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This is a positive view of conflict, which on the surface may appear negative. If one asked nurses if they wanted to experience conflict, they would say no. Probably behind their response is the fact that they do not know how to handle conflict and feel uncomfortable with it. However, if you asked staff, “Would you like to work in an environment where staff at all levels could be direct without concern of repercussions and could actively dialogue about issues and problems without others taking comments personally?” many staff would most likely see this as positive and not conflict. Avoidance of conflict, however, usually means that it will catch up with the person again, and then it may be more difficult to resolve. There may then be more emotions attached to it, making it more difficult to resolve.

Causes of Conflict

Effective resolution of conflict requires an understanding of the cause of the conflict; however, some conflicts may have more than one cause. It is easy to jump to conclusions without doing a thorough assessment. Some of the typical causes of conflict between individuals and between teams/groups are “whether resources are shared equitably; insufficient explanation of expectations, leading to performance being questioned; unexplained changes that disturb routines and processes and that team members are not prepared for; and stress resulting from changes that team members do not understand and may see as threatening” ( Finkelman & Kenner, 2016 , p. 336).

Two predictors of conflict are the existence of competition for resources and inadequate communication. It is rare that a major change on a unit or in an HCO does not result in competition for resources (staff, financial, space, supplies), so conflicts arise between units or between those who may or may not receive the resources or may lose resources. Causes of conflict can be varied. An understanding of a conflict requires as thorough an assessment as possible. Along with the assessment, it is important to understand the stages of conflict.

Stages of Conflict

There are four stages of conflict that help describe the process of conflict development ( MBA, 2014 ):

1. Latent conflict. This stage involves the anticipation of conflict. Competition for resources or inadequate communication can be predictors of conflict. Anticipating conflict can increase tension. This is when staff may verbalize, “We know this is going to be a problem,” or may feel this internally. The anticipation of conflict can occur between units that

Figure 13-2  Stages of conflict

accept one another’s patients when one unit does not think that the staff members on the other unit are very competent yet must accept orders and patient plans from them.

2. Perceived conflict. This stage requires recognition or awareness that conflict exists at a particular time. It may not be discussed but only felt. Perception is very important as it can affect whether or not there really is a conflict, what is known about the conflict, and how it might be resolved.

3. Felt conflict. This occurs when individuals begin to have feelings about the conflict such as anxiety or anger. Staff feel stress at this time. If avoidance is used at this time, it may prevent the conflict from moving to the next stage. Avoidance may be appropriate in some circumstances, but sometimes it just covers over the conflict and does not resolve it. In this case the conflict may come up again and be more complicated. Trust plays a role here. How much do staff trust that the situation will be resolved effectively? How comfortable do staff members feel in being open with their feelings and opinions?

4. Manifest conflict. This is overt conflict. At this time the conflict can be constructive or destructive. Examples of destructive behavior related to the conflict are ignoring a policy, denying a problem, avoiding a staff member, and discussing staff in public with negative comments. Examples of constructive responses to the conflict include encouraging the team to identify and solve the problem, expressing appropriate feelings, and offering to help out a staff member. ( Figure 13-2 highlights the stages of conflict.)

Prevention of Conflict

Some conflict can be prevented, so it is important to take preventive steps whenever possible to correct a problem before it develops into a conflict. A staff team or HCO that says it has no conflicts is either not aware of conflict or prefers not to acknowledge it. Prevention of conflict should focus on the typical causes of conflict that have been identified in this chapter. Clear communication, known expectations, appropriate allocation of resources, and delineation of roles and responsibilities will go a long way toward preventing conflict. If the goal is to eliminate all conflict, this will not be successful because it cannot be done.

Since not all conflict can be prevented, managers and staff need to know how to manage conflict and resolve it when it exists. It is important to identify potential barriers that can make it more likely that a situation will turn into a conflict or will act as barriers to conflict resolution. First and foremost, if all staff make an effort to decrease their tension or stress level, this will go a long way in preventing or resolving conflict. In addition to this strategy, it is important to improve communication, recognize team members as members with expertise, listen and compromise to get to the most effective decision given the available data, understand the roles and responsibilities of team/staff members, and be willing to evaluate practice and team functioning.