Conflict Resolution

Definition:Webster a clash, competition, or mutual interference of opposing incompatibilities, forces, qualities (ideals, interest, wills) value and belief conflict within one individual, between two or more individuals, between two or more group.

Importance of conflict:Dealing with has become increasing important to in health care institution:1.Increasing complexity of delivering health care.2.Rising expectations of those delivering and receiving health care.3.Changing role of nurse.4.Increasing competition among health care institutions.5.Pressure from Medicare.6.Increasing threat posed by legal action.

Positive aspect of conflict::Even though conflict is inevitable in organization, it dose not have to be destructive to the organization. There can be many positive consequences of conflict.

1.It provides heightened sensitivity to problem.2.Conflict can serve as stimulus in developing new facts or creative solutions when there are disagreement.3.Changing and developing to the best in the work.4.Refresh to the team activity and breakdown to the routines work.5.Increasing good relationship between health team worker into other department in the hospital.6.Increasing good competition between others hospital and make high quality of care.

Negative aspect of conflict:Conflict can result in the conflicts being suppressed, which dose not resolve, the conflict and may cause severe consequences in the future.

1.Conflict often lead to aggressive behavior on the part of those individuals or groups in conflict.2.Conflict can be very stressful to individuals.3.Bad relationship between health team worker.4.Lead to bad result reflects to the health patient.5.Increase tendency to occur many big problems.6. Conflict effect on work quality and quantity of care..

Type of conflict:There are two type of the conflict constrictive conflict (competition conflict), destructive conflict (disruptive conflict).constrictive conflict:It means building on positive things with suitable method and follow up to principles also main goal achievement to the goal without prevent goal to other person.Destructive conflict:It mean building on negative things with illegal method and no any principles also the person emphasize win and give loss to the other person into nervous environment..

Antecedate conflict

Perceived conflict Felt conflict

Manifested behavior

Conflict resolution

Resolution aftermath

Other antecedent condition:Roles are defined as the expectations of each regarding ones own and behavior.

Unclear roles.Occur when one or more parties have related responsibilities that are ambiguous or overlapping. The nurse manager might experience conflict in her responsibility as administrator versus her roles as staff member. Similar to this are unclear or overlapping job description or assignments. For example, there could be conflict over such mundane issues as the responsibility of the nurse versus transported in sending a patient to another department or moving a patient from bed to chair.

Competition for scarce resources.Could be internal (among different units in the hospital) or external (among different hospital). Internally competition for resources could involve the assigning of staff from one unit to another or the stockpiling of supplies, such as linen or wheelchair’s, by one unit. Externally, hospital may compete for patients due to reduced occupancy rates. Recently, competition for resources has become conflictive factor between nurses and physicians. Physicians have challenged the role of nurse practitioners, charging them with practicing medicine without alicense, on the basis of legal interpretations of medical and nursing practice acts. While these charges are publicly touted to promote patient care, many of the involved parties believe they really stem from economic concerns and are intended to reduce competition for health care services.

Differences in values and beliefs.Is frequent contributor to conflict in health care institutions. Values and beliefs result from the socialization processes that individual experience. Conflict between physicians and nurses or between nurses and administrators, or even between nurses with associate degrees verses diploma verses baccalaureate degrees often come from differences in values and beliefs. The latter division raises conflict over which education is the best preparation for practice.Task interdependency.Is a potential source of conflict in health care institutions. The three levels of functional interdependence are pooled interdependency, sequential interdependence, and reciprocal interdependence.

Pooled interdependence exits.When units are relatively independent of each other they are members of the same organization and draw their budgets and other resources from a common pool. An example in a health care unit might be the interaction between the finance department and the nursing department. Direct interaction seldom occurs, and managing the relationship between these units is not difficult.Sequential interdependence.Is where the output of one unit is the input of another unit, where the tasks of the first unit need to be performed before the second unit can perform its task. This I similar to the relationship between support such as admission, discharge and nursing. Functional nursing involves sequential interdependence. Sequential interdependence can become a particularly difficult situation when the dependent unit is of higher status for example, when a nurse has to wait for housekeeping services.

Reciprocal interdependence.Is where the output from each unit becomes the input of the other unit and vice- versa. The relationship between the nurse and the physician is typically reciprocal in nature, as are the relationships among shifts; among the LPN, NA, and the RN; and between units such as radiology and the medical-surgical unit. Team nursing and primary nursing are also examples of reciprocal interdependencies.Distancing mechanisms or differentiation.Serve to divide a group member into small distinct groups, thus increasing the change for conflict. This tends to lead to a (we- they) distinction. Examples might be opposition between intensive care nurse and floor nurses, night versus day shifts, and nursing aides versus registered nurses. One of the more frequently seen examples is distancing between physicians and nurses. Differentiation among subunits is also due to differences in structure. Many of the administrative units are

very bureaucratic in nature, nursing unit are structured on amore professional basis, while the staff physicians have even ad efferent structure, and the non staff physicians, who are entrepreneurs, are relatively independent from the heath care unit.

Unifying mechanisms.Occur when greater intimacy develops or when unity is sought. All nurse managers might be expected to reach consensus over an issue but experience internal conflict, as they may not be wholly committed to the group’s position. The most classic example of a unifying mechanism is the relationship between husband and wife. As intimacy increase, issues arise that would not normally cause conflict in a casual relationship but do affect these closer relationships. A nurse manger friendship with a staff member may lead to this type of conflict.Structural conflict.Is commonly seen in the health care environment is often structural conflict. This conflict evolves from the relationship between members of organization. These relationships

((superior to subordinate, peer to peer) provoke conflict due to inadequate communication, competition for resources, opposing interest, or a lack of shared perceptions or attitudes. A nurse manager (superior) stimulates conflict between herself and a staff member (subordinate) in reprimanding the staff member for some inappropriate act. If the nurse manager is unable to communicate to the staff member why the act was unacceptable, opposing interests develop and the conflict is sustained. In this situation. Positional power is often imposed. Positional power refers to the authority that is inherent in a certain position for example, they director of nursing service has greater positional power than a nurse manager.

  Other aspects of the conflict process:Perceived and felt conflict are parts of the conflict process that explain how conflict may occur when the parties involved view the situations or issues from differing perspective’s or misunderstand each others position or when positions are based on limited knowledge perceived conflict refers to each parities perception of the others position it is a logical and impersonal set of conflicting conditions present between two or more parities felt conflict refers to the feelings of opposition within the relationship of two or more parties it is characterized by mistrust,hostility,and fear.To demonstrate how this process may work, consider this situation nurse manager joins and surgeon smith have worked together four years they have mutual respect for each others ability and skills and communicate frequently when their subordinates clash, they are left with conflicting accounts of a situation where the only agreed-upon fact is that a patient received less than appropriate care now consider the same

the same scenario if the nurse and doctor have never dealt with each other or if one feels that the other will not approach the problem constructively in these situations The attitudes and feeling of the nurse and doctor are critical in the first situation, because of their positive regard for each others abilities, nurse and physician believe they can constructively solve the conflict the nurse does not feel the physician will try to dominate while the physician respects the nurse managers managerial ability with these preexisting attitudes the physician and nurse can remain neutral while assisting their subordinates to solve the conflict in the second situation the nurse and physician may approach the situation differently if each assumes the other will defend her or his subordinates at all costs communication will be inhibited the conflict is resolved by domination of the stronger person either in personality or position one wins the other loses.

Manifest behavior is the action that results or what happens overt action may take the form of aggression, competition, debate, or problem solving covert action may be expressed by variety of indirect tactics such as scapegogating, avoidance, or apathyThe final stages of the conflict process are suppression or resolution and the resulting aftermath suppression occurs when one person or group defeats the other only the dominant side is committed to the agreement and the loser may or may not carry out the agreement resolution occurs when mutually agreed-upon solution is arrived at, and both parties commit themselves to carry out the agreement the optimal solution to conflictive situations is to manage the issues in away that will lead to a solution wherein both parties see themselves as winners and the problem is defeated this leaves an aftermath that will affect future relations and can influence feelings and attitudes .

Groups processes:Groups are often a source of conflict in organizations understanding why group from and how they influence behavior in organizations is important for anuses manager whenever Hunan’s interact together in organizations they are likely to form cohesive groups nurses are no exception often highly cohesive groups of nurses develop strong norms as to how nursesought to behave cohesive groups are more likely to develop where there are shared values and beliefs where individuals have similar goals and tasks where individuals have to interact together to achieve these e tasks where there is proximity in both time and distance(I.e., they work in the same unit and on the on the same shift), and where they have specific needs that can be satisfied by the group .For example, groups provide a means of satisfying social needs and opportunities for interaction, provide an identity, provide protection from common enemies, provide a means of testing reality, and help to accomplish tasks that the individual cannot achieve alone. .

Interagroup conflict:Interagroup conflict can occur when these group norms or standards are violated or changed. For example, in an organization undergoing decentralization, nurse managers might be expected to change in various ways, such as earning a bachelor degree or wearing street clothes and lab coat instead of a conventional uniform. This change might conflict with group norms and could stimulate internal conflict for nurse managers who have perceived themselves differently.groups often develop norms relative to how hard a person is expected to work, making it more difficult for the nurse manager to influence productivity. Another potential intragroup conflict problem that a nurse manager must deal with would be the introduction of new members into a cohesive group. The nurse manager must make sure that the new members are accepted and made part of the group..

Intraorganizational conflict:Conflict between groups, departments, or divisions of an organization is often a consequence of the degree to which these units are differentiated from another. According to Lawrence and lorsch, differentiation between units may be due to differences in structure, time orientation, interpersonal orientation, or subenviroment orientation .For example, some units in hospitals such as food service and housekeeping tend to have more mechanistic structures while financial services and accounting might have a bureaucratic structure and units such as nursing will be structured on a more professional basis. In terms of time orientation, research units might have long-time orientations while the emergency room would be an example of a unit with a short-time orientation. Some units in a hospital such as personnel or public relations might have strong interpersonal orientation while laboratories might have strong

task orientations. The final dimension of differentiation is subenvironment orientation administrative units such as finance would have an orientation toward the economic environment while units such as radiology would have amore technical or scientific subenviroment orientation.Conflict management:The management of conflict is an important part of the nurse manager’s job. Anumber of technique’s can be used by the nurse manager to manage conflict..Smoothing: (lose-lose) is accomplished by complimenting ones opponent down-playing differences and focusing on minor areas of agreement as if little disagreement exists smoothing may be appropriates in dealing with minor problems but in response to major problems it produces the same results as withdrawing.

.Avoiding: (lose-lose) is similar to withdrawal except the participants never acknowledge that a conflict exists Avoidance is the conflict resolution technique often used in highly cohesive groups that are engaged in(group think).The group avoids disagreement because they do not want to do anything that may interfere with the good feelings they have for each other..Forcing: (win-lose) is a method that yields an immediate end to the conflict but leaves the cause of the conflict UN resolved. Superior can resort to issuing orders but the subordinates will lack commitment to the demanded action forcing may be appropriate in life or death.situations but is other wise inappropriate

Competing: (win-lose) is an all-out effort regardless of the cost. Competing like forcing may be needed to prevail in situations involving unpopular or critical decisions.negotiation: (win-lose) collaboration, compromise, and confrontation are generally more effective modes of responding to conflict. Negotiation involves give-and-take on various issues among the parties it is used in situations in which consensus will never be reached. Therefore, the solution is not often achieved. Negotiation often becomes a structured formal procedure as in collectives bargaining..

Collaboration: (win-win) implies a mutual attention to the problem that utilizes the talents of all parties in collaboration the focus is on solving the problem not defeating the opponent the goal is to satisfy both parties concerns collaboration is useful in situations where the goals of both parties are too important to be compromised.Compromise: (lose-lose) is used to divide the rewards between both parties. Neither gets what he or she wants. Compromise can serve as a backup to resolve conflict when collaboration is ineffective it is sometimes the only choice when opponents of equal power are in conflict over two or more mutually exclusive goals compromising is also expedient when solution is needed rapidly.

The confrontation: (win-win) technique of resolving conflict is similar to the collaboration technique and is considered to be the most effective means for resolving conflicts. This is a very problem-orientation technique where the conflict is brought out into the open and attempts are made to resolve it through knowledge and reason Lawrence and lorsch refer to this mode using aphorisms such as (by digging and digging the truth is discovered) and seek ‘till you find and you will not lose your labor .The goal of this conflict resolution technique is to achieve win-win solutions.

Conflict Intervention:The following are some of the basic rules on how to medicate a conflict between two or more parties:1.Protect each party self – respect. Deal with conflict of issues, not personalities.

2.Do not put blame or responsibility for the problem on the participants. The participants are responsible for developing a solution to the problem.3.Allow open and complete discussion of the problem from each participant.4.Maintain equity in the frequency and duration of each party’s presentation. There is a tendency for a higher status person to speak more frequently and longer than a lower status person. If this occurs, the mediator should intervene and ask the lower status person for response and opinion.5.Encourage full expression of positive negative feelings within an accepting atmosphere. There is a tendency for the novice mediator to discourage expressions of disagreement.

6.Make sure both parties listen actively to each other’s words. One way to do this is to establish the ground rule that requires each person to summarize the comments of the other prior to stating her or his own position.7.Identify key themes in the discussion and restate these at frequent intervals.8.Encourage the parties to provide frequent feedback to each other’s comments. Each must truly understand the others position.9.Assist the participants in developing alternative solution, selecting a mutually agreeable one, and developing a plan to carry it out. All parties must be a greeable to the solution for successful resolution to occurs.10.At an a greed- upon interval, follow up on the progress of the plan.11.Give position feed back to participants regarding their cooperation in solving the conflict.

Reference:Reference:.Health cares manager book..Organizational behavior book..Leadership management book..www. Googol. com.

.Working By:Working By:

1.Rasha Abu Abdo3.Asma Hamad

2.Rana Abu Abdo4.Maha Abu Hajar