Running Head: FAMILY CONFLICT RESOLUTION
Family Conflict Resolution Joshua Jacopetti, Maneet Kaur, Michael Figueroa, and Don Vieira California State University, Stanislaus
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Family Conflict Resolution Conflict always has negative views and connotations to the world. People try to avoid conflict at all costs because it may be uncomfortable or create a hostile environment. Yoder-Wise (2015) states, “Conflict is a disagreement in values or beliefs within oneself or between people”. This is why conflict resolution is such a necessity in the medical field. We work in collaboration with many different ethnicities, beliefs and upbringings. All these mixed individuals and personalities will result in conflict sooner or later. All medical personnel who will experience conflict in one way or another need to know how to approach and resolve conflict in a timely manner. This is important when it comes to dealing with patients and their families as well. Yoder-Wise (2015) also states that conflict “has the potential to cause harm if unresolved”. When conflict resolution is the determining factor in an individual’s health it becomes increasingly important to know how to perform conflict resolution with peers, subordinates and even more importantly the families. A hostile work environment can lead to undesired outcomes with patient care as well as high turnover rate. Patients deserve to be cared for in a professional environment and proper conflict resolution in the nursing field allows for this to occur. Yoder-Wise (2015), defines conflict as a “disagreement in values or beliefs within oneself or between people that causes harm or has the potential to cause harm”. Folger, Poole, and Stutman (2012) add that “conflict results from the interaction of interdependent people who perceive incompatibility and the potential for interface” (Yoder-Wise 2015). Conflict in a workplace, within a group, or between individuals stimulates change that can be either beneficial or detrimental. In the world of nursing, there are many different types of conflict. The professional healthcare team undergoes constant change and includes many individuals from different disciplines. Conflict within the healthcare team is unavoidable and must be dealt with
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in a professional manner to benefit the well-being of the involved patient. Also when dealing with family wants versus what is in the patient’s best interest causes turmoil. There are three different types of conflict discussed in the literature. These include intrapersonal conflict, interpersonal conflict, and organizational conflict. Intrapersonal conflict is conflict that occurs within one’s self. Intrapersonal conflict arises when an individual is faced with a situation where they are to either act in a way or do something that they would not normally do. A person’s standards, morals, and values usually come in to question when faced with interpersonal conflict. Interpersonal conflict is conflict that arises between either two individuals or a group of individuals. According to Yoder-Wise (2015), “interpersonal conflict is the most common type of conflict and transpires between and among patients, family , nurses, physicians, and of other departments. Conflicts that occur focus on a difference of opinion, priority, or approach with others.” Interpersonal conflict is noted to be the type of conflict to inspire the most change. The reason being is that interpersonal conflict often involves a group of individuals and is reported to supervisors and managers who are then forced to implement change in order to satisfy all parties involved. This is the type of conflict that also arises between family and the healthcare team. This is the one of the hardest types of conflict to control especially with a difficult family member or loved one. Organizational conflict is the third and final type of conflict discussed in the literature. Organizational conflict arises when discord exists about policies and procedures, personnel codes of conduct, or accepted norms of behavior and patterns of communication (Yoder-Wise, 2015). One of the most common organizational conflicts that nurses encounter almost on a daily basis is staffing issues. Department heads, supervisors, and managers seem to struggle with ensuring that
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their units are sufficiently staffed with enough nurses to complete the shift. On the other end, nurses take on the burden of extra patients and work overtime to compensate. Another common cause of organizational conflict arises from lack of effective communication and communication breakdown. Conflict resolution can be approached in several ways. The first website studied was at Mediate.com, which was an article called “Conflict Management Training for Health Care Professionals”, by Deborah Geradi. The article appeared in AC Resolution, the quarterly magazine of the association of conflict resolution spring 2003. The author is a mediator and healthcare dispute consultant. The author is also a critical care nurse, with 15 years of experience in academics. She has trained over five thousand medical professionals in conflict resolution techniques. The purpose of this site is to inform the healthcare worker about conflict resolution and how to become a better conflict manager as well what not do in conflict situations. The site provides guidelines as well as includes things to avoid when trying to resolve a conflict. The author has her personal email as well as online access to other articles she has written in her personal website. The article is from 2003 but still has relevant and applicable data with instructions to being a more developed conflict resolution individual. The site itself is well maintained and easily accessible. With a navigation tool bar that includes an open search of the internet and site, as well as drop down menus to search other articles, in regards to conflict resolution. The author of the second article is Jeffery Kaufman and is published on an online journal at the Southern Illinois University website. The purpose of this webpage is for research, development, and information for a scholastic website. The article on this site provides a more in depth look in conflicts from a nursing resolution standpoint. It’s a how to of what is needed to
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resolve conflict as well as what prevents conflict resolution in the medical feel from being obtained. For example egocentric behavior or competitive nature between medical professionals. The data is objective but gives an outline to allow an individual to perform conflict resolution so patients receive the best care that is available to them in the medical setting. This website gives access to a conflict online journal. The site gives no way to the author or the publisher of the journal but gives the option to the library staff of the college directly. This website is updated on a regular basis with new articles and journal entries being it is a scholastic website and database. The article analyzed is from a 2011 journal issue. The website is well maintained however leaves much to be desired in of accessibility. The article itself is difficult to find without the link but the site has a significant amount of data on conflict resolution. Overall a good article but would not be a top choice in this matter. Another site that was used was The College of Nurses of Ontario‘s guideline for “Conflict Prevention and Management.” This site is extremely helpful in providing ways to help deal with conflict resolution. This guideline provides key factors, prevention strategies, and management strategies in regards to nurse-client conflict, conflict with colleagues, workplace conflict, and the role of nurses in formal leadership positions. Conflict is an unavoidable aspect of life and the more educated and prepared one is when it comes to dealing with conflict, the better the outcome. The College of Nurses of Ontario’s guideline also gives a decision tree that guides the resolution process. The College of Nurses of Ontario’s website meets all the credible criteria according to the University of Maryland’s Library. After careful evaluation of the College of Nurses of Ontario’s online guideline, it meets all of the criteria of UOM’s evaluation checklist. The guideline is part of CNO’s standards of care and was copyrighted by CNO in 2009. There are no individual
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authors noted, the organization is the author. The URL for the website is a non-profit organization and ends with “.org”. According to CNO, “the College of Nurses of Ontario is the governing body for ed nurses (RNs), ed practical nurses (RPNs) and nurse practitioners (NPs) in Ontario, Canada”. The guideline for conflict prevention and management clearly states CNO’s mission and vision on the second page. According to CNO, their mission is to protect the public’s right to quality nursing services by providing leadership to the nursing profession in self-regulation. CNO’s vision is excellence in nursing practice everywhere in Ontario (CNO 2009). The website provides clear and reliable up to date information. The Advance Healthcare Network for Nurses (AHNN) provided another source for information in “Resolving Workplace Conflict” that ties directly to healthcare conflict issues. Efficient and streamline healthcare delivery is contingent upon a work environment that allows staff, other departments, and clients that runs smoothly. This system is interrupted when conflict arises between the groups involved. In order to continue forward and restore stability the group must find ways to resolve the issues at hand. This is achieved with effective and functional communication between the involved parties. The model for conflict resolution described by AHNN utilizes Emotional Reactions and Rational Reactions. Emotional reactions yield: avoidance, compete, and give up responses. Rational reactions yield: accommodate, compromise, and collaborate reactions. The chart also expresses the outcomes of each reaction in which collaborate reaction yields a win-win situation. Effective resolution must address both substantive workplace issues and the emotional concerns of those involved. This article met some of the criteria that such as content and knowledge related to effective communication, the site was somewhat difficult to access and not many sources were easy to find.
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The last sources that were looked included an article from the Practice Nurse Journal and the Contemporary Nurses Journal. The article by Taylor (2014) took managing conflict to another level when conflict and aggression are intertwined together. Conflict is always talked about but rarely is conflict that escalates into physical violence discussed. Although verbal abuse is common in the medical setting, physical violence has been on an upward trend. The factors are relatively the same and involve: Circumstances, system and organizational problems, environment, patient factors, and staff factors. This source brought to light a lot in regards to information regarding dealing with conflict. The article by Losa Iglesias (2012), was a crosssectional survey that looked at conflict in both the educational and clinical settings. It was evidenced based responses from Nurses in the field. This article concluded that the most frequently used styles of conflict were compromise, competition, followed by avoidance and accommodation. These were more of a persuasive articles on management than a guideline that could be accessed easily. The content criteria was met however. These articles were the least helpful of the sources that was found, but were good evidenced based research. Out of the articles used the CNO website was the most helpful. The website objective had clear information, and is similar to the California Nurses Association website. The CNO website was last updated on February 17, 2015. The website is well maintained and there are no issues with linking websites. Overall, the website appears to be well maintained, well organized, well designed, and very easy to use. All of the articles and journals were easy to find and their hip criteria and benefits were easy to find. This is a great website to find articles and journals related to conflict resolution. The guideline gives nurses a great layout of preventing and managing conflict resolution. The decision tree can be applied to situation where conflict resolution is needed. A situation that occurred during the nursing program for one of the writers
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could have benefited from this decision tree. During the nursing program, a nurse was faced with a patient and a very active family. The nurse was giving the patient the morning medications with the family at beside. The family had been present throughout the morning, and the nurse assumed it was ok to distribute the medications to the patient. During the medication istration the patient interrupted the nurse and asked the loved one to step outside. The nurse was confused and the patient responded, “It was rude of you to not ask if I was comfortable with my medications being told in front her.” The nurse then apologized for the mistake and would not let that happen again in regards to any visitors to this patient. The patient was on certain antidepressants that were not know to family and had not wanted them to know. Using the guideline tree from the CNO website, the nurse had followed appropriate path to quell the conflict. There was no imminent danger to the patient, so care was continued, the situation was then reported off to the charge nurse. The nurse did resolve the situation with the patient and family and communicated this to the healthcare team. Personal life conflict resolution varies with each situation and in whom the other individual is. In regards to conflict with the spouse a wise man once stated, “If you want to be right, don’t get married” and the common, “Happy wife, happy life”. Therefore the accommodation reaction comes to mind for one of the writers, especially when the spouse has a law degree. If conflict is with a close friend the issue is open for discussion with consideration taken and re-evaluated with the other party for a best possible outcome. This style is more of the collaborative rational reaction which yields a win-win outcome. Other types of personal conflict are not dealt with on a verbal level and it is left up to the other individual to see how much they are willing to risk. Another author of this paper deals with conflict by collaborating directly with those in conflict with. This is beneficial for all parties to be involved in the conflict resolution. It
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is important for conflicting parties to collaborate on solutions because this allows them to find solutions that satisfy both sides. There is no reason to avoid conflict, and that avoiding conflict only prolongs and worsens the issue. Also, when conflict arises in the work place, he always puts his patients’ well-being before his own and advocates for his patients by being assertive when dealing with conflict and approaching the situation with an open mind. Whether it’s conflict between co-workers or conflict with a patient’s family member, these guidelines gives nurses the tools needed to effectively deal with many situations. , “It is easy to escalate, but hard to deescalate” (Koga, 2013). So once all those involved are calm and rational, the resolution process can effectively begin. This starts by determining the source of conflict, how important are the issues, and is resolution urgent or can it be delayed. This takes a conscious decision on behalf of all parties in order to move forward and place the issue behind them (Stanton, 2015). Nurses understand that conflict can be an inevitable process of healthcare when it comes to patient, families, and other of the team, therefore knowing conflict resolution techniques and access to tools to learn them is highly essential.
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References College of Nurses of Ontario (2009). Practice Guideline: Conflict Prevention and Mangement. Retrieved from http://www.cno.org/Global/docs/prac/47004_conflict_prev.pdf Gerardi, D. (2003). Conflict Management Training for Health Care Professionals. ACResolution, The Quarterly Magazine of the Association for conflict Resolution. Retrieved from http://www.mediate.com/articles/gerardi4.cfm#top Kaufman, J. (2011). Conflict management education in medicine: considerations for curriculum designers. Online J Workforce Educ Dev. Retrieved from http://opensiuc.lib.siu.edu/cgi/viewcontent.cgi?article=1101&context=ojwed Koga Institute (Producer). (2013). Robert Koga Memorial Video (Video podcast). Retrieved From http://vimeo.com/85494032 Losa Iglesias, M. E, & Becerro De Bengoa Vallejo, R. (2012). Conflict Resolution Styles in the nursing profession. Contemporary Nurse: A Journal of the Australian Nursing Profession, 43(1), 73-80. Stanton, K. (2015). Resolving workplace conflict. Advance Healthcare Network for Nurses. Retrieved from http:nursing.advanceweb.com/Continuing-Education/CEArticles/Resolving- Workplace-Conflict.aspx Taylor, K. (2014). Managing conflict. Practice Nurse, 44(10), 32-4. Yoder-Wise, P. (2015). Leading and Managing in Nursing. (6th Ed.).