CONFLICT MANAGEMENT By: Miss Ann H. Abrigunda, RN Definition: Conflict is present in all organizations.

This is especially true in hospitals because of the complexity of the institutional relationship, interactions among the staff, and their dependence on one another. Poorly managed conflict is the problem. It can result in distrust among employees, ultimately affecting the quality and efficiency of patient care (Zimmermann, 2002). Conflict management is the process of planning to avoid conflict where possible and organizing to resolve conflict where it does happen, as rapidly and smoothly as possible) http://www.etu.org.za/toolbox/docs/building/conflict.html). According to Marquis and Huston in 2003, the optimal goal in resolving conflict is creating a win win solution for all involved. This outcome is not possible in every situation, and often the managers goal is to manage the conflict in a manner that lessens the perceptual differences that exist between the involved parties. Venzon and Nagtalon stated in 2006 that conflict management keeps conflict from escalating, makes work productive, and helps translate conflict into a positive or constructive force. Managing conflict effectively requires an understanding of its origin. Some of the most common sources of organizational conflict are communication problems, organizational structure, and individual behavior within the organization (Marquis and Huston, 2003). Discipline In using discipline to manage or prevent conflict, the nurse manager must know and understand the organizations rules and regulations. It is the last resort in correcting undesirable employee behavior. The following rules will help in managing discipline: Discipline should be progressive. The punishment should fit the offense, be reasonable, and increase in severity for violation of the same rule. Assistance should be offered to resolve on the job problems Tact should be used in administering discipline The best approach for each employee should be determined. Managers should be consistent and should not show favoritism The individual should be confronted and not the group. Disciplining a group for a members violation of rules and regulations makes them angry and defensive, increasing conflict Discipline should be clear and specific It should be objective, sticking to facts. It should be firm sticking to the decision Discipline produces varied reactions. If emotions are running too high, a second meeting should be scheduled. The nurse manager performing the discipline should consult with her supervisor. One should expect to be overruled sometimes. Knowing the boundaries of authority and the supervisor will avoid most overrules. A nurse manager should build respect, trust, and confidence in her ability to handle discipline.

Considering Life Stages Conflict can be managed by supporting individual nurses in achieving goals that pertain to their stage (Swansburg, 1993). The three developmental stages are: The young adult stage. This is the stage during which the nurse is establishing a career. People at this stage pursue knowledge, skills, and upward mobility. Conflict may be facilitating career development. Middle age, during which the nurse becomes reconciled with achievement of lifes goals. This nurse helps to develop careers of younger nurses. After age 55, adults integrate their own ego ideals with their accomplishments. At this stage the nurse is thinking in terms of completing her work and retiring. Communication Communication is an art essential to maintaining a therapeutic environment. It is necessary to accomplishing work and resolving social and emotional issues. To promote communication that prevents conflict: Teach nursing staff effective communication and their role in it. Provide factual information to every one be inclusive, not exclusive Consider all aspects of a situation- emotions, environmental considerations, verbal and non verbal messages. Develop basic skills of: Reality orientation, by direct involvement and acceptance or responsibility in resolving conflict Physical and emotional composure Having positive expectations that generate positive responses. Active listening Giving and receiving information Techniques for Active or assertive listening Do not share anger; it adds to the problem. Remain calm and matter of fact. Respond constructively in both verbal and non verbal language. Be cheerful but sober. Maintain eye contact. Prevent interruptions. Get the problem into the open. Make the employee comfortable. Act serious. Always be courteous and respectful. Ask questions and listen to the answers. Determine the reasons for the anger. Separate fact from opinion, including your own. Do not respond hastily. Plan a response. Consider the employees perspective first.

Help the employee find the solution. Ask questions and listen to responses. Do not be paternalistic. Assertive training Open assertive communications and problem solving are particularly good approaches to dealing with conflict (Tomey, 2003). Assertiveness can be taught through staff development programs. In these programs nurses are taught to make learned, thoughtful responses. They learn to accept responsibility rather than blame others. They learn to hold people to a standard. When they are dissatisfied they do something to increase their satisfaction. Most of these assertive behaviors can be learned with case studies, role playing and group discussion (Swansburg, 1993). When they finish their training, assertive nurses will reinforce their expectation that others will do their job by positive comments. Praise and consideration promote wellness and positive individual behavior, which are linked to effective management and communication (Swansburg, 1993). Assertive people have the following characteristics (http://en.wikipedia.org/wiki/Assertiveness): They feel free to express their feelings, thoughts, and desires. They are "also able to initiate and maintain comfortable relationships with [other] people" They know their rights. They have control over their anger. This does not mean that they repress this feeling; it means that they control anger and talk about it in a reasoning manner. "Assertive people ... are willing to compromise with others, rather than always wanting their own way ... and tend to have good selfesteem". "Assertive people enter friendships from an 'I count my needs. I count your needs' position". Zimmermann stated some specific conflict management techniques to use during the process. Protect the self respect of the parties involved Avoid placing blame for the problem on either participant Allow open discussion of the problem from each party Make sure both parties listen to each other Identify the key theme in the discussion Assist the parties in developing alternative solutions Select a follow up meeting on the progress of the plan Schedule a follow up meeting on the progress of the plan Give positive feedback to both participants regarding their roles in resolving conflicts.