Conflict resolution in nursing: 7 essential strategies

Nurses are one of the most important groups of essential healthcare professionals. They make up over half of Australia’s health workforce and provide care for people in nearly all healthcare settings. Nurses are critical to the functioning of our world-class health system.

Nursing is a rewarding career, but healthcare workplaces can also be fraught with differences of opinion and disputes. Many factors cause this, including high stress levels, fatigue, the need for constant teamwork, workplace changes, staff shortages and high staff turnover.

As pressures on our nursing workforce increase, conflict resolution is becoming an increasingly critical skill for nurses in both clinical and leadership roles. In fact, having these skills can be a major boost to your nursing career.

Below, we’ll explore conflict resolution in nursing, why conflict occurs and key conflict resolution strategies you can use as a nurse leader. 

What is conflict resolution in nursing?

Conflict exists in most workplaces and healthcare settings are no exception. Health services and hospitals are complex operations involving many types of care, multiple administrative systems and a wide range of stakeholders, which increases the potential for different forms of conflict.

The types of conflict that nurses can be involved in range from differences of opinion about care and work practices to frustration, personal disagreements, bullying, abusive behaviour and even threats of violence.

Disputes can be between different groups of people, including:

• Nurses working within the same team or from different teams
• Nurses and their managers
• Nurses and other health professionals, including doctors, allied health and administrative staff
• Patients, their families and nurses
• External organisations and health services.

These varying types of conflict often need to be managed in different ways.

What are the causes of conflict in healthcare settings?

The main causes of conflict in health and nursing workplaces include:

• Constant changes in the healthcare landscape, including technological change, scientific advances, and disruptive factors such as pandemics and the health impacts of climate change.
• Workplace stress, long hours, fatigue and burnout.
• High staff turnover and personnel shortages, which are more prevalent in some sectors, such as remote services, mental health and aged care.
• The necessity of teamwork, including in both nursing and multidisciplinary teams.
• The physical and emotional challenges of nursing due to the heavy workload, and morbidity and mortality of patients.

The importance of conflict resolution in nursing

Resolving conflict in healthcare settings is particularly important and can have life-saving consequences for several reasons.

Firstly, recognising and solving conflict is essential to ensuring that interpersonal issues don’t interfere with day-to-day nursing practice and the quality of care provided.

Secondly, a positive environment and healthy workplace culture are vital to keeping nurses in their jobs and attracting new nursing staff. This is essential in today’s environment of burnout, high staff turnover and personnel shortages in the healthcare sector.

And thirdly, conflict can spiral into severe workplace issues, such as:

• Toxic workplace environments in which staff make mistakes and find it difficult to function.
• Increasing violence against healthcare workers - which can include both physical and non-physical violence as well as sexual harassment.

7 strategies for conflict resolution in nursing

Let’s face it, nobody likes conflict. However, given that conflict is inevitable in most nursing workplaces, it’s important to understand how best to manage it.

Many people associate workplace conflict with hostile and threatening situations, but this does not need to be the case. When handled effectively, conflict can deliver positive outcomes, such as improved communication, better relationships, increased efficiency and well-functioning teams.

Some of the most important strategies for conflict resolution in healthcare are outlined below.

Understand potential responses to conflict

Understanding how different people respond to conflict is extremely helpful in working out how best to resolve it. 

The Thomas-Kilmann Conflict Mode Instrument (TKI), developed in the 1970s, has been successfully used for decades to achieve this. It identifies five different modes of responding to conflict:

• Competing: Pursuing a person or group’s own concerns at the other’s expense in a way that is uncooperative, assertive and focused on winning. This often involves the use of power dynamics such as rank or position.
• Accommodating: Neglecting one’s own priorities to satisfy the other party. This approach is cooperative and unassertive, including elements such as selflessness, self-sacrifice, obedience and yielding.
• Avoiding: Sidestepping the issues and not pursuing the interests of any party. This method is unassertive and uncooperative, and it can involve making diplomatic excuses, postponing an issue, or simply withdrawing from a conflict.
• Collaborating: Working with others to find outcomes that satisfy everyone in a way that’s both assertive and cooperative. This involves exploring the needs and viewpoints of all parties to find creative solutions.
• Compromising: Resolving conflict in a way that at least partially satisfies the needs of all involved. This is a more moderate approach to being both assertive and cooperative, and it can include compromising or exchanging concessions.

Most people have a preferred type of response due to both character traits and learnt behaviour. In nursing environments, where conflict can involve overstressed staff and emotionally charged situations, collaborating and compromising are often preferable.

Identify communication styles in conflict

In a conflict, a person may intentionally or unintentionally use a variety of communication styles – some more adaptive than others. Understanding communication styles helps determine the best conflict resolution method for any given circumstance and redirects default responses to conflict when necessary.

Commonly used communication approaches include:

• Assertive: Expressing views in a way that’s direct, clear, respectful and considerate. This can minimise anger, enable better meeting of needs and build positive relationships. 
• Aggressive: Forceful, pushy and uncompromising, this approach focuses primarily on an individual’s own needs and feelings. This can hurt relationships, build hostility and damage the self-esteem of others.
• Submissive: Avoiding expression of one’s own views, needs and feelings, and prioritising those of others. This is often aimed at people-pleasing and avoiding conflict, and can lead to repressed emotions, angry outbursts and resentment. 
• Passive-aggressive: Indirect, unclear and often convoluted communication, such as using sarcasm or innuendo. This is usually due to an unhealthy fear of confrontation and honest self-expression, which leads to misunderstandings, frustration, tension and mistrust.
• Manipulative: Using deceit and cunning to pursue self-advancement, for example, concealing facts or finding ways to create enmity between others for your own benefit. This leads to mistrust, confusion and toxic relationships.

Encourage empathy

A simple definition of empathy is “the ability to walk in another’s shoes and understand their experience.”

It involves listening rather than judging and communicating understanding of another’s feelings. Empathy is vital for nurses as it helps them better connect with and care for their patients. Not everyone is naturally empathic, but this trait can be learnt and developed through practice.

Empathy is also an important part of emotional intelligence, which is the ability to identify, harness and manage emotions. 

Research suggests that empathic and emotionally intelligent carers improve patient experience and produce better health outcomes. Importantly, these abilities also enable nurses to build respectful relationships with others, and to reduce and resolve workplace conflict.

Use active listening

Active listening involves being fully present when another person is speaking and letting them know that you both hear and understand their message. This requires:

• Full concentration
• Using body language to show you’re listening, such as eye contact and nodding
• Engaging with the speaker, for example, clarifying facts or asking questions
• Giving feedback and responding appropriately.

It builds respectful, empathic and trusting relationships, and is critical in reducing misunderstandings and disputes common in nursing contexts. 

Develop negotiation skills

Negotiation is the process by which parties to a conflict explore common ground to find mutually acceptable solutions. It’s one of the most effective and commonly used mechanisms in conflict resolution.

There are two broad approaches to negotiation, which are suited to different types of disputes that can occur in healthcare contexts:

• Distributive bargaining: Negotiating over a fixed resource, often referred to as “dividing up the pie.” This competitive, strategy-based approach is focused on the outcome rather than relationships and often leads to a win-lose result. An example is allocating scarce healthcare supplies to different teams during a crisis.
• Integrative negotiation: This is a more holistic approach that aims to identify win-win solutions. Rather than focusing on the resource, parties explore each other's needs in a collaborative way to find additional benefits they can offer – like “expanding the pie.”

For example, in allocations, all resources that each crisis-response team needs (such as extra beds or staff time and supplies) are considered.  

Develop mediation skills

Mediation involves acting as a neutral third party to help find a mutually acceptable solution to a conflict. Mediators help those involved to clarify their needs, communicate well, build understanding and apply creative problem-solving techniques.

Mediation is well suited to disputes within healthcare workplaces because it can:

Ensure an unbiased process.
Help all parties to feel that they are being treated equally and fairly, which is important when people are feeling stressed and vulnerable.
Reduce the need to allocate often-scarce staff time to conflict resolution.

Mediation skills include active listening, adaptability, concentration, empathy, objectivity, persuasion and perseverance as well as strong communication and problem-solving abilities.

Establish and apply appropriate policies

According to the Australian Medical Association, best practice employers should have fair, simple, confidential and transparent dispute resolution procedures in place.

Clear policies help employers to address conflict quickly and effectively, leading to less likelihood of disputes escalating, and benefits such as higher staff retention and reduced mediation costs.

Conflict resolution policies in nursing settings should include:

• Clear pathways for registering, assessing and responding to disputes.
• Conflict management options for different situations, such as negotiation, mediation and arbitration.
• A transparent and accessible system for recording disputes and outcomes.
• Clear timeframes for all procedures.

Nurses with advanced knowledge of conflict resolution can ensure that relevant policies and procedures are followed and can also take the lead in developing, improving and updating them as needed.

Advance your knowledge in conflict resolution and nursing

The knowledge and skills needed to implement these key conflict resolution strategies in healthcare workplaces can be developed through study and practice. JCU Online’s Master of Nursing offers a Leadership and Management specialisation that develops expertise in dispute resolution.

This stream includes a dedicated conflict resolution unit where you will learn about the key theories, styles, strategies and tactics of negotiation, mediation and coaching. You will also build all-important communication skills, and gain practical experience in analysing and resolving conflict in nursing contexts.

With so many changes and pressures on Australia’s healthcare system, leaders in nursing are more important than ever. Advanced skills in conflict resolution will prepare you to take on management roles that empower nurses to focus on what they do best – delivering outstanding patient care.

Gain the skills you need to evolve your nursing career. With JCU Online, you’ll study at one of Australia’s top universities, with 100% flexibility and unparalleled support.

Find out how JCU Online’s Master of Nursing can give you the leadership skills you need to drive positive change. Speak to one of our Student Enrolment Advisors today on 1300 535 919.