#1: You have a heated exchange with an attending physician. To your dismay, you realize that you still have to make rounds with him or her.

#2: In the middle of a code or a cardiac arrest, one of your patients is on the brink of dying as a result of disagreements between the code team members.

The above scenes are more common than we would like to admit. Problem-solving, decision-making, meeting needs, and maintaining human relationships are all parts of our daily personal and professional lives.

Conflict is a basic social interaction process that is part of our daily lives, too. It results from simultaneously emerging events that are incompatible.¹

The ability to manage conflict is a critical skill that every nurse must possess to be effective on the job. Whenever conflict develops, whether with a boss, subordinate, or peer, it is expected that nurses choose strategies that fit the situation. Unfortunately nurses tend to select approaches that are more often comfortable than effective.

A three-hospital survey of nurses revealed that regardless of institutional or demographic characteristics, nurses use avoidance as a primary strategy to resolve conflict. The second and third most frequently used were compromise and accommodation.

All three strategies involve losing on some level. On the other hand, nurses were least likely to use competition to settle disagreements. Instead of choosing a strategy based on comfort level, nurses need to use the appropriate strategy to effectively and positively achieve beneficial outcomes.²

Choosing a Strategy

Strategies for resolving conflict include competition, accommodation, avoidance, collaboration, and cooperation. Each method can be appropriate in different situations.

Accommodation is a lose-win strategy that can be used when preserving relationships, being reasonable, or encouraging others to express themselves and learn by their actions. For example, in a situation where two team leaders have to decide which team should get the extra nurse, one leader might concede to the other, upon complete evaluation of the situation.

Competition is a win-lose approach. In some cases, it might be the only strategy that will achieve necessary change, as in the emergency situation described earlier. In an emergency, especially when a life is at stake, there is no time to negotiate disagreements between team members. When other reasonable strategies have failed, someone has to take charge and direct the team without disruptive discussions.

Avoidance, a lose-lose technique, can also be used effectively in certain cases. After that heated exchange with the physician, as in the earlier scenario, a nurse might choose to ask a colleague to make rounds with the physician until enough time passes for both parties to cool down.

Compromise is a win-lose/lose-win. This technique is best used to achieve temporary settlement and at least partially satisfy each person’s objectives. For instance, a day-nurse might cover an evening sick call if his or her next scheduled shift can be covered by another nurse.

Collaboration, a win-win approach, is best used to preserve objectives that are not synergistic with each other, but cannot be compromised. This particular method merges the parties’ experiences and feelings to explore creative alternatives that would not have been thought of individually.

Implementing a Strategy

Regardless of the chosen strategy, successful conflict resolution should start with a thorough assessment of the problem and the desired outcome before confronting the conflict. The timing and location are also critical factors. An environment that affords privacy is always best. At all cost, confrontation should be avoided when emotions are high.

During the discussion, listen and respond with empathy. Display credibility and confidence, and avoid automatic and reactive responses.

Professionals need to conduct self-evaluation to gain insight about their methods of resolving conflicts and factors that tend to trigger inappropriate responses. Knowing how to choose and apply appropriate strategies will allow nurses to manage conflict and achieve the patient’s, the organization’s and their own professional goals.