Vivar in her article reflected on a nursing case study and discussed the significance of conflict management for health care workers. She discussed the nature, types of conflicts, ways and strategies of conflict management and reasons for conflicts among healthcare workers.
The topic of conflict management is important for nursing practice because health care organizations often are exposed to different constructive (functional) and destructive (dysfunctional) conflicts. Dysfunctional conflicts can become reasons of increasing stress, work dissatisfaction and influence the quality of patient care. However, it is important to understand that conflicts also can be sources of innovations, growth, motivation, creativity, etc. Fritchie also describes hot and cold conflicts. Hot conflicts are similar to constructive one while cold conflicts arise when a conflict is denied.
As results of different surveys demonstrate, the most frequent reasons for conflicts in health care organizations are relationships in nurse-doctor dyads, divergent management style, different goals, limited resources, organizational changes. Also, power conflicts often can be observed in relationships between subordinate and head healthcare workers (Vivar, 2006, p. 202).
Vivar indicates that the first step in efficient conflict management is recognizing a nature and a type of a conflict. Also, the author points five most common strategies for conflict resolution. The strategy of competition suggests the dominance of one person or a group over others. Also, in the case of competition somebody become winners and someone loses in a result of conflict resolution. Avoidance can be recognized when people deny some conflict situation. The accommodation strategy involves the position of “giving in”. Using this approach one person makes concessions. The collaborative way of conflict management suggests “win-win” situation when everyone wins when both parties find the decision that is appropriate for both of them. The compromise strategy means that both parties lose something and gain something. However, the best strategy for conflict resolution is a collaboration; there are situations when it is necessary and better to use other strategies. For example, competition may be preferred when there is a limit of time and a decision must be made quickly, etc. (Vivar, 2006, p. 203).
Vivar describes case study of the conflict between leader nurse and staff included 11subordinate nurses. The main reason for the conflict between the head nurse and the nurse staff is the excess power of the head nurse. The strategy chosen by subordinate nurses to resolve the conflict is avoidance (Vivar, 2006, p. 202). Vivar reflecting on this case indicates that it seems that avoidance in the particular situation is not the efficient strategy. Avoidance can be appropriate at the beginning of the conflict when there is the lack of information to resolve a conflict. But in described case avoidance has been used during a long time and this strategy became inefficient. The head nurse uses the competitive style in the particular situation. It creates consistent tension among subordinate nurses and generate relationships built on the base of absolute dominance and obedience to the authority.
One of the main questions which can help to resolve the conflict is why subordinate experienced and new registered nurses prefer avoidance. Reasons for choosing avoidance by nurses with significant work experience can be explained by nurses` fear to make a situation worse. Also, nurses may prefer avoidance because they want to save their energy and time: instead of spending energy and time to reveal and trying to manage the conflict they prefer to direct their energy for spending more time with patients.
Inexperienced nurses may avoid conflict situation because they are at the phase of the dependence on authority. Also, new registered nurses, probably, perceive their head nurse as more experienced, powerful, a person who has more knowledge, etc. new registered nurses can feel uncomfortable with expressing their thoughts, feelings in the group because their professional environment is still strange and unexplored for them.
There are also reasons why leader nurse does not try to resolve the conflict. The first reasons may be that the head nurse does not have specific knowledge, skills for recognizing and solving conflict situation. That is why advanced courses among head and subordinate nurses must be promoted and provided (Vivar, 2006, p. 204).
One more reason that hinders resolution of conflicts is the lack of time and space for discussing conflicts which arise in nursing units. That is why it is essential to promote the necessity of conflict resolution among nurses, to encourage nurse staff and nurse managers to find the opportunity to solve conflict situation.
Probably, the best way to resolution the conflict in the particular case will be encouraging a head nurse to change her leadership style and begin to use more accommodative behavior in communication with subordinate nurses.
On the base of information from this article, I can do next conclusions which can be useful for my practical issues. First of all, I understood that conflicts can be constructive as well as negative. Conflicts may be a source of innovation, staff development, etc. That is why it is necessary to notice conflicts and to try to resolve them in the best possible and collaborative way. After reading and analyzing the article, I also understood that such strategies as competition and avoidance may be efficient in the particular context. So, now I know that avoidance, for example, may be used at the beginning of conflict situation and competition is the best choice when there is a lack of time.
Also, in the article, I found information about the reasons and fears which may hinder constructive resolution of conflicts. This knowledge will help me to recognize my fears and concerns of others nurse in future conflict situations and not allow my fears to become barriers to conflict management.
References
Vivar, C. G. (2006). Putting conflict management into practice: a nursing case study. Journal of Nursing Management, 14(3), 201-206.
