5 mins: Ask group to brainstorm a definition of conflict.
(5min)Conflict = tension arising from incompatible needs in which the actions of one frustrate the ability of the other to achieve a goal (Valentine, 1995, cited in Arnold & Boggs 2007)Conflict always has an emotional componentIntrapersonal = conflict within our selfInterpersonal = conflict between people.Relate to nursing role: intra, when personal morals do not match patient request, e.g terminationInter-personal with colleagues, patient or familyPotential Causes: misunderstanding/poor communication/differences in values/goals/personality differences/stress.
(20 min)Lecturer to conduct exercise in understanding personal responses to conflict . Self-awareness of existing response is first step in developing increased ability to resolve conflict. Students participate in the Student Activity as outlined on Page 273 of Arnold & Boggs, 2007. or stage a conflict in class either with two students or two lecturers and ask students to identify their feelings in response to the tension in the classroom using slide 7 to support discussion.
Assumptions: conflict is NOT uncommon; it is the nurse’s responsibility to attempt to resolve the conflict; self-awareness is essential in improving ability to resolve conflict; conflict involves a perceived threat to self in some way.Conflict can be worsened by: using accusatory or blaming toneOffering false sympathy or unrealistic reassuranceConveying a lack of understanding of client’s viewpointUnrealistic expectations of clientUsing authoritarian tone, seeing self as infallible
10 mins:Four Styles: Students to complete activity to identify own conflict resolutions style in lecturer resources10 mins: Lecturer led discussion exploring the four stylesAvoidance: most frequent style demonstrated by female nurses. Appropriate when the other party is more “powerful” or the cost of addressing outweighs benefit of resolution. Can lead to a lose-lose situation.Accommodation: very common response. Cooperative but not assertive. Maintains the peace. A “lose-win” situation.Competition: a style of conflict management characterised by aggression and lack of compromise with the goal of one party dominating the other.Authority may be invoked to bring change. Maybe appropriate for quick decision-making but in the long term ends in lose-lose situation.Collaboration: a solution-oriented approach: Characterised by directly confronting the issue, acknowleding feelings and using integrative approach.
Explore issues underpinning conflict. Students actively discuss with lecturer, their experiences and reflections on material.Gender: Expression of emotions differs between genders Women are socialised to respond in ways different to men (“tend and befriend” response) Women tend to use accommodative styles Men tend towards collaboration … literature inconclusive on gender howeverCulture Behaviours are learned through cultural socialisation process Those from group-oriented cultures tend to use avoidance - those from individual-oriented cultures tend to use competitive/dominating styles.Professional ethics/role socialisation studies show that 75% of nursing ethical dilemmas relate to perceptions of inadequate care woman are often socialised to “not make waves” Intrapersonal conflict often arises from an ethical dilemma where there are two different options.
Conflict is inherent in our world – it is not something that can be avoidedStop and discuss the potential benefits that can come about from successful resolution of conflict: Within selfBetween nurse and clientBetween nurse and colleaguesBetween nurse and society. Professional image in public arena. Perception of nursing compared to reality
Emotion is integral component but can overrun the resolution process when they dominateEmotions must be recognised and acceptedEach party must accept ownership of their emotions and not project themParties must accept the potential for emotional responses to be misunderstood or expressed too intensely.Relate back to EI, how our self concept and management will impact on our emotional responses
1.) Be specific on the issue2.) Know your own triggers and buttons3.) Be aware of history of relationship issues and keep separate4.) Keep on track with the current issue and nothing else5.) Creatively consider the range of issues – consider options from both parties6.) Look for similar decisions that have been made that reflect fairness and objectivity.
Links to next slide, characteristics of passive, assertive and aggressive responses
10 mins:Can students identify their own behaviours, responses. Can they identify people that they know from the descriptions above.
defines who we are, involves making decisions for ourselves, how we will spend our time, how much privacy we need, letting others know how we expect to be treated, set the boundaries between ourselves and others.means making decisions based on how we feel – not on the basis of what others expect of us or what they want, we recognise our own needs as primary, we do not feel guilty about saying ‘no’ – avoid negative feelings, we still have regard for the needs or requests of others – but we don’t lose sight of our own. We do not have to justify a ‘no’means sticking to our position, repeatedly outlining our message clearly and positively until it is understood, try not to repeat ourselves ‘parrot-fashion’ - use a variety of language to convey a similar message, important to acknowledge we have heard the other person’s view, we will be seen as being prepared to stand up for ourselves – not submissive.it is a basic right to ask, in a reasonable manner, for what we want, be aware of what we want, state what we want in a non-threatening way – use clear assertive language, do not apologise when requesting what we want,aim for a win-win outcome.
25 mins . Assertiveness training: scripting assertive responses. Groups of 3, two to role play, third to decide if response assertive, passive or aggressive in lecturer resources Day 6.
Use this slide to wrap up todays session and link back to conflict resolution.
Session outcomesBN 506: 20111. Specify the characteristics of assertivecommunication2. Define conflict3. Describe factors that impact on effective conflictresolution4. Examine strategies to conflict resolution5. Employ foundational communication skills in aconflict situation6. Recognition and strategies for de-escalation ofvolatile situations.
Why is conflict functional ?A component of an ever-changinghealth contextWhat do you think?BN 506: 2011
Identifying Dysfunctional Conflict:• When emotion distorts the issue• Feelings that aredenied/projected/misperceived/overstatedBN 506: 2011
Principles of ConflictResolutionX1. Identify the issue2. Know your own responseto conflict3. Separate the problemfrom the people4. Stay focused5. Identify all options6. Look for goodprecedentsBN 506: 2011
Assertive vs Aggressive• “To stand up for your rightswithout infringing on therights of others and toreduce anxiety.”• Assertive statementscontain “I” statements thattake responsibility.• Tend to dominate andsuppress the other personsrights.• Aggressive responses oftenconsist of “you” statementsthat place blame and undueresponsibility.Arnold & Boggs (2007) pg322-323BN 506: 2011
Type of behaviour Passive Assertive AggressiveMaking decisions Allowing others tomake decisions foryouMaking your owndecisionsMaking decisions forothersDealing with feelings Keeping quiet aboutown feelings andthoughtsTactfully conveyingyour own thoughtsAggressivelyconveying thoughts,without tact orconsiderationAchievement of goals Trying to reach goalsindirectly withmanipulation orflatteryReaching goals in adirect, self-respectingmannerReaching goals in anintimidating,overbearing mannerSelf perception Feelings ofanxiousness,disempoweredBelief in yourself andcapabilitiesDomineering,belittling, poorperception of selfOther’s perception Little or no respect Trustworthy Do not trust, or arescared of youBN 506: 2011
Four steps to assertiveness• Setting limits• Refusal, saying no• Persistence, using a broken record technique• Making a requestBN 506: 2011
ReferencesAllnurses.com. (2009). Concept analysis: patient advocacy. Retrieved fromhttp://allnurses.com/nursing-articles/concept-analysis-patient-389357.htmlArnold, E. C. & Boggs, K. U. (2007). Interpersonal relationships: professionalcommunication skills for nurses (6th ed.). Saunders Elsevier: St Louis.Craven, R. F, & Hirnle, C. J. (2009). Fundamentals of nursing: human healthand function (6th ed.). Lippincott Williams & Wilkins: Philadephia.Negarandeh, R, Oskouie, F, Ahmadi, F.; Nikravesh, M.; & Hallberg, I. R. (2006).Patient advocacy: barriers and facilitators. BMC Nursing, 5(3). Retrievedfrom http://www.biomedcentral.com/content/pdf/1472-6955-5-3.pdfRoger, B. E, Gates, B. & Kenworthy, N. (2003). Interpersonal communication innursing: theory and practice (2nd ed.). London: Churchill Livingstone.Turnbull, J. et al (1990). Turn it around: short tem management of aggressionand anger. Journal of psychosocial nursing, 28, 6-12BN 506: 2011