CONFLICT MANAGEMENT IN

NURSING WORK PLACES

MAGISTER KEPERAWATAN F.KEP UNIVERSITAS

ANDALAS TAHUN AJARAN 2013/2013
DR YULASTRI ARIF, M.KEP

Resources
2

1. Judith Albino, PhD Why

Cant 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 multiparty conflicts

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
5

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
The good
clarify important issues & concerns
abilities and potentials surface
motivate people to do better
provide creative, constructive, innovative ideas
stimulate energy
require new decisions & 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?
11

Use cognitive conflict

13

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

14

Personal antagonism

fueled by differences
of opinion

Destructive to group

performance and
cohesion

Ibid., 24.

How can we keep conflict

cognitive?
15

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

16

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

17

Ask for the other

persons perspective

Paraphrase what

you hear

Acknowledge your

contribution

Describe your

perspective

Ibid.

Understand why your views

differ
18
(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

19

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

20

Discuss one issue

at a time

Clarify assumptions
Explore interests

and feelings

Ibid.

Step 4. Agree on solutions

21

Reality test

Is this doable?

Durability test

Is this durable?

Interest test

Does this meet all

parties interests?
Ibid.

Step 5. Plan next steps

22

Jointly

plan

create action

What needs to

happen?

Who needs to do

what? By when?

How will interaction

take place if
problems occur?

Ibid.

Tools for
Conflict Management
23

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

find a middle ground.

to

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 its important for others to learn from experience

Avoiding Is Effective:
When the issue is relatively trivial
When you know you cant be satisfied
When the costs of conflict outweigh the benefits of

resolution

To allow cooling off

When its 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. Whats 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 departments
most distinguished, albeit somewhat imperious, professor. He also
chairs the departments 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 Krafts
reputation youll do the work, and hell be PI and get first authorship.
When you tentatively suggest that you just dont 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 youre 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 Universitys 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. Dont let me
down. I need your support on this, he says in concluding the call.

Conflict Case 3: Profiting from

You are an assistant professor and have been working with Dr.
Research
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 youre worried. You think this constitutes selfdealing and is against University policy, but you dont want to offend
someone who clearly could make or break your scientific career. You
wish he would reconsider.

Conflict Case 4: Research

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
Collaboration
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, restandardize, 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..