Strategies for Effective Conflict Management (for Nurse and/or Nurse Practitioners)

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•  Strategies for Effective Conflict Management (for Nurse and/or Nurse Practitioners)
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• Length: A minimum of 250 words, not including references
• Citations: At least one high-level scholarly reference in APA from within the last 5 years

Write a short scenario that illustrates a particular type of dysfunctional conflict. Provide the who and what of the conflict. Discuss the components of the scenario that characterize the particular type of dysfunctional conflict. From your readings, identify and explain two strategies to effectively deal with the conflict.

 

 

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Just an added info:

The Lecture:

 

Clarifying Terms by Lucille A. Joel

*Used with Permission from the Joel’s Faculty Resources

Defining negotiation – Effective negotiation helps you to resolve situations where what you want conflicts with what someone else wants. The aim of negotiation is to find a solution that is acceptable to both parties and leaves both parties feeling satisfied with the outcome. Displays of emotionality play no part in negotiation and in fact undermine the rationality of the interaction, introducing an element of manipulation. But emotions must be part of the discussion, because if they are ignored the solution is at best temporary and fragile.

There are different styles of negotiation, depending on circumstances. There is win-lose negotiation. This is usually reserved for situations where you do not need goodwill in the aftermath. But this approach is counterproductive when the dispute is with people with whom you have an ongoing relationship. When people work together routinely, tricks and manipulation will damage trust and weaken the therapeutic relationship. Honesty and openness are the best tactics. In either situation, it is in order to prepare and scrutinize your gamesmanship.

The nurse and negotiation/conflict resolution – APNs are constantly embroiled in a world of negotiation and conflict resolution and are eminently suited to deal with such circumstances. Such situations may involve a patient, the patient’s family or caregiver, representatives of volunteer services, physicians, a myriad of other professionals, and more. For the nurse, much of this proceeds unofficially, with little credit being given to the nurses for the skills that they bring to the encounter. Though not officially schooled in negotiation skills or conflict resolution, APNs are prepared by virtue of the content that is inherent in their educational program, such as interpersonal skills, well-honed communication ability, and a logical mind and a healthy respect for process. Even though the skills are there, a lack of confidence may mitigate against success in negotiation. This lack of confidence may stem from the image of subservience that has historically characterized nurses. According to the literature, the two conflict resolution strategies used most commonly by all categories of nurses are avoidance and compromise. The third most usual strategy is accommodation. These findings are sobering because avoiding and accommodating lead to outcomes where one disadvantages oneself, while compromise runs a weak second because here all parties are equally disadvantaged (Kelly, 2006). Such qualities may weaken the nurse’s position in advanced practice.

In consideration of collaboration – In discussing negotiation and conflict resolution, the term collaboration often comes into play. Registered nurses and advanced practice nurses (APNs), much like other health-care providers, cannot function without a collaborative relationship with many other professionals and nonprofessionals. This is the nature of the work: care, cure, and coordination. But nurses are virtually the only profession that has “collaboration” as a legal mandate. Over the years, APNs have considered collaboration an improvement on the use of the term supervision, even though federal law has defined collaboration as follows (Social Security Act, 42 U.S.C.S., 1395x(aa)(6)): “A process in which a nurse practitioner works with a physician to deliver health care services within the scope of the practitioner’s professional expertise, with medical direction and appropriate supervision as provided for in jointly developed guidelines or other mechanism as defined by the law of the State in which the services are perform

 

The emergence of an NP as a primary provider rather than a supervised helper is not reflected in the Social Security Act as cited above. State law may not mention collaboration or may even define collaboration without using the term supervision; however, federal law requires, through its definition of collaboration, supervision. Although there is a difference in the dictionary definition of these words—collaborate means to work jointly with others and supervise means to oversee or superintend—the legal term to collaborate means that the group to whom this mandate is directed is not the final authority. APNs are not the final authority on all things, but they are the final authority on some things. APNs cannot expect that health insurance plans will accept them as primary care providers unless there is legal justification for a significant degree of authority. The Balanced Budget Act of 1997 gave direct reimbursement to APNs for services to Medicare recipients, but it would take another act of Congress to change this definition of collaboration. This remains one of the dilemmas, and state laws have not been tested enough on this issue. APN leadership cautions one to be very careful of state-to-state variation in the use of terms. In many states there is no requirement for collaborative agreements. Rather, some APNs, administrators, and physicians incorrectly refer to the Joint Protocol as a collaborative agreement. The Joint Protocol is required in many jurisdictions for prescribing purposes. The language of the Joint Protocol should be as broad (as opposed to task-specific) and simple as possible. Some APNs also refer to the business agreements they develop with a physician employer as “collaborative agreements.” In other states, APNs are required to have an agreement with a physician collaborator that covers all aspects of their practice. These agreements may go much further than prescriptive authority and include activities that are in the domain of nursing, thereby limiting practice rights that were ours originally. Laws vary from state to state. These terms are very precise and should not be used out of context. The best source for state-specific information is Buppert’s Nurse Practitioner: Business Practice and Legal Guide (2011) and Pearson’s annual summary of state legislation (2012).

Addressing power imbalances – Power is an important and complex issue facing anyone seeking a negotiated solution to a conflict. Before negotiating, clarify the true sources of power in the situation. Your supervisor or the physician may have legitimate power; either may also have coercive power, supported by statute that compels you to behave in certain ways and do certain tasks associated with your work. You may have a great deal of expert power from your education and experience. Any of you may possess information power by knowing institutional systems and how to get things done. And you all may possess referent power, through which others refer to you with respect for the manner in which you conduct yourself. It is unfair to simplify power as something only belonging to a select few. It is also well to emphasize that power is given. Nurses have the potential for enormous power derived from their place in the public trust, their special knowledge and skills, and their intuitive grasp of the way things work in health care (Joel, 2011).

Reference

Buppert, C. (2011). Nurse practitioner: Business practice and legal guide (4th ed.). Sudbury, MA: Jones & Bartlett Learning.

Joel, L. A. (2011). Kelly’s dimensions of professional nursing. New York: McGraw-Hill.

Kelly, J. (2006). An overview of conflict. Dimensions of Critical Care Nursing, 25(1), 22–28.

Pearson, L. (2012). The Pearson report: A national overview of nurse practitioner legislation and healthcare issues. American Journal for Nurse Practitioners, 16(2), 9–80.

Social Security Act. 42 U.S.C.S., 1395x(aa)(6)