Clinical Leadership and Management in Nursing and Specialisations

Introduction to Conflict Resolution

Conflict resolution is defined as a process through which the engaged parties can resolve a dispute through a mutual settlement and agreement (Cherry & Jacob, 2016). Conflict resolution has been defined as a primary characteristic of a competent nurse as it helps in the development of leadership skills and helps in maintaining a healthy work environment. The Nursing and Midwifery Board of Australia identifies conflict resolution as a primary possession of a good nursing practice (Nursing and Midwifery Board of Australia, 2018). The importance of conflict resolution in nursing is also explained in healthcare by its multidisciplinary nature and collaborative approach. Since healthcare professionals are often working in teams, conflicts may arise as a natural consequence of the interaction (Lahana et al., 2019). Conflicts also present their importance in terms of maintaining the cohesion in a team as it helps in the identification of areas of common value, provides greater stability through team building, serves to provide a balance between the extremes, provides clarity in the rules and responsibilities, and assist in the determination of roles and responsibilities by diminishing ambiguities (Baddar et al., 2016). This essay will provide a critical reflective analysis of a conflicting situation in a clinical setting by discussing the immediate measures of conflict resolution and the development of further steps for conflict resolution. This essay also discusses the outcomes of the scenario and provides recommendations to further improve them and prevent such conflicts in future.

Description of Event

In my recent appointment in a clinical setting as a registered nurse, my responsibility was to attend patients in pediatry ward in the morning shift. I saw a fellow student nurse in a rush going to see and see a patient in the next clinical ward. I acknowledged the unusual haste and asked her if everything was fine. She said that she was getting late to attend the patient. I asked her if she required any assistance and also if she has been able to collect the handover from the last nurse in this haste. She said that she didn’t have time and had not been able to get the ISBAR handover from the previous nurse in duty and was carrying the regular medications to the concerned patient I interrupted her and told her that I remembered doctor making a few changes for the patient. Since she was not informed about this incident and assumed that this would be regular doctor visit, she asserted that the medications available to the patients are the same and the vitals are in congruence to other days. I suggested her to still collect the handover before coming just to be sure as it was the part of patient safety protocol of the hospital. She got agitated and asserted that this was an unwanted intervention and was causing a delay. I requested a senior nurse to follow up with the handover to prevent the medication error. Eventually, the fellow student nurse acknowledged that she should have taken the advice and thanked me as it helped prevent a medication error.

Immediate Resolution

Conflict resolution requires immediate action as it helps in preventing further complications associated with the problem and ensures the most suitable outcome. The immediate resolution should be to communicate (Labrague & McEnroe–Petitte, 2017). Communication plays an essential role in conflict resolution and has been considered as an ideal method to resolve a dispute. Effective communication allows to negotiate, understand, and deliver in a situation. Communication helps in the expression of concerns of the individuals present in the dispute and helps in the delivery of a suitable outcome (Aqqad et al., 2019). The immediate resolution to this situation would be communicated. It is important to be polite, patient, and be free from assumptions while having a conversation in a dispute and the individual in question must be given adequate time to think and derive to a logical conclusion (Hamdan et al., 2019).

The second essential immediate response will be to assert the importance of collaboration and teamwork. Since the primary goal of the entire healthcare system is to ensure the well being of the patients and ensure their beneficence. Since the student nurse failed to collect the ISBAR handover, it becomes the responsibility of other healthcare professionals to remind and follow the regulations to ensure the beneficence of the patient. Therefore, through strong communication and a collaborative approach, the conflict can be resolved. A patient and persistent approach are ideal that provides adequate time to investigate and provides equal opportunity for each side to present the with the case important for immediate resolution and was therefore followed (Özkan Tuncay et al., 2018).

Outcomes of Conflict Resolution

The immediate outcome of this approach was that the student nurse was able to realize her limitation and was able to rectify her behaviour that ensured the wellbeing of the patient. The resolution of this conflict prevented a medication error and therefore enables maintenance of patient’s beneficence and professional conduct in the nursing practice. The healthcare services are a collaborative effort that ensures the overall well being of the patient through team efforts. It was my responsibility as a registered nurse to ensure that the student nurse had collected the handover as I had remembered medication changes with the concerned patient. The assistance of a senior authority with the ISBAR handover had helped the student nurse understand the importance of handovers in the nursing practice and the need to verify them before addressing the patient. She also understood the importance of rules and regulations as they ensure the best practice in the clinical setting. If this conflict would not have been resolved, it could have given rise to several problems. First, the treatment of the patient without the handover would be the breach of the hospital regularizations. Further, the medication error would be the breach of the code of conduct and could also result in patient harm (Özkan Tuncay et al., 2018). The well being of the patient is the responsibility of the healthcare professional and must be ensured with responsibility. Lack of which, could result in the termination of the nurse responsible for this ignorance (Choi et al.,2018).

Critical Evaluation of Conflict Resolution

The steps in conflict resolution include clarification on the disagreement and then the establishment of the goals (Arveklev et al., 2018). The discussion is done to reach a common goal. The barriers to the application of a common goal are addressed and the best suitable way to resolve the conflict through communication is derived (Choi et al., 2018). The agreement is acknowledged and the cumulative decision is accepted (Hamdan et al., 2019). In the provided scenario, the common goal was identified was to ensure the beneficence of the patient at high priority and provide him with the requisite medication without any further delay. However, the conflict stayed on the need for cross verification of the medication from the ISBAR. The student nurse asserted that the treatment was already delayed and further verification would take even longer. However, as a registered nurse, I could recall the doctor visit and certain changes, I asserted on checking the handover. A mutual point arrived when assistance from the senior nurse was taken who had collected the handover of the concerned patient from the last nurse in charge.

The availability of handover signalled the change of medication error and therefore, the required medication was provided to the patient eliminating the risk of medication error. Through communication and collaborative effort was essential for this resolution as the student nurse was in charge of the patient care in the ward and it was her responsibility to cross verify the handover before treating the patient. ISBAR handovers are a crucial form of written communication in healthcare as they ensure that the patient needs and progressions are duly noted regularly and communicated with the healthcare staff to avoid any ambiguities (Chiew et al., 2019). Since the student nurse had developed an agitated response in the course of the discussion, the communication with the nurse could have been better to avoid such a reaction.

The primary goal of the intervention could have been stated more clearly so that the student nurse did not find it invasive and would have considered this as a gesture of assistance, as it was meant to be (Kim & Kim, 2018). However, in the end, the student nurse did express gratitude for preventing the medication error in the clinical setting that helped in the resolution of this dispute with a positive note. Further, through this incidence, the student nurse was also able to learn the importance of handovers and maintain professional conduct established by the healthcare systems for regularizations as they not only help in guiding towards the lawful behaviour but also ensure the best practice in the clinical setting aimed for highest quality care (Wallensteen, 2018).

Recommended Steps for Improvements

The senior professional in the conflict needs to embrace the conflict and understand every parameter before taking any steps. When a conflict arises, its ignorance may result in further complications and worsen the situation. It is, therefore, important to indulge in a communication that is meaningful and clear. It is also important to establish a suitable goal aimed with mutual discussion (Wallensteen, 2018). Therefore, it is recommended that the goal of the conversation is shared early in the conversation to determine the course of the discussion. It is import to be assertive yet, polite and persistent ensure a discussion that is free-flowing and in the best spirit in the clinical setting (Sexton & Orchard, 2016). Conflicts are natural in a work setting as every individual may have a different approach for how the situation is dealt with. It, therefore, provides a medium for the discussion providing scope for exploring the better-suited alternatives. The agreement should be eventually be drawn in alignment with the goal for the best outcome (Vandergoot et al., 2018b). It is recommended that listening should be given high importance in the course of conflict resolution as it helps in understanding the idea of the other individual involved. In the given case scenario, even when the conflict was resolved with a suitable outcome, the communication skills could have been further improved and more persuasive for the collection of the ISBAR handover. The course of conversation did not establish a common goal verbally and therefore could have affected the course of the discussion.

Prevention of Further Conflicts

To prevent conflicts in a healthcare setting, a professional code of conduct must be made mandatory and explained to all the individuals to assure their understanding and importance (Kim et al., 2016). This helps in the development of discipline and prevents conflicts that may arise due to ambiguities in the rules and regulations. Further, it is important to teach and develop competent care in the healthcare services with virtues that enable a collaborative approach, flexible attitude, and importance of cooperation to ensure the best optimal outcome for the company (Kim et al., 2016). The importance of effective communication must be provided to the entire staff to ensure strong communication and development of reliable interpersonal relationships in the work environment for the best outcomes in the clinical setting. In the given scenario, the conflict could have been prevented if the ISBAR handover was collected timely by the concerned professional and was provided to the student nurse at the time of duty. An alert approach where a track of the progression of the care needs of the patients to ensure proper medication and care is essential and by following the rules and regulations, this scenario could be avoided and prevented (Vandergoot et al., 2018a).

Conclusion on Conflict Resolution

This document presents a conflict resolution scenario that was experienced by me as a registered nurse. A concise description has been provided in this document that establishes the importance of following the rules and regulations of the healthcare setting to ensure patient beneficence. This document also provides measures for immediate resolution and critically evaluates the outcomes of this conflict. Recommendations to improve the conflict resolution strategy and prevention of such scenarios in future have also been discussed to ensure the development of a healthy working environment in the clinical settings.

References for Conflict Resolution

Aqqad, N., Obeidat, B., Tarhini, A., & Masa'deh, R. E. (2019). The relationship among emotional intelligence, conflict management styles, and job performance in Jordanian banks. International Journal of Human Resources Development and Management, 19(3), 225-265.

Arveklev, S. H., Berg, L., Wigert, H., Morrison-Helme, M., & Lepp, M. (2018). Learning about conflict and conflict management through drama in nursing education. Journal of Nursing Education, 57(4), 209-216.

Baddar, F., Salem, O. A., & Villagracia, H. N. (2016). Conflict resolution strategies of nurses in a selected government tertiary hospital in the Kingdom of Saudi Arabia. Journal of Nursing Education and Practice, 6(5), 91-99.

Cherry, B., & Jacob, S. R. (2016). Contemporary nursing: Issues, trends, & management. USA: Elsevier Health Sciences.

Chiew, L., Bakar, S. B. A., Ramakrishnan, S., Cheng, P. L. C., Karunagaran, Y., & Bunyaman, Z. B. (2019). Nurse’s perception and compliance on identification, situation, background, assessment and recommendation (ISBAR) tools for handoff communication in tertiary hospital. Malaysian Journal of Medical Research, 3(4), 26-32.

Choi, Y., Lim, J. Y., & Lee, E. H. (2018). Effects of Nurse Managers' Conflict Management Styles on Nurses' Leader Trust and Organizational Commitment. Journal of Korean Academic Society of Home Health Care Nursing, 25(3), 215-223.

Hamdan, Z., Adnan Al‐Ta'amneh, I., Rayan, A., & Bawadi, H. (2019). The impact of emotional intelligence on conflict management styles used by jordanian nurse managers. Journal of Nursing Management, 27(3), 560-566.

Kim, S. Y., & Kim, K. K. (2018). Relationship of conflict management style, professional autonomy, role conflict and organizational commitment of nurses in general hospitals. Journal of Korean Academy of Nursing Administration, 24(5), 387-395.

Kim, S., Buttrick, E., Bohannon, I., Fehr, R., Frans, E., & Shannon, S. E. (2016). Conflict narratives from the health care frontline: A conceptual model. Conflict Resolution Quarterly, 33(3), 255-277.

Labrague, L. J., & McEnroe–Petitte, D. M. (2017). An integrative review on conflict management styles among nursing students: Implications for nurse education. Nurse Education Today, 59, 45-52.

Lahana, E., Tsaras, K., Kalaitzidou, A., Galanis, P., Kaitelidou, D., & Sarafis, P. (2019). Conflicts management in public sector nursing. International Journal of Healthcare Management, 12(1), 33-39

Nursing and Midwifery Board of Australia (2018). Code of conduct. 

Özkan Tuncay, F., Yaşar, Ö., & Sevimligül, G. (2018). Conflict management styles of nurse managers working in inpatient institutions: the case of Turkey. Journal of Nursing Management, 26(8), 945-952

Sexton, M., & Orchard, C. (2016). Understanding healthcare professionals’ self-efficacy to resolve interprofessional conflict. Journal of Interprofessional Care, 30(3), 316-323.

Vandergoot, S., Sarris, A., & Kirby, N. (2018a). Factors that influence the training transfer and maintenance of conflict resolution programs of healthcare training and development units: a retrospective study. In Applied Psychology Readings (pp. 103-121). Singapore: Springer.

Vandergoot, S., Sarris, A., Kirby, N., & Ward, H. (2018b). Exploring undergraduate students’ attitudes towards interprofessional learning, motivation-to-learn, and perceived impact of learning conflict resolution skills. Journal of Interprofessional Care, 32(2), 211-219.

Wallensteen, P. (2018). Understanding conflict resolution. USA: SAGE Publications Limited.

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