CONFLICT MANAGEMENT IN

NURSING WORK PLACES

F.KEP UNIVERSITAS ANDALAS TAHUN AJARAN 2013/2013

DR YULASTRI ARIF, M.KEP

 Resources
2

1. Judith Albino, PhD “Why Can’t We All Just Get

Along? Working Effectively with Conflict “
 Learning Objectives
3

• Understand the fundamental concepts of conflict

management

Acquire specific tactical approaches to conflict

situations

Apply that understanding to more effectively assess

and manage two-party and multi-party conflicts
WHAT IS CONFLICT
4
What are your associations to the word,
“conflict ” ?

Beliefs about conflict…

• Conflict is generally negative and destructive

• It is better to ignore small problems
• Recognizing conflict can make it increase
• Problems will work themselves out
• Conflict is the result of bad management
• There are usually single, simple causes of conflict
 CONFLICT HAPPENS
6
Conflict is…
•a normal, inescapable
part of life
•a periodic occurrence in
any relationship
•an opportunity to
understand opposing
preferences and values
•ENERGY
 The Cost of Conflict

• Over 65% of performance problems result from

strained relationships rather than skill or motivation
problems

• The amount of managerial time spent dealing

with conflict was 30% in 1976 and 42% in 1996

• Amount of time wasted during conflict can be as high as

50% of gross salary, defending, avoiding & venting

• Chronic unresolved conflict is a decisive factor in 50% of

people leaving, and 90% of involuntary terminations

• Projected costs should include estimates of wasted time,

reduced decision quality, loss of skilled employees,
restructuring, sabotage, lowered motivation, lost work time,
and health costs, loss of innovation & initiative.
 When it really gets bad…

• In 1994 18 million cases were filed in US courts at

a cost of $300 billion
• 20% of Fortune 500 executives’ time is spent on
litigation related activities
• Average cost is $80,ooo per case for wrongful
discharge and employment related suits
 Outcomes of Conflict:
The Good, Bad and Ugly

he good…
• clarify important issues & concerns
• abilities and potentials surface
• motivate people to do better
• provide creative, constructive, innovative ideas
• stimulate energy
• require new decisions &T rules
• generate changes to prevent future disputes
• facilitate understanding of people & problem
• increase trust and improve relationships
and the Bad & Ugly…
• consumes time & energy
• takes people away from primary tasks
• promotion of self interest at expense of organization
• stress induced illness
• lower morale, sabotage, polarization, job dissatisfaction, loss of
productivity, apathy, etc.
Two Types of Conflict:
 People want the same thing, but have to settle
for different things.

or

 People want different things, but have to settle

for the same things.
Four Possible Outcomes:
 Problem resolved; relationship maintained or
improved
 Problem resolved; relationship deteriorates
 Problem not resolved; relationship deteriorates
 Problem not resolved; relationship maintained or
improved
How can we manage the energy of conflict?
12
 Use cognitive conflict
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 Disagreement about ideas

and approaches

 Issue focused, not personal

 Characteristic of high
performing groups

Amason, A.C., Thompson, K.R., Hochwarter,

W.A., & Harrison, A.W. (1995, Autumn).
“Conflict: An Important Dimension in
Successful Management Teams.”
Organizational Dynamics, 24(2), 22-23.
Avoid affective conflict
15

Personal antagonism
fueled by differences of
opinion

Destructive to group
performance and
cohesion

Ibid., 24.
How can we keep conflict cognitive?
16

1. Make the approach

2. Share perspectives

3. Build understanding

4. Agree on solutions

5. Plan next steps

Mediation Services. (2003). Foundational concepts for understanding conflict. Winnipeg, MB,
Canada.
 Step 1. Make the approach
17

Reflect before you begin

Invite the other party to

a conversation
Be clear about your
intentions
State your goal - a
positive resolution
Ibid.
 Step 2. Share perspectives
18

Ask for the other

person’s perspective
Paraphrase what you
hear
Acknowledge your
contribution
Describe your
perspective
Ibid.
Understand why your views differ
19

(Read from bottom to top)

I take action
I adopt beliefs
I draw conclusions
I add meaning
I select data
Observable data
Clark, W. (October 17, 2005). People Whose Ideas Influence Organisational Work
- Chris Argyris. In Organisations@Onepine. Retrieved March 8, 2009, from
http://www.onepine.info/pargy.htm
 Name the issues
20

Identify topics that the

parties view as
important to address
Use concise neutral
language
Avoid pronouns

Use issues to create the

agenda
Foundational Concepts for Understanding Conflict.
 Step 3. Build understanding
21

Discuss one issue at a

time
Clarify assumptions

Explore interests and

feelings

Ibid.
 Step 4. Agree on solutions
22

Reality test – Is this

doable?
Durability test – Is this
durable?
Interest test – Does this
meet all parties’
interests?
Ibid.
 Step 5. Plan next steps
23

 Jointly create action

plan
What needs to happen?

Who needs to do what?

By when?
How will interaction
take place if problems
occur?
Ibid.
 Tools for
Conflict Management
24

THOMAS KILMANN CONFLICT MODE

INSTRUMENT
Thomas-Kilmann Conflict Mode Instrument:
5 styles of conflict
Conflict Styles:
Assertiveness and Cooperativeness
Five Conflict Styles (TKI)
1.Competing – “Might makes right.” (Hi A, Lo C)
2. Accommodating – “Kill your enemies w/kindness”
(Lo A, Hi C)
3. Avoiding – “Leave well enough alone.” (Lo A, Lo C)
4. Collaborating – “Two heads are better than one.”
(Hi A, Hi Co)
5. Compromising – “Split the difference.” (Mod A,
Mod C)
Which Style is Best?

Most people use all at various times.

Most people naturally prefer one style.

Situation, culture, personality can influence the

best style at a given time.
All styles can be useful!
Different Styles have Different Goals

Competing: the goal is to win.

Accommodating: the goal is to yield.

Avoiding: the goal is to delay.

Collaborating: the goal is multiple participation.

Compromising: the goal is to

find a middle ground.
Competing is Effective:

When quick decisive action is needed

On important issues when unpopular action must

be taken
When the issue is vital, and the right course is clear

To protect against people who take advantage of

noncompetitive behavior
Accommodating is Effective:

 When you are wrong, when learning is important, or

when demonstrating reasonableness is critical

 When creating goodwill is paramount

 To build social credits for later use

 To stop unproductive or damaging competition

 When harmony is important

 When it’s important for others to learn from experience

Avoiding Is Effective:
 When the issue is relatively trivial

 When you know you can’t be satisfied

 When the costs of conflict outweigh the benefits of

resolution
 To allow “cooling off”

 When it’s important to have more information

 When others can resolve the issue more effectively

 When the conflict is tangential to something more

important
Collaborating Is Effective:
 When it is important that both sides be integrated

 When you want to learn and fully understand others’

views

 To merge different perspectives and insights

 To gain commitment through consensual decisions

 To work through hard feelings that have interfered with

interpersonal relationships
Compromising Is Effective:
 When goals are less important than avoiding the
disruption caused by more assertive conflict resolution
styles

 When opponents have equal power and commitment to

mutually exclusive goals

 To temporarily settle complex issues

 To quickly achieve an expedient solution

 As a backup style when collaboration or competition fails

Whatever style you use, there are some
Basic Skills for Conflict Resolution:
1. Manage anger
2. Listen actively
3. Avoid assumptions
4. Find something on which to agree
5. Be cautious with criticism
6. Negotiate (more later!)
7. Get help
Your Style and Negotiation

What is negotiation?

a discussion between two or more disputants who are

trying to work out a solution to their problem.

Win-Lose or Win-Win
"In a successful negotiation, everyone wins. The objective
should be agreement, not victory."
Preparation for Negotiation
1. What do the parties want?
2. What can be “traded”?

3. What are the alternatives to agreement?

4. How does the relationship affect negotiations?

5. What can be expected, based on the past?

6. What’s at stake? Consequences on both sides?

7. What are the power issues?

8. What are the possible compromises? Creative options?

9. What are the conflict styles of negotiating parties?

 Summary:
What is a Successful Negotiation?
 Parties willingly work together to resolve an issue by:
Understanding respective interests
Identifying objective criteria
Generating options

The result is satisfactory to both parties.

Win-Win!!
 Analyzing Conflict Situations

Four Cases

Work Individually and in Groups

Report Back
Conflict Case 1: Ambiguous Power
You are an assistant professor sitting in your office in a clinical department,
pouring over some data from a recent study. You hope these data are sound
enough to produce a paper for an upcoming conference and perhaps a manuscript
for publication as well. There is a knock at the door, and you turn to see Von
Kraft, the department’s most distinguished, albeit somewhat imperious, professor.
He also chairs the department’s promotion and tenure committee. He announces
that he has an idea for a new research project, and he wants you to work with him.
The project sounds interesting, but it is not in an area in which you have been
working. He has minimal funding from a foundation, but assures you it will allow
for completion of a pilot. Your mind is racing. Taking this on would throw off
your research agenda and publishing schedule. You also know Von Kraft’s
reputation – you’ll do the work, and he’ll be PI and get first authorship. When you
tentatively suggest that you just don’t think you have the time, he gives you a stern
look and says, “That would be a big mistake; this is a major opportunity.” You
know that he needs pilot data to prepare an NIH application, but you’re hoping to
pull together your own R01 with the data in front of you now.
 Conflict Case 2: Role of Research
You are an assistant professor of pediatric medicine and were hired with the
expectation that your primary focus would be on research. Moreover, the
University’s new promotion and tenure policy reflects even greater emphasis on
research than in the past.  Nonetheless, you understand that you must also demonstrate
proficiency in teaching and service. You have been doing your share of clinical
teaching, and you are on the curriculum committee, which is especially time-
consuming this year, since re-accreditation is only a year away. Yesterday, your
department chairman, Dr. Mort, called to say he wants you to represent the department
on the School Admissions Committee. He explained that it is an unusual role for a
junior faculty member, but he thinks your work on the curriculum committee
demonstrates your talent for this sort of demanding assignment. You know that this
will involve many hours pouring over applications and interviewing potential
students. It would be interesting, but you see no way to leverage scholarly efforts
from this effort, and you are feeling a great deal of pressure to demonstrate your
ability to develop a funded research program. When you explain, Dr. Mort assures
you that committee work also is valued. “Don’t let me down. I need your support on
this,” he says in concluding the call.
Conflict Case 3: Profiting from Research
You are an assistant professor and have been working with Dr. Avarizo for several
years. A senior scientist, he has been successful not only in obtaining grant funding
for his work, but also in obtaining patents; he runs a company which produces and
sells the medical devices developed with those patents. Although you have heard
rumors that he developed some devices at the University and that graduate students
were involved in the work, you have never seriously questioned his behavior. This
is the first time that you have been asked to oversee the budget on one of his grants,
and you are disturbed by one of the items on your desk. Dr. Avarizo has asked you
to order one of his instruments for measurement of blood oxygen capacity in study
participants and to certify that his company is a “sole source” provider. You wrote
much of the grant, and you know that a simpler (and less expensive) instrument
would do the job. When you asked whether he really thought the extra features
were needed, he just said breezily, “We should get the best; I assure you it will be
worth it.” Now you’re worried. You think this constitutes self-dealing and is against
University policy, but you don’t want to offend someone who clearly could make or
break your scientific career. You wish he would reconsider.
Conflict Case 4: Research Collaboration
You are an assistant professor at Best University School of Medicine and are
working on a project with a colleague, for which you have a small grant to study
a new way of screening for otitis that uses health educators who will teach
parents basic identification and early management skills. You worked well
together in planning, but now find that you are clashing during the
implementation phase of the project. Your colleague, Dr. No Wei, has a
tendency to micro-manage the three health educators who, in turn, complain to
you. Now, one of them has quit three months into the project, and your
colleague insists that the trial cannot continue, since the original design called
for 3 interventionists. He wants to hire another health educator, re-standardize,
and start over. You want to calibrate a third educator -- or just continue with
two. When you suggested this, your colleague insisted that your approach would
violate the scientific integrity of the study. You are willing to report all issues
and changes in your write-up of the data, but since this is a pilot, you believe it is
important to move ahead. Your colleague is adamant, however, and says that he
will instruct the remaining health educators not to report again to their assigned
practice locations. You know the funding will not support his approach, and you
are somewhat offended as well by his attitude..