Conflict Resolution in Healthcare

It happens all the time: conflict rises up on the healthcare workplace floor. A staff nurse resents a travel nurse’s higher hourly wage or signing bonus. Opinions on care plans differ, with some staff interpreting disagreement as disrespect. A physician thinks of herself as forthright while others consider her brusque and unfriendly.

These conflicts play out every day in different hospitals – and with the different cultures, personalities, and communication styles staff bring to the table, it’s not surprising that they clash on occasion.

Travel nurses can find themselves in an especially murky position. We’ve all heard the saying that “nurses eat their young” through workplace bullying. Travelers, who usually lack the allies that come with long-term facility employment, may not feel they have anyone to turn to with legitimate grievances. They may worry about being labeled a complainer or losing their good relationship with their agency.

Ultimately, any conflict has the potential to impact patient care – which shapes Tribal Health’s approach to conflict resolution. As Brian Gallagher, Chief Clinical Officer, says, “We put patient care and patient safety first.” With that in mind, we’re sharing tips on addressing conflict at work as a team member, traveler, and manager.

Conflict Repercussions: The Good and the Bad

Healthcare staff respond in different ways to conflict. Some lash out in the moment; some silently brood over perceived slights and turn bitter. Some don’t realize a conflict is bothering them until after their shift ends and their thoughts return to an earlier incident. The high stakes and fast pace of a healthcare workplace can add anxiety and urgency to any issue. Over time, these conflicts can erode confidence and morale.

But conflicts can have positive outcomes, too. They can motivate teams to improve their communication or map out smarter protocols and practices. They can identify weaknesses and inspire improvements that help with Joint Commission accreditation and HCAHPS ratings.  

So while conflicts may not always feel great, they can serve a valuable purpose. The key is thinking of them less as “Someone is wrong” and more as “This is an opportunity for change.”

Let’s look at a few ways to address common conflicts.

7 Ways to Change Conflict Rancor to Conflict Resolution

Don’t ignore conflicts – but allow time to cool off.

Instead of ignoring a brewing storm, take care of it while it’s still a disagreement. But don’t jump into the fray when people are emotional. Brian Gallagher has a twenty-four rule. “When emotions are heightened due to conflict, I frequently deploy the twenty-four-hour rule,” he says. “It allows the team to go home, cool off, self-reflect, and then address the conflict the next day at a neutral location.  I have found it far more likely to have a positive conversation and productive outcome.”

Take a team approach.

Even if a conflict appears to be between two people, working as a team can lead to a more informed and thoughtful outcome. Collaborative problem solving can better help identify both the root of a problem and the solution.

Practice active listening.

In the heat of conflict, it’s common to focus on mentally crafting your response instead of listening to what the other person is saying. When both people practice active listening, they’re more likely to understand each other’s point of view.

Respect differences.

Nurse recruiter Nicole Streich, RN, points out that facility staff may do things differently from what a traveler nurse expects. “I think it is important for the traveler to be ready and willing to listen to the suggestions from the staff,” she says. “There could be a misunderstanding about a cultural norm that the traveler is unaware of.”

Clarify expectations.

Clearly setting expectations during orientation benefits travelers who move from facility to facility. And if travelers don’t feel they’ve received the right guidance? They should be able to ask their staffing agency for cultural advice.

Turn to your support team.

At Tribal Health, healthcare staff have a direct chain of command for help with conflict resolution: the medical director, then our Chief Clinical Officer, then our CEO. Leadership is available 24/7. But many nurses’ first instinct is to report a conflict to their recruiters, “because of the trusting nature of their rapport,” Nicole Streich explains. “In that scenario, the recruiter can bring it to the attention of the account manager who has a direct contact at the facility.” Others prefer to ask their nursing supervisor how to address concerns around conflicts and clinical practice issues.

Build a healthy workplace culture.

While conflicts are inevitable, building a positive culture goes a long way to supporting open conversations and collaborative solutions. A good training program can also reduce frustrations or different opinions on patient care by ensuring all staff are trained in new care delivery methods and that they understand the reasons behind the new facility policies.

Resolving Conflicts with Good Communication

Brian Gallagher shared some communication techniques he finds useful in managing conflicts. One is recapping, such as confirming another person’s thoughts and words. By saying, “what I hear is <x>, what I understand is <x>, is that correct?” and “Can you agree to <x>?” everyone leaves the discussion on the same page.

Also valuable: providing constructive criticism. Start by identifying positive accomplishments or traits so the other person understands you’re not attacking them as an individual but addressing a problem. This shifts the focus to collaboratively solving the conflict together.  

Brian also recommends learning to identify dynamics like the Karpman Drama Triangle, in which people may take on the roles of Persecutor, Victim, or Rescuer in stressful situations. “It’s not a great place to be, so I’ve learned how to coach people out of the drama role and to be a problem solver,” Brian says, pointing out that medical professionals have a tendency to fall into the hero role. “Nobody wants to work closely with someone who creates drama.”

Finally, nursing supervisor Dianne Kandt, RN, emphasizes the value of pairing empathy with honesty. “Always remain kind,” she says. “Everyone deserves a grace note.  Assume the best.  Don’t be afraid to address specific behaviors.  Praise in public, criticize in private, and be ready to forgive.”

Supporting Frontline Staff with Healthy Conflict Resolution

In Deloitte’s new “Addressing Health Care’s Talent Emergency” report, 46% of providers reported high levels of burnout. Overtime, staff shortages, and burdensome admin tasks have become the norm in many healthcare workplaces, forming a breeding ground for conflict. None of that is going to vanish overnight – which makes healthy conflict resolution more important than ever in keeping staff connected and committed on the job.

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