What should you do when staff have conflicts?
December 1, 1999 4 minutes read
What should you do when staff have conflicts?
In most cases, conflict resolution should be handled at the staff level, urges Colleen Bock-Laudenslager, RN, MSN, a Redlands, CA-based consultant with Bock-Laudenslager & Associates, which specializes in ED issues. "But all too often, staff nurses write up’ other departments and forward the issue to their manager, which creates a paper trail. Then managers are forced to respond to all the issues," she says.
Here are some strategies to manage conflicts between ED staff and other departments:
• Encourage staff to deal with conflicts directly first.
If staff find they can’t deal with conflicts themselves, they will have to take it to another level, says Bock-Laudenslager. "But if staff take the risk and try to resolve the conflict, often further action is not necessary. Hospitals are not made up of people trying to be hateful. Many are frustrated with having to do more with less, and we are all human."
• Give other departments a chance to clarify their standards.
Sometimes the staff ED nurse won’t understand what expectations have been set forward by the department they’re interacting with, Bock-Laudenslager notes. "So if that department explains their standards and the ED nurse can live with that, the conflict possibly could be resolved and dropped."
• Know when to work through leadership.
If a department is truly negligent, the conflict should be handled by department heads, she advises. "Often, the conflict occurs because we don’t understand the pressures they’re dealing with. Communi cating and sharing concerns provides a mutual understanding."
If there is a negative outcome with patients or an extremely negative verbal interaction even once, the staff need to work through their leadership to discuss the situation, says Bock-Laudenslager.
A peer review of the situation should be conducted to examine the process and implement solutions to avoid future conflict. "In reviewing all the issues, policies and procedures should be taken into consideration," she says.
The following scenarios should be addressed by ED leadership and not handled by the individual staff member, says Thomas:
— if conflicts jeopardize patient care;
— if there are public displays of anger and unprofessional behavior to patients, staff, or physicians;
— if the standard of care in another department is negligent;
— if there is harassment.
• Determine boundaries for inappropriate behavior.
"As a general rule, staff might permit three minor infractions before they pursue a more formal complaint process," says Bock-Laudenslager. "When a trend or pattern develops, the staff should be instructed to document the facts and include their leadership in the discussion."
• Resolve conflicts on a lower level if possible.
If the conflict is specifically a nursing issue, it’s not always necessary to involve the physician chief of ED services, for example, she says. "Try to resolve the conflict at the lowest level to ensure professional accountability and to avoid staff embarrassment." Instead, contact your counterpart at the involved unit. "Say, I’m sure your staff will have a different idea of what happened, but can we discuss these issues and develop a strategy for problem resolution?’" she suggests.
• Bring the involved parties together.
Set ground rules when you bring individuals together to discuss conflicts. "Explain that we’re not here to personally attack others. We are here to resolve issues through creative solutions," Bock-Laudenslager advises.
Ask employees to document the statement of facts, including supportive evidence, she suggests. "For example, they might provide incorrect lab results or copies of medical records to illustrate a problem."
• Ensure that staff are skilled in conflict resolution.
Hire staff who are flexible and good communicators, Bock-Laudenslager says. "During orientation, teach the standard for resolving conflict."
• Be a good role model.
Leaders need to demonstrate good conflict resolution, she emphasizes. "If staff see them overreact and launching into huge vendettas with other department heads, then they will follow suit."
• Intervene for staff when appropriate.
If individuals are habitually rude or abusive to ED staff, establish clear boundaries for acceptable behavior. "Otherwise, they will never respect you and will continue to try and take advantage," says Larry B. Mellick, MD, MS, FAAP, FACEP, chair of the ED and professor in the department of emergency medicine at the Medical College of Georgia in Augusta.
When you interface with colleagues, healthy functional relationship guidelines apply, he emphasizes. "Right from the beginning, set boundaries. Every body needs to know this ED does not accept blaming or abusive behavior. It may take a couple of telephone calls, saying, You were out of line in how you acted. I don’t allow my people to accept this type of behavior.’"
You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
- Award-winning Medical Content
- Latest Advances & Development in Medicine
- Unbiased Content