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
14

 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..