Have you ever felt the stress and tension caused by conflict at work? No matter your position or work setting, at some point, everyone experiences workplace conflict. In nursing, knowing how to identify causes of conflict and remedying them is essential to providing high-quality patient care and improving patient and organizational outcomes.
Perhaps you have heard the term conflict resolution but wonder, “What is conflict resolution in nursing?” You may ask, “What can I do to help promote conflict resolution in nursing?” In this article, I will explain what conflict resolution in nursing is and give some insight into why it is so important. As you continue reading, you will learn about various stages and types of conflict nurses experience, find examples of common conflicts in nursing, and learn ways to resolve them.
Conflict resolution in nursing is the process by which two or more nurses work together to find a reasonable solution to a dispute or problem. The process may involve peer-to-peer collaboration or involve supervisory staff, administrators, and nursing teams. No matter the source of the conflict and who is involved in the resolution, the primary goal is to bridge gaps caused by conflicts and build stronger teams who work together to improve outcomes.
As nurses, we have a moral and ethical responsibility to promote a safe environment for patients, their loved ones, and our teams. Because conflicts have the potential to affect everyone, when disagreements or challenges arise between nurses, it is crucial that we work together to resolve the issues. The following are three main reasons why conflict resolution in nursing is essential.
When implemented correctly, conflict resolution in nursing reduces work-related stress and anxiety, which helps boost employee morale. Employers benefit because employees who are happier at work are more productive. Also, when there is good employee morale, there is less turnover, which is important given the current nationwide shortage of nurses.
Another reason conflict resolution is so important in nursing is that it results in improved patient outcomes. When conflicts are resolved, nurses communicate better, promoting good team dynamics and interprofessional relationships. As a result, patients benefit from cohesive work environments and relationships, which leads to better health outcomes.
Have you ever tried to get a job done while working with someone who was angry or disgruntled? It makes accomplishing tasks challenging, to say the least. Conflict resolution is crucial for teams who must work together to accomplish a goal. In nursing, it is especially vital because unresolved conflicts can jeopardize patient safety and negatively impact outcomes. Demonstrating conflict resolution in nursing helps promote better work environments where nurses provide safer, more effective care.
Many types of conflicts occur in the nursing workplace. Most conflicts can be grouped into one of five main categories. The following list represents the main types of conflicts in nursing and examples of how to identify them.
Ethics/Values-Based Conflicts are the type of conflict that results when nurses have opposing or different values or beliefs. Having beliefs or values that are different from your coworkers can create tension, especially when it comes to deep personal convictions.
For example, if you are pro-choice and your coworker is a pro-life advocate, your conversations about a patient having an abortion could get a bit heated. Conflict resolution in nursing is about coming to a happy medium. You may not agree with one another, but you can agree that patient safety and quality care are paramount, and work toward the goal of achieving that for your patients.
As the name implies, Task-Based Conflicts in nursing are associated with specific nursing tasks. This type of conflict typically occurs when two nurses disagree on the way a task should be completed. For instance, they may disagree about the proper technique for inserting or discontinuing an IV.
Task-Based Conflicts are usually easily resolved because most common tasks have a proper procedure nurses should follow. In cases where more than one technique is appropriate, it may be necessary to verify your organization’s protocol for those procedures and follow their guidelines accordingly.
I strongly believe that there is no room in nursing for egos. We all have something to add to our teams and the nursing profession, and learning to appreciate and embrace our differences makes us better nurses. Because I believe in this so strongly, Ego-Based Conflicts are the most frustrating type of conflict to me.
An Ego-Based Conflict occurs when one nurse feels their self-esteem or position in the relationship is threatened by another. The perception may be real or imagined but creates a conflict, nonetheless. The threat becomes a conflict, and if it is not resolved, it only makes the situation worse. For example, suppose during an end-of-shift report, a nurse asks questions about whether a patient received a treatment during the previous shift. The nurse may have asked to verify so they can follow up on the patient following treatment. If the nurse working off takes offense and lashes out in front of other staff or patients, this creates a conflict rooted in the nurse’s ego.
In cases of Ego-Based Conflicts, it is wise to avoid confrontation. Instead, try communicating with the other person in a calm manner and in a private or neutral setting. If there is a lot of tension between you and the other person, having a supervisor mediate the conversation could be helpful.
When two nurses have differing communication styles and personalities, an Interpersonal Conflict may occur. While communication may not start on a negative note, if nurses cannot accept differences in personality, opinions, or communication and work together, conflict eventually results. Depending on the extent of the differences and how each nurse responds, these conflicts can turn into serious situations involving bullying or lateral violence in nursing.
If possible, I recommend that any nurses who feel there is a chance of a conflict arising because of interpersonal differences be open to discussing differences with one another. If the issue is causing stress or anxiety, or if one party in the conflict feels threatened, it is best to talk with your team leader, manager, or director to see how they want to handle the situation.
Issue-Based Conflicts are probably the simplest type of conflict to resolve. These conflicts occur when nurses disagree on how to handle a situation or problem. For instance, suppose a patient reports feeling nauseated to two nurses. One nurse feels the patient should be given anti-nausea medication immediately, while the other feels non-pharmaceutical interventions should be implemented first. In this case, a conflict could arise based on the different opinions about the most appropriate intervention.
When Issue-Based Conflicts like this example arise, collaboration and compromise are the most effective strategies for conflict resolution. For instance, the nurses should discuss options for patient care and refer to the physician's orders in the patient's care plan. By referring to the orders and collaborating, they can come to an agreeable solution to the conflict that benefits the patient.
Conflict resolution in nursing involves a process. Resolution typically occurs in five stages: latent, perceived, felt, manifested, and aftermath. The following are explanations of each stage of conflict resolution.
The first stage of conflict resolution in nursing is the Latent Phase. You may not even be aware that a conflict exists at this stage.
For example, you may have a patient who was admitted with a liquid diet whose doctor just wrote an order to change his diet to soft foods, but before realizing the order changed, you order a liquid tray for your patient's breakfast. You ordered the wrong tray, which can cause a conflict. However, the conflict has not yet occurred because the patient has not yet received his tray and does not know the wrong tray was ordered.
The Perceived State of conflict resolution is when everyone involved has become aware of the issue. For instance, your patient received the wrong tray and complained to the charge nurse. The charge nurse has now come to you to address the situation.
In the third stage of conflict resolution in nursing, the individuals involved experience anxiety or stress caused by the conflict. In this case, the patient may feel anxiety because he fears you will be angry that he reported receiving the wrong tray. Your supervisor may feel tension because they do not want conflict between staff and patients, and you may feel stressed because you do not want to be reprimanded or criticized.
The Manifest Stage of conflict resolution is when the conflict is evident and can be observed. This stage may involve face-to-face interaction between you, your supervisor, and the patient. It could involve documenting the incident in your nurse's note or notifying the doctor. If your nurse manager speaks to you and others are aware, they perceive a conflict, which also makes it manifested.
In the Aftermath Stage, some type of outcome related to the conflict has occurred. For example, once your nurse manager makes you aware of the order for the change in the diet, you contact the dietary department to order the correct tray and serve the patient.
There is more to conflict resolution in nursing than recognizing the conflict, and everyone deals with it in their way. The following are six of the most common strategies nurses use to resolve conflict.
Many nurses use the obliging strategy of resolving conflicts. Those who use this strategy are usually known as people-pleasers. While I understand the concept and have used this strategy myself, it is not always the best solution. If you want to come to a solution to a conflict quickly, obliging may be helpful.
However, if you must neglect things you feel are priorities or go against personal beliefs or convictions, using this strategy could result in internal conflicts, which could spill over into your work relationships. I urge you to weigh the situation carefully before conceding to this type of conflict resolution to ensure it does not lead to more conflict later.
Avoidance is the strategy you may use if you prefer to ignore the conflict instead of addressing it head-on. You may use this strategy if you want to avoid the person or source of the conflict altogether. This strategy can be an effective strategy for conflict resolution in nursing, but it is crucial that you know when avoiding an issue is beneficial and when it could cause problems in the long run.
A common form of conflict resolution in nursing is competing. Although this resolution strategy may not be the best and may seem inappropriate, at times, it is most effective. The competing conflict resolution strategy involves using decision-making power to assertively resolve a conflict. For example, if a charge nurse and floor nurse experience a conflict that is not easily resolved, the charge nurse may assert authority by making decisions and end the conflict.
Compromise does not have to be a negative option. Instead, it is a great way to resolve a conflict to satisfy all parties, which may help salvage relationships. The compromising strategy of conflict resolution involves finding common ground amidst the conflict and then agreeing on how to resolve the issue.
I believe the strategy for conflict resolution in nursing that offers the best, long-lasting results is collaboration. As nurses, we know the importance of collaboration in patient care. We work closely with patients, their families, physicians, and other nurses to develop care plans that are individualized to our patients’ needs. When looking for an effective conflict resolution strategy, we can use the same approach by listening to different views or opinions and working together to come to a creative resolution to the problem.
Typically, the best way to lead is by example. Although it may not happen daily, experiencing conflicts at work is inevitable. If you want to see conflicts resolved amicably, consider modeling the type of behavior you want others to demonstrate. I think it is important to remember that you do not need a leadership title or role to lead by example. Taking the initiative to model good behavior is something every nurse can do to help promote conflict resolution in nursing.
(The following are the 8 most common examples of conflict resolution in nursing.)
If you have worked as a nurse for any time, at some point, you may have felt like work assignments were unfair or disproportionately assigned. Even if the intention was not to make you feel as if you were treated unfairly, it can still create tension and result in conflict, which needs resolving.
Having worked in healthcare leadership, I can honestly say that there are times when work assignments seem unfair, but that not all leaders do so intentionally. If a situation arises when a team member feels their work assignments are unfair, I recommend going directly to your supervisor (or the person making the schedule). Approach them calmly and rationally, asking them to discuss the matter.
You may find that you were given more challenging assignments because your manager feels you can handle them and provide good patient care. A good nurse leader will work with you to remedy the situation if it is an oversight. When all else fails, and if your manager does not see the need for amended assignments, you can go to the next person in your chain of command.
As nurses, we typically understand what is expected of us by the roles outlined in our job descriptions. When nursing roles are poorly defined, however, it can lead to conflict among nursing team members, especially when roles seem to overlap.
From a leadership standpoint, having nurses on staff whose skills and abilities allow them to fill overlapping roles can be helpful, especially when there is a staff shortage. As a nurse working in a clinical role, I learned that when overlapping roles occurred, collaborating with team members and managers helped us identify what was expected of us each day.
Although role clarity is not always an issue that leads to serious conflict, if conflict does occur, nurse leaders can help resolve the problem with open communication. Discussing roles and responsibilities can help identify any confusion and clarify expectations for each team member, making units run more smoothly and helping promote conflict resolution.
Ethical dilemmas often occur when nurses feel torn between the demands of the job and what they feel is morally right. For example, when a nurse's religious beliefs go against a patient's choice of care, it can create an ethical dilemma or conflict. Also, suppose a nursing supervisor gives an assignment that a nurse feels is inappropriate or against the Nursing Code of Ethics. In that case, the nurse may feel tension or anxiety, resulting in a conflict.
In this example, the first step in finding appropriate conflict resolution is to be mindful of your beliefs and set boundaries regarding what you feel you can do without compromising your values and morals. Suppose a patient makes a healthcare choice that you disagree with. In that case, you must remember that it is their right to choose whatever treatment they want or deny treatment without fearing retaliation or abandonment from you.
However, if they expect you to participate in their care and their choices conflict with your religious beliefs or morals, talk to your supervisor to discuss options for a new assignment. Likewise, if you receive an assignment that violates your personal beliefs or morals, your supervisor may not be aware unless you tell them. Knowing what you believe and are comfortable with is essential in conflict resolution related to ethical dilemmas. The next step is communication. You must speak up and advocate for yourself as much as the patients you care for.
Good team dynamics require communication, collaboration, and strong leadership. When a nursing team lacks good dynamics, it is a breeding ground for a multitude of conflicts. In these situations, egos run hot, values and beliefs are challenged, and everyone suffers.
While good leadership is essential in building good team dynamics, not all the responsibility falls on the leaders. Each nurse is responsible for their actions and how they treat others. Finding a resolution to conflicts caused by poor team dynamics takes effort from each member of the nursing and administrative team. Team meetings, strategy sessions, and open discussions are great ways to promote conflict resolution in nursing and develop strong team dynamics.
High nurse-to-patient ratios lead to feelings of conflict in nursing. Research indicates poor staffing ratios are associated with increased rates of job dissatisfaction and burnout among nurses. Burnout often leads to increased nurse turnover rates, which only worsens the staffing ratio issues, making the conflict increasingly challenging.
In situations with widespread illness or a pandemic, even healthcare facilities with large staff pools may face challenges maintaining favorable nurse-to-patient ratios. Finding a resolution to the staffing ratios conflict is not always simple and takes effort from everyone on the nursing team. While you cannot prevent unforeseen events, you can help be part of the solution by being present at work when scheduled. You may also have options to work some prn shifts to help alleviate some of the stress of poor nurse-to-patient ratios, which not only helps resolve the conflict but can also help boost your income!
In my experience, ineffective communication is one of the most common and easily resolved causes of conflict in nursing. Several factors may hinder effective communication. For example, busy schedules with heavy patient loads and being short-staffed may leave you feeling there is little time to communicate with your team. However, each nurse is responsible for promoting positive, effective communication within their teams and between themselves and their patients.
When effective communication is lacking, it affects patients, staff, and the organizations where they work. Some effects include increased wait times, risks to patient safety, increased chance of medication errors, and patient dissatisfaction. Nurses must learn ways to communicate with one another to experience conflict resolution in nursing. Collaborating, accommodating, and compromising are three effective conflict resolution strategies to utilize as you try to overcome the conflict caused by ineffective communication. Be sure to maintain a positive attitude and gather your thoughts before initiating a conversation or responding to others.
Poor leadership or lack of managerial support in nursing causes dissatisfaction among nurses, creating the perfect environment for various types of conflicts. An ego-based conflict could occur if a nurse complains about a manager or leader. If management does not define clear objectives, goals, policies, and procedures, issues-based and task-based conflicts could arise.
Effective conflict resolution in nursing begins with leadership. As nurse leaders, we must create an atmosphere conducive to educating and building strong teams of nurses dedicated to providing high-quality patient care. To achieve this goal, nurse leaders must take ownership of leadership and management responsibilities and prioritize supporting nursing teams. It is equally important for staff nurses to collaborate with managers and leaders to develop strong interpersonal relationships.
Another major factor leading to nursing conflicts is nurses having too few resources to provide safe, effective patient care. Whether it is a lack of enough equipment, not having enough wound care supplies or poor budget allocations, limited resources often lead to feelings of conflict. When conflicts arise because of limited resources, if the issue is not addressed and resolved, it can lead to increased stress and anxiety as nurses feel unprepared to provide essential patient care, which may lead to nurse turnover. Unfortunately, the ones who suffer most from this are patients, who may not receive needed care promptly or who do not receive adequate care at all.
One of the most essential skills for nurses is critical thinking, and utilizing this skill is one way to accomplish conflict resolution in nursing caused by limited resources. Using the collaboration strategy, you can work with your team to decide how to prioritize care and allocate resources to benefit everyone. Resolving this conflict requires teamwork and good communication, but achieving a resolution is possible.
In your quest to work with your nursing team to develop better relationships and overcome challenges, maybe you wondered how to resolve conflicts or improve team dynamics. Perhaps you heard the term conflict resolution but questioned, “What is conflict resolution in nursing?" Suppose you are a nurse who desires to work with a strong team, promote good patient and organizational outcomes, and grow professionally. In that case, you realize the importance of conflict resolution in nursing.
By utilizing the information in this article, you have the tools you need to engage in and support positive team relationships and reduce the negative effects of conflicts in nursing. I encourage you to remember that building strong teams and supporting our patients, peers, and the profession is every nurse's responsibility, and by working together, we can accomplish anything!
1. NCSBN Research Projects Significant Nursing Workforce Shortages and Crisis (National Council of State Boards of Nursing)
2. 20 Common Examples of Ethical Dilemmas in Nursing (https://www.nursingprocess.org/ethical-dilemma-in-nursing-examples.html)
3. What is Critical Thinking in Nursing? (https://www.nursingprocess.org/critical-thinking-in-nursing.html)
4. Patient-Nurse Ratio is Related to Nurses’ Intention to Leave Their Job through Mediating Factors of Burnout and Job Dissatisfaction (National Library of Medicine)
Darby Faubion, RN, BSN, MBA
Darby Faubion is a nurse and Allied Health educator with over twenty years of experience. She has assisted in developing curriculum for nursing programs and has instructed students at both community college and university levels. Because of her love of nursing education, Darby became a test-taking strategist and NCLEX prep coach and assists nursing graduates across the United States who are preparing to take the National Council Licensure Examination (NCLEX).
