MANAGING CONFLICT

Conflict
Definition according to Merriam Webster:
strong disagreement between people, groups, etc., that results in often angry argument
a difference that prevents agreement : disagreement between ideas, feelings, etc.

Conflict occurs when two or more values, perspectives and opinions are contradictory in
nature and have not been aligned or agreed upon. It occurs naturally in and among groups
and individuals. It is an inevitable condition that is essential for change.
Conflict Process

Stage 1: Potential Opposition or Incompatibility
The first step in the conflict process is the presence of conditions that create opportunities for
conflict to develop. These cause or create opportunities for organizational conflict to rise.
These three conditions causes conflict:
A. Communication
Different words connotations, jargon insufficient exchange of information and noise in
communication channel are all antecedent conditions to conflict.
Too much communication as well as too little communication can lay the foundation for
conflict.
B. Structure
Include variables such as size, degree of specialization in the tasks assigned to group
members, jurisdictional clarity, members/ goal compatibility, leadership styles, reward
systems and the degree of dependence between groups.
The size and specialization act as forces to stimulate conflict.
The larger the group and the more specialized its activities, the greater the likelihood of
conflict.
The potential for conflicts tends to be greatest when group members are younger and when
turnover is high.
C. Personal Variables
Certain personality types- for example individuals who are highly authoritarian and
dogmatic- lead to potential conflict.
Difference in value systems Value differences are the best explanations of diverse issues
such as prejudice disagreements over ones contribution to the group and rewards one
deserves.
Stage 2: Cognition and Personalization
Conflict must be perceived by the parties to it whether or not conflict exists is a perception
issue.
If no one is aware of a conflict, then it is generally agreed that no conflict exists. Because
conflict is perceives does not mean that is personalized.
Example:
A may be aware that B and A are in serious disagreements but it may not make A tense or nations
and it may have no effect whatsoever on As affection towards B It is the felt level , when
individuals become emotionally involved that parties experience anxiety , tension or hostility.
Stage2 is the place in the process where the parties decide what the conflict is about and emotions
plays a major role in shaping perception.
Perceived Conflict
This is the stage at which members become aware of a problem.
Incompatibility of needs is perceived and tension begins as the parties begin to worry about
what will happen.
Sometimes conflict may be perceived when latent conditions are not in existence in the
system. Such a situation arises when one party perceives the other to be likely to thwart or
frustrate his/her goal.
Felt Conflict
Emotional involvement in a conflict creating anxiety tenseness, frustration and hostility is
known as felt conflict.
It is that stage when the conflict is not only perceived but actually felt and cognized.
Parties to the conflict feel that they have some conflict among themselves.
Parties become emotionally involved and begin to focus on differences of opinion and
opposing interest sharpening perceived conflict.
Internal tensions and frustration begin to crystallized around specific, define issues and
people begin to build and emotional commitment to their position.
Stage III: Intentions
Intentions intervene among peoples perceptions and emotions and overt behaviors.
These intentions are decisions to act in a given way.
Intentions are separated out as a distinct stage because you have to infer the others intent
to know how to respond to that others behavior.
A lot of conflicts are escalated merely by one party attributing the wrong intentions to the
other party.
Stage IV: Behavior
This stage is where conflicts become visible.
The behavior stage includes the statements, actions, and reactions made by the conflicting
parties.
These conflict behaviors are usually overt attempts to implement each partys intentions,
but they have a stimulus quality that is separate from intentions.
As a result of miscalculations or unskilled enactments, overt behaviors sometimes deviate
from original intentions.
This stage is a dynamic process of interaction.
o Ex: you make a demand on me; I respond by arguing; you threaten me; I threaten
you back; and so on
Conflict intensities escalate as they move upward along the continuum until they become
highly destructive.
o Ex: Strikes, riots, and wars
Stage V: Outcomes
The actionreaction interplay among the conflicting parties results in consequences.
May be:
o Functional in that the conflict results in an improvement in the groups
performance
o Dysfunctional in that it hinders group performance.
Conflict is constructive when it:
improves the quality of decisions,
stimulates creativity and innovation,
encourages interest and curiosity among group members,
provides the medium through which problems can be aired and tensions released, and
fosters an environment of self-evaluation and change.

Types of Conflict
o Intrapersonal: this happens when individuals do not live according to their own
values;
o Interpersonal: this happen between individuals;
o Intragroup: this happens among members of a specific group;
o Intergroup: this happens between two or more groups
1. Intrapersonal occurs within an individual.
Example:
When an employee needs a degree to advance his/her career yet has neither resources nor the
time to go to school.
A frequently occurring intrapersonal conflict for healthcare providers is deciding how to allocate
time with patients. This requires prioritizing and using time effectively to meet the needs of all
patients. It also requires the ability to delegate effectively. This employee has an internal fight
between what the heart wants to do and what the brain says to do.
2. Interpersonal is seen when two or more people do not agree on issues or the best way to
manage a specific problem.
Examples of interpersonal conflicts that might occur are:
o A staff member wants to take care of patients on a specific team. Staff might not
like their assignments and interpersonal conflicts might occur;
o Assignments may be heavier for the person who has been floated. This individual
might confront the person making the assignment, causing more conflicts;
o A patient becomes non-compliant with her treatment and resists the physician's
orders;
o Some staff members want to work twelve hour shifts and single parents or staff with
young children want eight hour shifts;
o Pre-scheduling to be off on holidays has created anger between employees who
have seniority and those who made their request months in advance;
o A nurse and a doctor disagree on giving specific medications to a patient with end-
stage liver disease.
3. Intragroup Intragroup conflict occurs between individuals within a specific group.
o Intragroup conflicts are most common in workplaces that divide employees into specific
teams or departments.
o These conflicts arise from objective differences of interest, and are aggravated by
antagonistic or controlling behaviors and attitudes.
o Individuals may strive for power, position, economic incentives, value differences, or
differences in gratification of personal needs.
o Often there is a mixture of all of these and these incompatibilities may develop into
intragroup conflicts.
Some signs of intragroup conflict are:
o Talking about another team member behind her/his back in a negative manner
o A team member saying they are too busy to help another member
o A team member ignoring another member when asked a question
o Failing to provide safe quality care
o Not completing work on-time
o Passive/aggressive behavior
o Complaining
o Finger pointing
o Not returning phone calls
o Not attending required meetings
o Verbal abuse
*Each behavior, by itself, does not necessarily indicate conflict. People don't always complete work
on time or answer all phone calls. Sometime they miss meetings. These individual behaviors might
be acceptable. A conflict is present when a behavior is taken to an extreme and causes severe or
irreparable damage. This is when the conflict has to be dealt with before a negative outcome affects
others and affects the quality of patient care.
4. Intergroup Intergroup conflict is defined as an incompatibility of goals, beliefs, attitudes or
behaviors between groups.
o Intergroup conflict occurs between two competing or distinct groups.
o Intergroup relations between two or more groups and their respective members are often
necessary to complete the work required to operate a business.
o Many times, groups inter-relate to accomplish the organization's goals and objectives. If
these goals or objectives are not mutually compatible conflict can occur.
Example:
Members of the hospital marketing group debating with the fiscal department about the best way to
launch a new service. If the marketing group felt that advertising the new service on the internet
was best but the fiscal department felt strongly that newspapers ads were best, this would be
intergroup conflict. Some examples of intergroup conflict are listed below.
Other Examples:
o Nurse Managers perceive that certain policy and procedures are not up to date and
do not meet the needs that change has incurred, and administration is not
concerned
o Emergency room nurses feel that the lab is not working with them in providing lab
results in a timely manner
o The shared governance group perceives that the organization is more concerned
about the fiscal bottom line than providing the needed equipment to help prevent
falls
o The nursing team on a dementia unit perceive that Nurse Managers are not
supportive of their actions when dealing with patients who are non-compliant,
possibly confused, and disrespectful

*Groups have identities.
A group's sense of its particular identity will influence how it interacts with other groups.
*Goal of group:
To focus on the tasks that needs to be accomplished. Intergroup conflict causes changes to
happen, both within the groups in conflict and between them.
*Communication is the key between groups who depend on each other. Conflict is a
common occurrence between groups, and lack of effective communication will prevent or
delay effective resolutions.
Characteristics of Conflict Situation
1. Conflicts do not just appear. Conflicts evolve.
2. Conflict is like a virus when it appears it begins to spread like crazy.
3. Conflicts are bred by differing values.
4. Conflict is energized through opposing interests.
5. Conflict is fueled by poor communications.
6. Conflict intensifies when trust breaks down.
7. Conflict is festered by incompatible goals.
8. Conflicts are encouraged by differing personalities.

*Understanding these characteristics of conflict can help any team leader in helping to establish a
strong team. If conflict can be seen for its positive results it will aid any leader and his or her team.
Conflict can be energizing for a group when it forces people out of their comfort zones. Conflict
can introduce diversity. Diversity can be seen as a wealth of information if handled in a healthy
fashion

Management of Conflict
Nurse Managers, department heads, Charge Nurses, and Team Leaders have to develop
managerial actions and structures to minimize conflicts, and they must handle conflicts in a
constructive manner and with a positive attitude, using effective communication and listening skills.
3 basic strategies for managing conflict (Sullivan & Decker, 2005):
o Win-lose
o Lose-lose
o Win-win
WIN-LOSE
o Win-lose scenarios often times involve groups and intragroup conflicts.
o When the group votes on an issue and majority rules there is a winner and a loser.
o This can erode the cohesiveness of a group and may diminish the group leader's authority.
o Another scenario could involve a nurse who has 30 years of seniority and wants a specific
holiday off and another new employee also requested the same holiday off. The senior
nurse refuses to give in and wants to win this argument.
LOSE-LOSE
o Lose-lose scenarios involve losses to both parties.
o This is often is the case when a union arbitrator in union contract negotiations gives
something to both parties and yet neither party gets what it wants.
WIN-WIN
o Win-win scenarios involve collaboration: all groups or parties work together to meet the
goals and objectives of all involved.
o Group consensus is reached after careful investigation of the situation, specified needs of
the group are understood by all, and a workable solution is reached.
o In this type of win-win scenario there is no voting or other traditional dispute measurement:
only the true group consensus counts.
o Everyone involved usually feels good about the outcome.
o This is seen when Nurse Managers and Nursing Supervisor work together to staff a unit
that is constantly needing help to cover their close observation or 1:1 patients while meeting
their own unit needs.

Reactions to Conflict

1. Avoidance
People who use this technique withdraw and detach themselves from the issue.
They do not want to assert their own perspectives nor do they want to help others resolve
the situation.
They just want to mind their own business.
People will often use avoidance if they do not have a vested interest in the situation. They
may say they are choosing to pick their battles.

2. Accommodating
When a person uses this technique, they may do so in order to avoid conflict, or to help
the other person get what they want.
A person who uses this style often gives in to others to avoid disagreements, and they may
give in to others to the extent that they compromise themselves.

3. Competing
When someone competes, their only interest is to resolve the conflict their way, rather than
clarifying or addressing the issue.
They have no interest in the well being or satisfaction of others, they just want to be right.

4. Compromising
Compromising is a mutual give-and-take.
It is often used when both parties are willing to concede and make concessions.
It is a good strategy for when
the parties want to resolve
the issue quickly.

5. Collaborating
Collaborating
is when the parties work
together with the goal of
resolving the conflict
to everyones complete
satisfaction.
The parties approach the situation with a solution-oriented, team approach.
This approach also results in buy in and a higher level of commitment.









References:
Sullivan, E., Decker, P. (2005). "Effective leadership and management in nursing" Third Edition
Addison - Wesley. Reading, MA.
Almost, J. (2006). Conflict within nursing work environments. Journal of Advanced Nursing, Vol.
53 Issue 4, p 444-453.
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