Resolve the conflict

Conflict discussion from week 4 to write from:

There were many situations where conflict has arisen but one that sticks out that had a resolution attached to it was one when I was a new graduate nurse. When I was a new graduate nurse, it was very hard to establish yourself as a nurse when you are the new person on the floor. It was also intimidating because I was new, and there were people who have been on the floor for way longer than I have. I feel as though, this is an ongoing conflict that not only I had encountered, but many other nurses have encountered as well. I also don't believe that this is just for the new grad nurses. I believe that this happens when someone is new, someone is traveling, or the person may be easily taken advantage of.

As a nurse on a medical surgical unit, sometimes we are overwhelmed by the amount of medication passes that we must do. For us to do our medication passes correctly, we like must have the correct vital signs. I was having a power struggle with one of the nurse assistants on the floor. This does not come to a surprise to me because struggles over issues of control are very common in interpersonal conflict (Northouse, 2021). She was working there for over five years and felt as if she could do as she pleases. When getting the vital signs, sometimes they do not cross over immediately on our side of things so that we can see them. It was time for another medication pass, and the nurse assistant did not alert me that one of my patients’ blood pressures was way above average. We are supposed to be alerted of out-of-range vital signs. She did not do her duty and communicate this because she did not particularly like me. In hindsight, she put the patient’s safety at risk because she had a vendetta against me as a new nurse. This conflict effected me with my satisfaction on the job and also had a negative impact on the patient (Huber, 2019).

If I was alerted about the above average blood pressure, it would have prompted me to administer medication passes in a different order than I was currently doing so. I would have promptly gone to the patient's room to administer their blood pressure medications first instead of whatever order that they were in. This frustrated me immensely. What the nurse assistant did was put my license on the line.

I reported this to my manager after I administered the patients’ medications. We both went to her office and talked about the situation. The nurse assistant was very stale during the conversation and basically said she was busy getting calls and that it slipped her mind. She explained to her that the registered nurses are the ones that will be at fault if something goes wrong with a patient. She also explained that it is important to communicate between the nurses so that the patient may receive the best care possible. She also mentioned that nurses can do a nurse assistance job, but a nurse assistant is not trained or licensed to do a registered nurses’ job. So therefore, it is imperative to have that open line of communication between the two. In this situation the manager made sure that it was not about us as individuals, but about what's best for the patient. It took the focus off of us and made sure that we did our best to communicate for the patients’ well-being (Northouse, 2021).

Huber, D. L. (2019). Organizational Climate and Culture. In Leadership and nursing care management (6th ed., pp. 50–56). introduction, Elsevier.

Northouse, P. G. (2021). Introduction to leadership: Concepts and practice (5th ed.). Sage.

Some responses that my classmates gave:

Hello,

It is unfortunate what you have gone through in your first year as a nurse. What the nursing assistant did was out of line, and they should have never put a patient’s life in jeopardy for the simple fact that they do not like you. Also, great job on reporting it directly to your manager because it truly shows that your top priorities are your patients and not tolerating bullying or inappropriate behavior. Interpersonal conflict in the workplace can draw attention away from the patient, thus causing a decrease in quality patient care (Cullati et al., 2019). In this situation, the conflict management style of compromising could have been useful. In compromising, you could have introduced a conversation with the nursing assistant to find an appropriate solution that benefits the both of you (Alan et al., 2022). This style requires people skills, which a new nurse might not yet have developed, which would make the task difficult. The nursing assistant may be used to dealing with nurses that do not give the proper respect she deserves. When compromising, it makes people feel heard and you are willing to work with them as a team. You may also gain respect from the nursing assistant because the desire to compromise shows a sign of maturity. Another conflict management strategy that can be effective in your past situation was separating the person from the issue (Northouse, 2021). Instead of constantly pointing out things that the nursing assistant did, it might be a good idea to confront the problem with her and try to work with her. It is beneficial to separate the person from the problem because there is more of an inclination to work together to solve issues. Work together and attack the problem, not one another. It may seem like these conflict management strategies may not work based on the personality of the nursing assistant, but it may have worked with her after the meeting with the nurse manager. The reason for this is because she may have realized she made a mistake, and it was seen by the nurse manager, and she may felt more inclined to make appropriate decisions because she thought she was invincible.

References

Alan, H., Gül, D., & Baykal, Ü. (2022). The relationship between the conflict management strategies and ethical leadership behaviours of nurse managers perceived by nurses. Journal of Nursing Management (John Wiley & Sons, Inc.), 30(7), 2370–2378. https://doi.org/10.1111/jonm.13840

Cullati, S., Bochatay, N., Maître, F., Laroche, T., Muller-Juge, V., Blondon, K. S., Junod Perron, N., Bajwa, N. M., Viet Vu, N., Kim, S., Savoldelli, G. L., Hudelson, P., Chopard, P., & Nendaz, M. R. (2019). When team conflicts threaten quality of care: A study of health care professionals' experiences and perceptions. Mayo Clinic Proceedings: Innovations, Quality & Outcomes, 3(1), 43–51. https://doi.org/10.1016/j.mayocpiqo.2018.11.003

Thanks for sharing, I know when a new nurse starts in the field these issues of control are frequently seen. What this nurse assistant did was not right by any means and it’s a tough situation when a nurse starts to feel like their license is being put on the line. However, I think the situation was handled very well. I am interested to learn if you were able to continue working with this nurse assistant without further conflict? In my experience these situations often lead to “bad blood” between team members and it is difficult to rekindle an effective working relationship afterwards.

Your manager did an excellent job at resolving this conflict by focusing on the fact that it’s not about the two of you verses each other, but instead it’s about the patient and being able to deliver the best care possible. This is the goal of both parties’ jobs and when the patient receives high quality care it’s a win-win for both of you (Northhouse, 2021). It also sounds as though your nurse manager was able to keep an open line of communication and look at the situation objectively. In Booth et al. (2018) a crucial conversation was defined as “a discussion between 2 or more individuals when the stakes are high, opinions differ, and emotions are elevated”. With your patient’s safety being at risk, the stakes were high and likely the nursing assistant believed she needed to get to those calls, I know their jobs can be insanely busy at times. This type of conversation is designed to be inclusive for both parties to reach an effective solution (Boothe et al., 2018). I applaud your manager for their ability confront the conflict and handle it so well, an excellent example of leadership.

References:

Boothe, A., Frasier, N., Weaver, C., & White-Kiehle, J. (2018). Resolving Conflict: What Does the Giraffe Say? Nurse Leader, 16(2), 121–126. https://doi.org/10.1016/j.mnl.2017.10.008

Northhouse, P.G. (2021). Introduction to leadership: Concepts and practice (5th ed., pp. 277-297). Sage.