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8/2/2019 Report Conflict Theory Dizon Jayvee
1/22
H O L Y A N G E L U N I V E R S I T Y
G r a d u a t e S c h o o l o f N u r s i n g
_________________________________________________________________________________
WRITTEN REPORT
Submitted by:
Jayvee Bartolome C. Dizon, R.N
Submiited to:
Lillibeth L. Caparas, RN, MAN
Professor, GSNANM
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STRESS MANAGEMENT
SOURCES OF STRESS
Adjustment to change is stressful. Many events in life produce individual stress
reaction. Death of a spouse or close family member, divorce, marital separation,
marriage or remarriage, and personal injury or illness is highly stressful events.
Change in the health of a family member, marital reconciliation, increased arguing
with spouse, sexual difficulties, changes in financial state, mortgages, trouble with
in-laws are stressful. Changes in living condition and personal habits also causes
stress. Even personal achievements, vacations, and holidays are stressful. These
personal stressors can affect ones job performance.
In addition to personal stressors, there are many sources of stress at work.
Dismissal and retirement are highly stressful. Business readjustments such aschanging jobs or responsibilities, and problems with the boss are stressful.
Nurses face stress with life and death situation; heavy workloads involving
physical and mental strain; knowledge of how to use numerous pieces of
equipment and consequences of equipment failure.
People often needlessly increase their stress. The difference between demands
people place on themselves or perceive from others and the resources they
perceive as available to meet the demands is a threat or stress.
STRESS RESPONSE
Stress is impossible to avoid. It is a nonspecific response of the body to any
demand. There are two types of stress: (1)eustress, a positive force that adds
excitement and challenge to life and provides a sense of well-being, and (2)
distress, a negative force cause by unrelieved tension that threatens
effectiveness. Whether one will experience eustress or distress largely depends on
the persons perceptions, physically activity or inactivity, mental activity or
inactivity, sound nutrition, and meaningful relationship.
A stressor is anything individual perceives is a threat. Stressors produce a state
of stress by disrupting homeostasis. There are three stages in the stress response(Box 2-1). First, the alarm reaction is the mobilization of resources to confront the
threat. Second, in the resistance stage, there is a large increase in energy
consumption. Once the reserve energy has been used, the body needs time to
recover and to replenish the supply. When stress continues for long periods of
time, the energy is used but not replaced and the third stage, the exhaustion,
results.
Consequently, unrelieved stress interferes with one physical and mental well
being. After the stress event the body return to a state of equilibrium. Stable
periods for bodies to restore adaptive energy allow one to meet new stressfulsituations.
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SYMPTOM OF STRESS
Numerous symptoms indicate that stress is becoming distress.
High stress levels accumulated over several months are likely to result in
physical and psychological reactions. The amount of stress necessary before onemanifests symptoms varies depending on factors such as heredity, habits,
personality, past illnesses, and previous crises and copying mechanism. Well-
educated, intelligent, creative people in management are at high risk and burnout.
They may become a workaholics but get little accomplished experience chronic
fatigue, feel they do not want to go to work, take increasing amounts of sick time,
become negative, blame and criticize others, engage in backbiting, and talk in
others backs.
STRESS CONTROL
The secret of happiness is to count your blessings while others are adding up theirtroubles
-Anonymous
Nurse managers can prevent and control burnout by setting personal and
professional goals, establishing properties, practicing good health habits and
relaxation techniques, improving their self-esteem by obtaining their skills they
need, and using support systems.
Values Clarification
Values clarification is a useful activity. Values should be chosen freely from
alternatives with thoughtful coordination to the consequences of each alternative.
They should be cherished and shared with others. The value should be integrated
in to ones lifestyle, and actions should be consistent with the values.
Goal Setting
Goals should be consistent with ones values, and one should consider goal
alternatives. To do this one considers why a goal is desired. One may want a
promotion for recognition or for economic reasons. If the promotion is not fourth
coming, one may receive recognition through community service. Money might begenerated through wise investments or fees for community services. The
achievement of the desired outcomes through different approaches increased
flexibilities and decrease stress causes by unmet goals.
Stress Avoidance and Regulation
When reappraising situations, ones should avoid troublesome transactions. Thefrequency of stress-inducing situations should be minimized. Every change takesenergy. Therefore during the high period of stress, routines and habits should bemaintained as much as possible. One should be cautious about moving and
starting a new job at the same time is getting a divorce. That also would be aparticularly poor time try to stop smoking or lose weight. Unnecessary changesshould be prevented during periods of high stress. Deliberately postponing some
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changes helps one deal with unavoidable change constructively and reduces theneed for multiple adjustments at one time. However, increasing positive sources oftension that foster growths, such as learning a sport, can help offset thedeleterious affect of negative tension.
Time BlockingTime blocking is the setting aside of specific time for to a stressor. To reduce thestress from having been promoted to a management position, you can set asidetime for reading about management or for observing a manager. This help ensurethat concerns are addressed and tasks accomplished. It decreased anxiety, timeurgency, and feeling of frustration. Define off-limit times, and set-aside time whenyou will not be interrupted by phone calls or by individuals except foremergencies. Schedule free time and exercise time, and put social events on thecalendar like you would be a business appointment.
Time ManagementTime management help control stress. Much time can be conserved when one
knows ones value system and act consistently with it, set goals, and plansstrategies for accomplishment of those goals. One can also use organizers such asto-do list and calendars to plan good uses of ones time.
AssertivenessWhen one asserts oneself, one increases self-esteem and reduces anxiety, thusreducing stress.As with time management, assertiveness involve thinking through goals andacting consistently with ones values through the uses of the effective work habitsand by setting limits on others attempts to block ones goals. It involves statingwhat one want and how one feels, making requests, taking compliments, handling,putdowns, and setting limits. An assertive person makes eye contact with other;stand straight; sit in an open, listening posture; and sits in an open, listeningposture; and speaks in a clear voice. Assertive people choose for themselves andachieve desired goals through self enhancing behavior that reduces stress.
Feeling Pauses
Feeling pauses are useful. One should take time to identify a feeling, label it,distinguish between thinking, and accept the feeling for what is rather than talkingoneself into what it should be.
Inner Shouting
Inner shouting is the process of shouting I feel. Inside ones head; the personblurts the feeling out spontaneously rather than saying it quietly. Anger should beviewed as a symptom. Pains should be focused on to help one take responsibilityfor feelings of hurt and humiliation.
Anchoring
Anchors are associated feelings that are initiated either by an event or by thememory of that event. Anchors may be sounds, lights, smells, taste or touchesthat stimulate positive or negative feelings. Birds chirping may remind one ofhappy, lazy mornings with the family. One may recall an awful accident at the
sight of blood. One might remember fall walks through the woods with a lover atthe smell of dry leaves. A taste may revive memories of Grandmas home cooking.
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A light touch to the face may remind on the earlier loving moments and cause oneto experience a sense of well-being. Our lives are filled with anchors that causeassociations. We can use anchoring in a useful way to experience desired feelings.Because touch can be inconspicuous and easy to replicate, one can associate apositive feeling with a familiar touch to the body. This may be as simple as
clasping ones hands and being reminded of soft music, beautiful colored glass,and the peaceful sanctuary of church. Exact pressure at a very specific spot makesthe anchor work most accurately and should be done when one desires to bringback a pleasurable feeling.
Sorting
Sorting is choosing the interpretation of an event. One can have an optimistic orpessimistic interpretation of events. Is the glass half full or half empty? Webecome what we think and therefore can make ourselves happy or miserable. Tobe happier and more fun loving, one should focus on the positive aspects ofsituations.
Thought Stopping
Thought stopping helps get rid of negative thinking. Excessive rehearsals in ourminds of negative past events are unhelpful thoughts that waste time, reduce ourself-esteem, and encourage maladaptive behavior patterns. To prepare for thoughtstopping, one should think of beautiful, pleasant experiences. One should alsoidentify the negative thoughts that are most bothersome. In private one can thinkabout negative thoughts momentarily and suddenly yell, Stop! while claspingones hands or hitting ones head or leg. One startles oneself, and the thoughtescapes. Immediately one should insert a pleasing thought.
Compartmentalization
Compartmentalization of thought is the deliberate decision to think negativethought at specified times of the day. During the allotted time one thinks aboutworry, guilt or jealousy. One does not allow oneself to think these thoughts atother times of the day.
Environmental Changes
Environmental Changes can be designed to reduce stress. This may be as extremeas changing job or residence or as minor as painting a room a favourite color or
adding a picture, candle, or basket. The short time inconvenience of remodellingmay be worth the long-term stress reduction. Temporary changes in jobs can addvariety and stimulation.
Humor
Humor related to an attitude toward life is most likely to reduce stress. There is acluster of qualities that characterize this frame of mind, including the flexibility,spontaneity, unconventionality, shrewdness, playfulness, humility and irony.
Centering
Centering helps reduce stress by bringing the mind and body back into balance.With left sided dominance, intuitive, aesthetic, and creative functions are reduced
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under stress. To center oneself, one is to put ones tongue on the centeringbutton, which is about one quarter of an inch behind the upper front teeth. Thisspot apparently stimulates the thymus gland, weaken the effect of stress, andbalances the cerebral hemisphere.
Nutrition
Good nutrition helps maintain the body for full functioning. Eating a balanced diet,taking vitamin supplements and drinking plenty of water are important.
Exercise
Regular, vigorous exercise can also help one withstand chronic stress. Aerobicexercise elevates the heart rate during and for a period after the exercise. Therange of elevation necessary to produce an aerobic effect is from 60% to 80% ofthe maximal heart rate the person can achieve, which is calculated at 220 minusthe persons age in years. Jogging, cycling, and swimming are particularly good
aerobic exercises. Dance allows to stretch and strengthen muscles and reducetension.
Sleep
Sleep is also important for dealing with stress. Sleep needs decrease with age, andpeople may awaken several times during the night as they grow older. This shouldnot be confused with insomnia, which is prolonged inability to sleep. There arethree types of insomnia: (1) initial, when it takes more than 15 minutes to fallasleep; (2) intermittent; with awakening during the night and difficulty returning tosleep; and (3) terminal, with early morning awakening and inability to go back tosleep.
RELAXATION
Abdominal Breathing
Numerous techniques can be used to foster relaxation. Abdominal breathing is aquick method. When stressed, people tend to breath in short, shallow breaths.Consequently, the lungs do not feel completely. The remaining air is stale, andoxidation of tissues is incomplete. Muscle tension results. Without beingconspicuous, one can take a few abdominal breaths almost everywhere at anytime.
Massage
Massage can relieve tension; provide passive form of exercise, and foster tactilecommunication. It stimulates relaxation and flexibility.
Meditation
Meditation focuses attention on an experience, helps one become aware of onesresponse, and facilitates the integration of the physical, mental, emotional, andspiritual aspects of ones life.
Visualization and Mental Imagery
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Visualization and mental imagery can be used to relax. One starts in relaxedposition and visualizes pleasant thoughts. One can meditate on a visualize coloredobjects such as blue sky, white cloud, green tree or pink flower.
Music
Soft classical music can help release feelings and emotions and bring aboutrelaxation.
Baths
Water is a relaxant. One should fill the bathtub with water that is bodytemperature and immerse oneself up to ones neck for about 15 minutes.
CONFLICT THEORY
Conflict, which is closely related to power and political issues, is inevitable and can
be constructive or destructive. It may offer an individual personal gain, provide
prestige to winner, be an incentive for for creativity, and serve as a powerful
motivator. Indeed, there seems to be an optimal level of conflict or anxiety
necessary for effective functioning. Conflict that is managed instead of avoided,
ignored, or suppressed can be used effectively. If conflict it goes beyond theinvigorating stage, it becomes debilitating. Conflict is warning in to management
that something is amiss, and it should stimulate a search for new solutions through
problem solving, the clarification of the objectives, and the determination of the
group boundaries. However, eliminating conflict is not necessary. If managers
learn the sources and types of conflict and how to manage them, they can
minimize stress on individuals and the organization and maximizes effectiveness.
SOURCE OF CONFLICT
Cultural differences may contribute to differing attitudes, values, beliefs, and
behaviours. Conflict can arise because the individuals involved do not have the
same facts. They define the problem differently, have different pieces of
information, place more or less importance on various aspects, or have divergent
views on their own power and authority. Varying goals and objectives or
contrasting procedural strategies for accomplishing mutually acceptable goals
produce conflict. Variation in personal value systems or in perceptions of ethical
responsibilities can lead to divergence in choices of both goals and methods, thus
producing conflict.
When people work together in a complex organization, there are numerous
sources of conflict. Conflict increases with both of number of organizational levelsand the number of specialities. It is greater as the degree of association increases
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and when some parties depend on others. Competition for scarce resources,
ambiguous jurisdictions, and the need for consensus all contribute to conflict.
Communication barriers impede understanding, and separations in time and space
fosters factionalism rather than the mutual cooperation. Although standardized
policies, rules, and procedure regulate behaviour, make relationships more
predictable, and decrease the number of arbitrary decisions, they impose addedcontrols over the individual. Men and women who value autonomy are likely to
resist such control. Clearly, the sources of conflict are endless, and the number of
conflicts increases with the unresolved differences.
TYPES OF CONFLICT
Structurally base conflict either vertical or horizontal .Differences between
managers and staff associates (vertical conflict) are often related to inadequate
communication, opposing interest, and lack of shared perceptions and attitudes. In
vertical situations, managers often attempt to control staff associates behaviour,and the staff associates resist, often causing managers to apply their position
power through impersonal bureaucratic rules. Line-staff conflict, which is usually
horizontal, is commonly a struggle among the domains related to activities,
expertise, and authority and is often to interdepartmental strife.
Interdepartmental differences are related to the degree of interdependence
among departments. Interdependence demands collaboration, and the later
provides the occasion for conflict. The need for the consensus, the work sequence,
and common use of shared facilities or services are areas of interdependence
aggravated by differing departmental goals. Both the personalities and the status
of the individuals involved affect attitude such as trust and cooperation, which arejust as important as the communication and interaction structures.
There are several types of role conflict. Intrasenderconflict originates in the
sender who gives conflicting instruction or expects conflicting or mutually
exclusive behavioural responses. For example, the same supervisor may demand
a higher quality of nursing care, refuse to allow the head nurse to fire equipment
help, and, in an effort to cut cost, refuse to increase an inadequate staff or to
permit overtime.
Intersenderconflict arises when an individual receives conflicting messages from
two or more sources. For example, management may implement an incentive plan
to stimulate production and peer pressures may discourage rate busting. In
university settings, the dean may expect department chairpersons to function as
administrators, and the faculty may expect them to act as their advocates. The
matrix organization that imposes project management on a functional structure
creates intersender role conflict.
Interrole conflict can occur when an individual belongs to more than one group.
Simultaneous, multiple roles within the same organization or the conflicting
expectations that result from being a member of more than one organization are
sources of such conflict. For example, a person may be expected to attend twodifferent committee meetings at the same time. Job expectations can easily
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within a limited time period. As a result, quality is sacrificed for quantity, the ego
threatened, and frustrations develop.
REACTIONS TO CONFLICT
Numerous psychological mechanisms exist for coping with ones own behavioralreactions to conflict, but such stress contribute to somatic reactions, for example,
cardiovascular diseases.lists some common reactions to conflict.
Sublimation is one of the most constructive psychological mechanisms
whereby unacceptable feelings are repressed and channelled into socially
acceptable activities. Energy from hostility and anger that would be
destructive if expressed directly is diverted with positive results into other
activities, such as jogging, tennis, or community service. Vigorous physical
activityoften reduces interpersonal aggression.
People who are displeased with the results of their behaviour may increasetheir efforts. Working longer and harder is likely to increase productivity.
Flight into activity, a defense mechanism whereby a person keeps busy to
avoid thinking about problems, provides some temporary relief but does not
solve the problems.
Identification is the practice of enhancing ones self esteem by imitating
anothers behaviour. The values and beliefs of the other person are
internalized, and both achievements and suffering experienced vicariously.
This illustrates the adage, If you cant beat them, join them. An individual
may compensate for a real or imagined inadequacy in one area bysubstituting a high degree of proficiency in another area. For example, one
who lacks social skills may excel academically.
Goals may be reinterpreted to attain an unmet goal, or the goal may be
lowered or another goal substituted. A person promoted to vice president
may decide that the vice presidency is a satisfactorily position. A rejected
applicant may find another job the applicant enjoys more.
Rationalization provides acceptable explanations for undesirable beliefs or
behaviours. Managers may find reasons to fire someone they do not like or
pad the expense account because everyone does it.
Attention getting may involve seeking highly visible jobs, engaging in loud
or excessive talking, wearing bright or sexy clothing and unusual hair styles,
or driving flashy cars. These displays are destructive only if they divert
attention from problem solving.
When individuals repress unacceptable behaviors and values and substitute
the opposite attitudes and behaviors, they are using a coping mechanism
called reaction formation. For example, an employee who was denied a
merit pay increase may defend the manager and vigorously support the
related policies.
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of-shift report in a timely way, and patients do not get the care they deserve at the
beginning of the shift. People have to tell you what you missed, and we all seem to
get off with the bad start. Dealing with personalities escalates conflict and is not
appropriate. We should separate the person from the problem. Issue expansion
includes issues form other times. We should stay focused. Bickering often makes
conflict worse unless we identify the problem causing discomfort and take aproblem-solving approach. Coalition formation gets other people involved and is a
power strategy. Constricting others and making threats escalate conflict. One of
the most difficult situations to handle is intentional hurt. That may lead to revenge.
STAGES OF CONFLICT
Conflict may be divided into four progressive stages: latent, perceived, felt, and
manifest. Latent conflictis a phase of anticipation in which antecedent conditions,
such as scarcity of resources, predict conflict behavior. When change is required,
the manager anticipates differences of opinion about the desirability of the
change, how it should be implemented, and how the consequences should be
handled.
Perceived conflict, which may or may not be discussed, indicates a cognitive
awareness of a stressful situation. Ones personal perceptions can contribute to
either an accurate or inaccurate assessment of the situation and affect the amount
of threat and potential loss the individual anticipates. Conflicts can be perceived
when antecedent conditions do not exist, such as when individuals have a limited
knowledge of the facts or do not know others opinions and values. For instance, a
manager may think there are limited resources or that someone else wants to use
the same materials when, in fact, there is plenty for everyone or no one else isinterested anyway. Personal perceptions also can help to avoid conflict. A
suppression mechanism may be used to ignore conflict that involves low potential
loss or is only minimally threatening. An attention focus mechanism helps the
individual select which conditions to change and which is to ignore.
Affective states such stress, tension, anxiety, anger and hostility are present
during the felt conflict. Feelings and attitudes may create or avoid conflict. Trust,
for example, is a significant factor in the development of a manifest conflict. If the
individuals involved possess trusting attitudes, they share information and control
and recognize their mutual vulnerability. In the absence of trust, individuals maywithhold information so it cannot be used against them or distort communications
to their advantage. They may scheme to increase their control over others and
strive to decrease others control over them. Clearly, trusting attitudes may
prevent potential conflict, and the lack of them may actually create conflict. Two
self-serving individuals are more likely to have manifest conflict than a dominant
and submissive pair.
The personalization or depersonalization of the situation affects the evolution of
conflict. When the situation is personalized, the individual is threatened or judged
negatively. With a depersonalized approach, the behavior rather than the
individual is identified as creating the problem. You are wrong is personalized,whereas your views are very different from mine is depersonalized. Personalized
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comments increase anxiety; a depersonalized approach is conducive to problem
solving.
Manifest conflict is overt behavior resulting from the latent, perceived and felt
conflict. It can be either constructive or destructive to problem solving.
Unfortunately, aggression, competition and other defenses are learnedunconsciously, whereas problem solving requires a more deliberate, conscious
effort.
CONFLICT MANAGEMENT
NATURE OF CONFLICT
Interactive processes of leadership are multifaceted, and the management of
conflict might well be the most challenging process of all. Acknowledging the dual
nature of conflict as potentially constructive or destructive and recognizing the
cues of each is the goal of managing conflict.
Anger is frequently a response to conflict. Lyon differentiates between situational
anger and chronic anger. Situational anger is energizing and constructive and
arises when realistic expectations are not likely to be met and involve the
following criteria: (1) the expectation has been clearly communicated; (2) persons
involved have the capability, knowledge, time and material resources to meet the
expectation, and (3) persons involved are willing to do what is expected.
Situational anger is empowering, and Lyon cites Florence Nightingales anger as
an example of how effective it can be in creating opportunities for nurses to
practice and improve health care. Nightingales anger was frequent, situational,
data-driven, and about matters that were changeable. She used her anger
effectively for action to correct appalling conditions in Londons hospitals. Lyon
challenges nurses today to empower themselves to change what is changeable
through Nightingale power. It can be used in variety of situations---in major
events or those of less consequence.
Where there is concern about an issue, collect data and present it, along with
suggestions on how the situation can be turned around, to enhance the nursing
practice. When nurses follow through with their concerns, they communicate to
others what nursing brings to health care that no other discipline can provide.
Keeping conflicts from getting out of control requires communication between
participants. Managers need to assure the staff that open sharing can be safe and
in their best interest as long as there is respect shown to each other. The open
communication should continue until there is consensus.
Not all conflicts are bad. Some conflicts are preventive and reduce hindrances to
goal attainment. Effective leader learn to curtail conflict on one hand and to design
or allow its influence on the other, becoming increasingly astute in determining the
need for each. Obsolete practices of entrenched groups can be shaken loose by
allowing or imposing conflict events. For example, identifying different
expectations that introduce new ideas and ways of doing things can pump newblood into stagnant, but otherwise competent, groups. Members gains new
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appreciations and readily incorporate changed expectations if the conflict event is
managed well. In the case of destructive conflict, early intervention is needed to
diffuse volatile emotions that threaten an attainment of the groups purpose.
Disarming instigators in some way through the use of various techniques is one
way of handling destructive conflicts are offered in the following section.
Collaborative conflict resolution is characterized by an approach when people
attack problems rather than each other. In order to avoid escalating conflict that
can occur when opposing forces hold different perspectives, participants should
answer some basic questions before entering into a collaborative effort. An
analytic approach includes consideration about: (1) what is essential and what can
be given up, (2) what the other person wants, (3) if either side holds false
assumption or incorrect perceptions, (4) what is the best strategy to use, (5) how
to handle hot button issues should they arise and (6) what precautions will
prevent further conflict? Preparation for collaborative conflict resolution pays
valuable dividends in terms of relationship, time, and the prevention of stress.Another technique to enhance collaboration is centering. It is a method that is
valuable in controlling stress during conflict resolution efforts. The goal of
centering is to relax the body and open the mind. It strengthens ones psycho-
physiological state and produces emptional and physical stability that affects
relationships and the environment. It allows individuals to move away from a line
of conflict and redirect negative energies.
In settings where conflict has traditionally been viewed as destructive, a new look
can broaden perspectives to consider the potential benefits that might result. A
simple question (will some change harm or help a situation?) leads to analysis,
which is the first stage of conflict management. Analysis reveals the nature of the
particular conflict, which must be considered within the context of a given
situation and point in time to determine its potential outcome.
The degree of conflict in a setting is an important factor to consider when
analyzing its effects. Situational factors influence the point at which a conflict is
good or bad. Competent groups handle conflicts differently than weak groups. The
collective strength of effective groups accommodates weaknesses among its
members. Such accommodation is not found in ineffective groups. The style and
strength of leadership operating in a specific setting influences individuals and
groups responses to disruptive events. The overall internal climate, therefore, isan important determinant of the outcome of any given conflict. It is important to
acknowledge the fluid nature of factors that contribute to the internal climate so
that frequent monitoring of the environment occurs. It cannot be assumed that the
cohesiveness of a group is constant.
Conflicts do not fall on a fixed point on a scale from beneficial and growth
producing to harmful. Multiple interactive situational factors determine the merit
of each. A conflict event might produce the cutting edge needed for growth at one
point in time and cause problems at another. For example, in times of
organizational prosperity, an announcement of no raises or cutbacks in salaries
will have a very different outcome on the workers than at that time of economic
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constraint and retrenchment that threatens job security. The same announcement
with the same individuals, but with different situational factors, produces different
consequences. The assumption that dissatisfaction can be expected from the
former situation and cooperation from the latter could be quite accurate
depending on the degree of shared information, understanding and fairness. If cuts
only affect the staff, while managers remain completely unaffected, and noexplanations are given, a perception of misuse power is likely, whether or not it is
true. Conflicts noted in misunderstanding, lack of cooperation, misuse of power,
and unfairness generally produce detrimental outcomes. At times, skilled
negotiators are needed to settle disputes when cooperative efforts within a group
fail. Differences in perceptions of events occur from time to time, and it is
important that nurses develop an appreciation of conflict as a significant force
influencing nursing practice. Failure to understand or handle conflicts
appropriately can account for serious internal professional problems.
BASIS OF CONFLICT
Conflict can be of an intra-psychic, interpersonal, or intradepartmental nature.
Nurses encounter varying degrees of each and need to develop understanding and
skill in managing them. Individuals can experience serious internal personal
conflicts that temporarily force reordering of their priorities. Personal conflicts can
put an individual at variance with work goals. In such instances, the collective
strength of effective work groups can temporarily compensate for an individuals
poor performance, but resolution is ultimately the responsibility of the individual.
Interpersonal influences, such as personality differences and conflicting ideas,
produce conflicts that can lead to either positive or negative results.Disagreements between individuals can be good or bad based on the degree of
mutual respect shared between them. The outcome of any interpersonal conflict is
related to complex, time related, situational factors surrounding the entire event.
Conflict is frequently associated with felt, unequal distribution of power, status,
and resources. It may be real or the result of inaccurate perceptions. In either
case, problems arise that must be handled swiftly if complications are to be
avoided. The outcome of these conflicts is determined by four critical forces: the
issue, power base of participants, cooperation between participants, and
communication. Selected courses of action can keep issues to manageableproportion or can escalate them. Power can be used to coerce or to compromise.
Individuals can hold onto bias or to work to dissipate it. Information can be freely
shared or withheld as means of control, and listening can become an integral part
of communication.
Clause and Bailey describe the use ofpower in two ways: directive and synergic.
Directive power shapes others for the purpose of advancing the interest of the
power wielder and is viewed as negative force. It is an example of unequal
distribution of power. Synergic power, however, incorporates group values and
cherishes other people. Synergic power is an essential element in balancing
control in competitive environments. Nursing is in a competitive environment inwhich bureaucratic goals dominate, putting professional goals and values at risk.
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Strong cohesive voices from nursing, plus intelligent and articulate nurse
representatives, are necessary to keep professional values/bureaucratic efficiency
conflicts to manageable proportions in complex organizations. In todays climate of
heath care delivery, ways must be found to conserve resources and use wisely
what is available. Professional nurses must spend their time providing professional
services rather than secretarial and hotel-typed activities that frequently consumetoo many professional nurse hours. An honest look at practices might reveal that
some nurses purposely hold on to non-nurses activities because they can provide
opportunities for closure task, which is satisfying, whereas many professional
activities leave nurses with some ambiguity more effectively.
Recognition of the basis of conflict can be helpful in managing it. Recognizing
events that are bound to be problematic can allow for effective interventions to
reduce their magnitude or to eliminate them altogether. Decisive action is
complex, and analysis of the premises from which action was formed is ongoing
and interactive.
Examples of Common Conflicts in Nursing
Nobel and Rancourt present evidence of a lack of cohesiveness in perceptions and
values among nurses, which causes major intradepartmental conflicts. They
discuss different modes of knowing and knowledge-accessing styles as causes. As
a result of the differences, nurses perceive the world of nursing and how they
conceptualize legitimate knowledge form opposing viewpoints. Educational
preparation was suggested as one factor in accounting for the differences, with
university-educated nurses being more flexible and broadminded about conflict
situations. Nurses with broader educational backgrounds were able to appreciate avariety of perceptions about a situation, whereas non-degree nurses tended to
hold on to their own perception as being correct. An unwillingness to develop
greater flexibility can lead to anger as responses to conflict.
Earlier research by Kramer and Schmalenberg has shown that commonly occurring
conflicts in nursing can be categorized according to type. Labels given to the types
of conflicts help identify the source and participants of conflict in nursing and
provide clues about interventions. Examples of classic conflicts in nursing include
professional/bureaucratic, nurse/nurse, nurse/doctor. Many nurse will be able to
see themselves in each one of these situation at one time or another. How theyare managed and what is learned from them is important. A description of each
type follows.
Professional/bureaucratic conflicts are the result of an incompatibility of
expectations produced by the system and perceived professional standards and
responsibilities. An imbalance of power is frequently at the root of such conflicts.
As such they lead to a great deal of frustration for nurses who feel helpless in a
situation.
Nurse/nurse conflicts results when directing values toward the philosophy of
nursing are held by nurses who work together. The differences interfere withteamwork. There can be ongoing problems between nurses who are consistently
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task oriented and those who wish to do holistic care. Assignment preferences of
task-oriented nurses might be based on the procedures to be performed, whereas
nurses who prefer holistic care continuity of patient care from admission to
discharge. Both approaches cannot exist on the same unit. Recently, nursing has
experienced the need for sensitivity training in order to manage staff conflicts that
arise out of multicultural issues. Martin, Wimberly, and O Keefe present a newview of multiculturalisms impact on the healthcare industry. U.S. standards
emphasize the individual, competition and accomplishment. Nurses strive to assist
patients to become more independent in healthcare matters. Western language is
considered to be low context, with many words used to make a point. In contrast,
eastern cultures are group oriented, and individual is subordinated. Harmony is
prized, and language is considered to be high context, with only a few words used
for necessary communication. Philosophical resources can become sources of
misunderstanding that can turn into conflict when planned efforts to improve
understanding are neglected.
Nurse/doctor conflicts spring from different expectations of each other in the
delivery of care. The stereotype of physicians dominating patient care has for
years submerged nursing. Some nurses continue to feel a need to compete with
doctors, and according to Cox and Sofield there remains instances of severe verbal
abuse of nurses by doctors. However, some doctors and nurses have worked
together and shown mutual respect for each others expertise and bottom-line
care outcomes. A trend toward educating doctors and nurses together for specific
areas of learning results in improved collaboration between the two groups. The
outcome promotes good practice, fosters respect for each other, and promotes
professional satisfaction. There are differences in the medical model and thenursing model. Each emphasizes different aspects of health care that
complement each other. Conflict comes about because of an imbalance of power
traditionally found in the system. Development of collegial relationships in which
there is mutual respect for each others complementary roles can prevent the
time-consuming and senseless problems that take attention away from the shared
goals of nurse and doctors. Nurses who take nursing forward through collaboration
recognize nurse and doctor contributions to health care as interdependent and
equal. They value nurses as full members of health care teams, and identify what
is essentially nursing in an overall plan of care. They recognize that incorporating
new technologies into healthcare is essential today and can be done without losingthe human element of compassion and ethical caring that meets spiritual and
emotional needs.
APPROCHES TO MANAGING CONFLICT
Some common approaches to handling conflict are avoiding, accommodating,
compromising, collaborating and competing (Box 6). Avoiding creates lose-lose
situations through unassertive and uncooperative means. The conflict is simply not
addressed. This approach may be appropriate when the other party is more
powerful, the issue is unimportant, one has no chance of meeting the goals, or the
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cost of dealing with the conflict is higher than the benefit of the resolution. It may
also be used when it is more appropriate for others to solve a problem, when more
information is needed, or when one wishes to reduce tension and gain composure.
Withdrawing from a conflict does not resolve it, and the individual who retreats
frequently harbours a gnawing anger over a situation that drains energy needed
for more constructive purposes.
Accommodating is cooperative but unassertive. It is self-sacrificing---the opposite
of competing. One neglects ones own needs to meet the goals of the other party.
It is appropriate when the opponent is right, the opponent is more powerful, or the
issue is more important to someone else. It can be used when preserving harmony
is important or when collecting social credits is necessary for later, more important
issues. By complimenting ones opponent and accentuating points of agreement,
one may smooth out an agreement or minor issues, but the real problem still have
to be dealt with.
Compromising moderates both assertiveness and cooperation. It addresses a
problem more effectively than avoidance but less than collaboration.
Compromisers are willing to yield less than accommodaters but more than
competitors as they seek expedient, mutually acceptable answers. Because both
parties feel that they sacrifice something, they are only partially satisfied, and a
lose-lose atmosphere results. Compromising is useful for reaching expedient
answers for limited periods when the goals are only moderately important and the
parties have equivalent power.
Collaborating is assertive and cooperative. It is a win-win strategy. It contributes to
effective problem solving because both parties try to find mutually satisfyingsolutions. This method integrates insights from different perspectives with the
commitment developed through participation and the resolution of hard feelings.
Problems are identified, alternatives explored, and ramifications considered until
difficulties are resolved. Unfortunately, it may take more time than the results are
worth. Generally this is a most effective method of conflict resolution. It should be
used for important issues and can be used to find creative solutions to
interpersonal problems.
Competing is a power-oriented mode that is assertive but uncooperative. In
competition one is aggressive and pursues ones own goals at anothers expense.This creates a win-lose situation. Nevertheless, it is appropriate when a quick or
unpopular decision is needed, when the person is very knowledgeable about the
situation and able to make a sound decision, or when one must protect oneself
from other aggressive people. If this strategy is used too often, colleagues may
become afraid to admit mistakes and may simply say that they think the
aggressor wants to hear. A manager can always fall back on authority and give
orders to a subordinate, but because the resolution is forced, it almost certainly
will be unsatisfactory.
A foundation of mutual trust must underlie any attempt to understand alternative
views and to actively seek solutions that will allow each party to achieve its goals.This trust creates an atmosphere conducive to successful conflict resolution.
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DEESCALATION-OF-CONFLICT TACTICS
Listening is a good way to deescalate conflict. It shows that you care about the
person by taking your time to listen to them. The other person may be able to talk
through the problem and solve it, particularly if you ask questions that lead her
through problem solving, such as the following: What is the problem? What areyour options? What will happen if you do that? What do you think is the best way
to handle this situation? What are you going to do? Showing tact and concern to
others is important. Appealing to de-escalation by saying something such as I
dont want to fight about this can help. Goodwill gestures such as Lets get a cup
of coffee and discuss this and allowing the airing of feeling are good. Our feelings
often dissipate after we talk about how we are feeling. We usually feel better after
talking about our feelings. Negative inquiry is an assertive technique of asking for
more information and trying to resolve the problem. When we are criticized, we
tend to get defensive, which escalates the conflict. Then the other person has to
work harder to get us to understand where we went wrong. When we ask for moreinformation, the criticizer may end up defending the accused.
Using metacommunications, one discusses the communication as it is occurring. I
am trying to talk to you, and you are walking away with me.It is important to
respond to all levels of communications, the facts and the feelings. I know that it
is my weekend to work, but I am angry that I have to work. Once again,
expressing the feelings helps dissipate them. Focusing on the facts helps with
reality testing and problem solving. Fractionalization breaks the problem down into
more manageable components. Position papers help move people from opposite
poles to a more middle-of-the-road stance. People will often follow flat statements
with qualifiers. Problem solving is a very effective deescalator. When all else fails,
establishment of outside criteria may be used.
STRATEGIES FOR MANAGEMENT OF CONFLICT
There are three ways of dealing with conflict: the win-lose, lose-lose, or win-win
strategy. Win-lose methods include the use of position power, mental or physical
power, failure to respond, majority rule, and railroading a minority position over
the majority. Lose-lose strategies include compromise, bribes for accomplishing
disagreeable task, arbitration by a neutral third party, and resorting to the use of
general rules instead of considering the merits of the individual cases. In win-loseand lose-lose strategies, the parties often personalize the issues by focusing on
each other instead of on the problem. Intent on their personal differences, they
avoid the more important matter of how to mutually solve their problem. Solutions
are emphasized instead of goals and values. Rather than identifying mutual needs,
planning activities for resolution, and solving the problem, the parties involved
look at the issue from their own point of view and strive for a total victor.
By contrast, win-win strategies focus on goals. They emphasize consensus and
integrative approaches to decision making. The consensus process demands a
focus on the problem, on the collection of facts, on the acceptance of useful
aspects of conflict, and on avoidance of averaging and self oriented behavior. Thusthe group decision is often better than the best individual decision.
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Problem solving strategies include indentifying both the problem and each partys
need, exploring alternatives, choosing the most acceptable alternative, planning,
defining roles, implementing, and evaluating the decision.
MEDIATION
Mediation is a friendly intervention by consent and invitation for settling
differences between parties. It is negotiation that involves a third party who is
knowledgeable about negotiation procedures can help the parties do their
bargaining. A mediator plays several roles. The mediator serves as housekeepers
who reviews the ground rules and keep the records. The mediator serves as the
ringmaster who chairs the meeting and determines when to recess, when to
adjourn, and when to have separate meetings. The mediator helps the parties
define the problems, identify the issues, and prioritize multiple issues. The
mediator is educator who facilitates the bargaining process and helps each party
consider how to achieve his/her objectives while accommodating the opponent to
create a win-win solution. The mediator is a communicator and an innovator.
Innovation can come about by making suggestions, but the suggestion should be
explored in separate meetings because the mediator should never raise questions
in the presence of both sides that could be embarrassing from either side. If one
party opposes the suggestion, it can be dropped. The mediator is a problem
explorer who helps analyzes issues from a variety of viewpoints; a resource
expander who links parties to outside resources; and an agent of reality who helps
creates a reasonable and implementable settlement. The mediator is a leader who
takes initiative to advance negotiations forward procedurally and may at times
offer suggestions for consideration. The mediator may also serve as a scapegoat
and take some responsibility and blame for an unpopular decision.
ARBITRATION
Arbitration is a structured method of dispute resolution. The arbitrator does not
interact with the parties but renders a binding decision based on a formal
presentation of information.
INTRAPERSONAL CONFLICT
Intrapersonal conflict occurs within the person and usually involves a struggle over
values, desires, or incompatible activities. The conflict is internalized. One shouldset personal goals and priorities and do problem solving. Being self aware and
working to resolve the conflict as soon as possible are important for the manager
to remain physically and psychologically well. The manager should help associates
be self aware and do problem solving too.
INTERPERSONAL CONFLICT
Interpersonal conflict is inevitable, but the manager can lessen its impact by
coaching staff associates in assertive communication and fair fighting. Engaging in
a fair fight demands that individuals with a complaint first ask their opponent for a
meeting. Once a time and place are agreed on, both parties should determinewhether their manager should be present. Moreover, a fair fight demands that
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both parties know the purpose of meeting so neither will be caught off guard---
each can be prepared. The encounter should begin with a statement of the
problem. The manager, if present, should act as a mediator, asking the complainer
to explain the perceived problem to the opponent. The opponent then should
relate her understanding of how the complainer perceives the problem. After each
has spoken, each can clarify any differences over the statement of the problem.Next, the opponent describes her perception of the problem; this description then
should be followed by the complainers repeating her understanding of how the
opponent perceives the problem. Again, there is a pause for clarification.
Helpful strategies for mediating interpersonal conflict include the following
(Loveridge and Cummings, 1996):
Do not blame anyone for the problem.
Focus on the issues, not personalities.
Protect each partys self-respect.
Facilitate open and complete discussion of the issues.
Give equal time to each party.
Encourage the expression of both positive and negative feelings.
Encourage each party to listen actively and try to understand the otherpersons point of view.
Help develop alternative solutions.
Summarize key points and plans.
Later follow up on the plans and give positive reinforcement as appropriate.
Facilitate further problem solving as necessary.
GROUP CONFLICT
Team development can help prevent and resolve conflict. Planning, goal setting,and rating goals represent the first team development. The statement of the coremission of the team is developed by brainstorming and sharing individual missionstatements.
The nominal group technique is very effective for developing team-performancegoals and priorities. First, individual group member list on separate pieces of paperwhat they think team performance goals should be.
INTERGROUP CONFLICT
Intergroup conflict is common and can be dysfunctional. As with interpersonalconflict, intergroup resistance may result from low trust, poor communications,and false assumptions.
ORGANIZATIONAL CONFLICT
Organizations in conflict display the collective symptoms of their members.Personnel feel frustrations at work. If they do not think their skills are being used,they experience loss of self-esteem and sense of powerlessness, both of whichlead to withdrawal from the situation instead of an attempt to solve the problems.
PREVENTION OF CONFLICT
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Careful development of an organizations structure, strategic, and comprehensiveplanning, management and organizational development, and careful selection andplacement of personnel help prevent organizational conflict.
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