members

Threaten

Undervalued Stressed

Underperforming

Healthy WorkplaceConflict can be corrected through

listening, informalproblem solving, dialogue and

collaborative negotiation(Cloke & Goldsmith, 2011)

Strategy to Solving Conflicts

Understand the situation

Use effective communication

Problem Solving

Response to conflict

There are five key responses to conflict:

Avoidance – withdraw from the situation; maintain neutrality; goal is todelay. (I lose - you lose)

Accommodation: satisfy others’ needs and concerns over your own;maintain harmony; goal is to yield. (I lose - you win)

Aggression/Domination/Competing: Being assertive and pursuing yourown concerns; win/lose power struggle; goal is to win. (I win - you lose)

Compromise: minimally acceptable to all; relationships undamaged; goal isfind middle ground. (win-win or lose-lose)

Collaboration: expand range of possible options; achieve win/winoutcomes; goal is to find a win/win situation. (I win - you win)

(Thomas, 1992, cited in RNAO, 2012)

Effective CommunicationCo

nstru

ctive • Specific Facts

• Disrespectful Opinions

Cons

truct

ive • Behaviour

• Personal Attacks

Cons

truct

ive • Supportive

• Negative Emotions

Destructive Language

Causes of Conflict at Workplace

A useful strategy:‘Say what you See’

Say what you see… ‘I notice that we keep returning to the same issue without

moving forward’ or ‘I’ve noticed a lot of raised voices in here’

Check for AgreementThis is vital – do they see things your way, if they do it

makes it a shared problem. If it’s shared you can proceed to the next step

Ask for suggestionsWhat do you think WE should do about it?

Wait the most important and usually hardest part of the strategy

but leaving time and space for a response is crucialEdmonstone (2013)

Managing Conflict

How to become self-aware during conflict: Listen, ask questions, make a commitment to resolving the

conflict Pay attention to the way you are when you are in conflict Choose to listen and learn (both to your internal voice and to

the voice of your colleagues). Alter the way you act, by exploring options, separating

problems from people, exploring the reasons for your own resistance

Remember it is small acts of kindness which can prevent conflict in the first place….

Conflict Management

NurseManager

Explain decisions,

process and context

Team development; trust, share

vision, accountability,attention to

results

In staff professional development

&trainingDeveloping

team connection

Planning meeting

Communication Retreats

Expectations

Nurses

Conflict Resolution

Analise the situationRecognizing fear as a factor of both sidesRespectCreative SolutionsRecognition of Injustice on both sidesWillingness to forgive and to be forgivenNo Belligerence

Conflict Resolution

Using the techniques of emotional intelligencesUnderstands values (Soul Profile)Never proving the other wrong/or make them lose faceIdeology & Religion should not be part of the discussion.

Change the way you think about disagreementswith others, and how you behave during conflict.Be willing to engage directly, constructively, and

collaboratively with your colleagues(Cloke & Goldsmith, 2011)

Any Questions?

Waiting for you

Thanks for Your Attention