Nursing -- Health Care Administration and Leadership The modern clinical health care environment can be highly stressful for employees and lead to various types of conflicts in the workplace. Within nursing, those conflicts typically manifest themselves as abuse of authority as between different levels of authority, a hostile climate with respect to reporting problems, scheduling preferences, and numerous problems associated with social cliques within health care teams and nursing units. If not addressed by administration, power struggles often develop, requiring negotiation and conflict management after the fact. In general, the conflict management strategies of avoidance, accommodation, smoothing, and competing are not particularly helpful. Instead, administrative policies emphasizing negotiation and collaboration is the most appropriate conflict management approach within nursing units and the enforcement of clear administrative policies and protocols are the most effective method of minimizing conflict as between different hierarchical levels of authority.

Negotiation and Conflict Management in the Health Care Setting

At the nursing unit level, the principal sources of interpersonal conflict are personality differences, group allegiances, social exclusion, and competition for preferred schedules and shifts (Marquis & Huston, 2008). None of those types of conflict is amenable to avoidance, accommodation, smoothing, or competition; all of those approaches to conflict resolution are more likely to perpetuate and exacerbate the underlying problems and magnify the interpersonal conflicts emerging...

Instead, health care institutions and administrators must set and enforce strict policies designed to minimize the development of interpersonal conflict capable of compromising the quality and safety of health care by undermining the effectiveness of nursing units (Marquis & Huston, 2008).
Negotiation and conflict resolution at the nursing unit level should emphasize administrative fairness and institutional expectations of mutual support and professional collaboration among coworkers (Rosengren, Bondas, Nordholm, et al., 2010). In principle, that requires addressing the typical sources of interpersonal conflict in advance, before they actually occur, and outlining the expectations of supervisors and administrators. A carrot-and-stick approach in that regard would involve establishing an institutional culture in which nursing units receive conflict awareness and avoidance training in connection with a zero-tolerance perspective on the part of administrators.

That would include addressing inappropriate social exclusion and the expectation of any unofficial privileges or latitude associated with seniority beyond those actually established and recognized by the institutional administration. Negative behaviors that undermine the effectiveness of teams should trigger intervention and positive behaviors in the area of collaboration should trigger recognition and reward. Therefore, at the nursing unit (or working group) level, the encouragement of collaboration and the discouragement of conflict-generating behaviors in relation to the typical causes of interpersonal conflict (i.e. social…