Essentials of Nursing Leadership and Management, 5th Edition

94 unit 2 | Working Within the Organization

(as in Case 1), two departments, or two different
professional groups (e.g., nurses and social workers,
over who is responsible for discharge planning). On
the organizational level, conflicts can occur
between two organizations (e.g., when two home
health agencies compete for a contract with a large
hospital). The focus in this chapter is primarily on
the first two levels: among individuals and groups
of people within a health-care organization.

Resolving Problems and Conflicts

Win, Lose, or Draw?

Some people think about problems and conflicts
that occur at work in the same way they think about
a football game or tennis match: unless the score is
tied at the end of the game, someone has won, and
someone has lost. There are some problems in this
comparison with sports competition. First, the aim
of conflict resolution is to work together more effec-
tively, not to defeat the other party. Second, the peo-
ple who lose are likely to feel bad about losing. As a
result, they may spend their time and energy prepar-
ing to win the next round rather than on their work.
A win-win result in which both sides gain some
benefit is the best resolution (Haslan, 2001).
However, sometimes the people involved cannot
reach agreement (consensus) but can recognize and
accept their differences and get on with their work
(McDonald, 2008).

Other Conflict Resolution Myths

Many people think of what can be “won” as a fixed
amount: “I get half, and you get half.” This is the
f ixed piemyth of conflict resolution (Thompson &
Fox, 2001). The problem is that if one side gets
everything, then the other side gets nothing.
Another erroneous assumption is called the deval-
uation reaction: “If the other side is getting what
they want, then it has to be bad for us.” These erro-
neous beliefs can be serious barriers to achievement
of a mutually beneficial resolution of a conflict.
When disagreements first arise,problem solving
may be sufficient. If the situation has already devel-
oped into a full conflict, however,negotiation,either
informal or formal, of a settlement may be necessary.

Problem Resolution

The use of the problem-solving process in patient
care should be familiar. The same approach can be
used when staff problems occur. The goal is to find

a solution to a given problem that satisfies every-

one involved. The process itself, illustrated in

Figure 7.1, includes identifying the issue, generat-

ing solutions, evaluating the suggested solutions,

choosing what appears to be the best solution,

implementing that solution, evaluating the extent

to which the problem has been resolved and, finally,

concluding either that the problem has been

resolved or that it will be necessary to repeat the

process to find a better solution.

Identify the Problem or Issue

Ask participants in the conflict what they want

(Sportsman, 2005). If the issue is not highly charged

or highly political, they may be able to give a direct

answer. At other times, however, some discussion

and exploration of the issues are necessary before

the real problem emerges. “It would be nice,” wrote

Browne and Kelley, “if what other people were really

saying was always obvious, if all their essential

thoughts were clearly labeled for us... and if all

knowledgeable people agreed about answers to

important questions” (1994, p. 5). Of course, this is

not what usually happens. People are often vague

about what their real concern is; sometimes they are

genuinely uncertain about what the real problem is.

High emotion may further cloud the issue. All this

needs to be sorted out so that the problem is iden-

tified clearly and a solution can be sought.

Problem

resolved

If yes, end

Begin

If not, here

repeat

process

Implement

solution

chosen

Generate

possible

solutions

Choose

best

solution

Evaluate

suggested

solutions

Identify

the

problem

Figure 7.1The process of resolving a problem.