Nurse leadership in conflict management
using current literature critically discuss the effectiveness of nurse leaders use of the five major
conflict resolution/management strategies (ie compromising, avoidance, collaboration, competition,
accommodation) in terms of evidenced patient, staff and organisational outcome in a range of
contemporary clinical practice context including new graduate practice context.
Nurse leadership
Leadership competencies are some of the most basic competencies that an individual in
any profession or organization must possess, whether at individual or at group level. Effective
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and efficient leadership in a healthcare setting is very necessary. Research on leadership reveals
that good leadership in a hospital environment contributes directly to patient outcomes (Curtis,
Vries & Sheerin, 2011). Leadership in nursing is one of the very foundations of a nurse because
great duties of interacting with the patients are more on the nurses than any other professionals in
healthcare setting. Good leadership, health work environment, job satisfaction, lower worker
turnover rates, positive outcomes for the patient and healthcare providers greatly rely on
effective leadership (Curtis, Vries & Sheerin, 2011).
Several researchers have come up with different leadership theories. Spector (2006, as
cited in Curtis, Vries & Sheerin, 2011) classifies these theories into four approaches:
a) The trait approach, which focuses on the individual characteristics of a person and
how these characteristics affect leadership
b) The behavior approach, which just like the trait approach looks at leadership from
the perspective of the leader, the way the leader behaves, and how it contributes to
effectiveness in leadership
c) The contingency approach focuses on leadership as the way a person applies
leadership skills according to the situation that they face within their environment.
d) The leader-member exchange approach, also called charismatic or
transformational leadership looks at leadership from the perspective in which the
leaders and supervisors engage in the coordination and delivery of organization’s
objectives.
While all these leadership theories are crucial in helping nurses lead, transformational
leadership is the most suitable choice for advancing nursing leadership. This type of leadership is
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all about vision and the ability to influence others, sharing a bond with followers, trust and being
able to empower others (Wagner, et. al., 2010). Nursing leadership differs from all the other
types of leadership because the nurse assumes and emphasizes more on nursing assuming
responsibility and improving the practice environment (AANAC, 2014). This assumption differs
from Lorber, Brigita and Savic (2011) findings in which they concluded that all leaders in
whatever position they were in a combined sphere of nursing practice. In this sense, nursing
knowledge derived from nursing leadership influences their leadership. In their definition they
defined nursing leadership as the ability to empower others, facilitating learning, developing
nursing knowledge and working with and through others in order to achieve success ( Lorber,
Brigita and Savic, 2011). This definition clarifies further that a nurse leader is any nurse who can
assist or help others. In this sense, it means a nurse student who provides medical assistance to
patients is a nurse leader just like a practicing nurse offering medical prescription to the patients
in a ward. A ward manager is a leader to all team members. From this definition we can derive
that every nurse is a leader, the only difference is the area under which they practice or the
authority that they practice.
Conflicts are very common in any working environment where people differ in terms of
ideas and ideologies. Conflict resolution competencies are very essential for nurses in a
healthcare setting. In their research, Khanaki and Hassanzadeh (2010) came up with the
conclusion that conflicts among individuals have proved to have a negative impact in on
organizational efficiency and efficacy. This gives us a reason why we should manage conflicts
effectively in a work environment. The manner in which the conflict is managed whenever it
occurs can determine the effectiveness of the organizations activities. There are several causes of
conflicts some of which include poor communication among individuals, dissatisfaction which
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may result out poor management style, desire to obtain power, ineffective leadership and lack of
openness. Khanaki and Hassanzadeh ( 2010) classify the causes of conflict into three major
categories, these are the power, value and economy. Power conflict results when one party
demands more power so that to influence the other lesser party. Value conflict results out of
inconsistence in people’s culture and way of life. This type of conflict results mostly when
individuals from different backgrounds are not ready to adjust to other peoples opinion because
to them they feel their opinion is the best. This may be caused by differences in cultural beliefs,
religious beliefs and political alignment. Economic conflicts results out of the competition for
human basic needs, which are ever limited in nature.
In nursing, conflicts occur in many circumstances. In the first circumstance is the nurse-
client conflict. Good nurse client relationship is the foundation of the clients well being
(Akerjordet & Severinsson, 2010). The main aim of the nurse in the nurse-client relationship is
to help achieve the client’s health goals (College of Nurses of Ontario, 2009). Existence of a
conflict can be a hindrance to the achievement of this goal. This conflict may escalate if the
client is constrained for instance not smoking, fatigued or over stimulated, tense anxious, worried
disoriented or afraid. In this case, the avoiding strategy will not help in such a conflict. The
conflict must be brought to an end in order to help achieve the health goals of the client. In this
case, the compromising strategy will help solve the problem partially. The nurse needs to find
out the medical history of the client by seeking to understand the healthcare needs of the client
and the client’s perspective. Acknowledging the clients concerns and addresses them calmly.
Anticipate the conflict in situations in which it has previously occurred and create a care plan to
prevent its escalation.
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Conflicts among colleagues at the workplace are also very common among individuals,
and nurses are no exceptional. Poor relationship among members of the healthcare team directly
affects the delivery of care to the patients (Henry & Ginn, 2010). For instance, workplace
bullying can interfere with the nurse’s confidence and the ability to foster therapeutic
relationships with the clients. Struggle and the desire for power can result to conflict in a
workplace. it’s not only the struggle but also misuse of power can also result to conflict in a
workplace where individuals do not feel comfortable with the manner in which they are lead by
their nurse leaders. Other major causes of conflicts in nurse leadership include differences in
practice perspectives where individuals feel their way of doing things is best based on
experience, education level and culture of practice. Bullying of junior staff such as the student
nurse on placement and age differences result to conflicts among colleagues (Royal College of
Nurses, 2011). It is very important to note that before seeking for a solution to a conflict one
must understand its root cause by interacting with the individuals conflicting in order to find out
the real cause of the conflict. Collaborating and compromising strategy can help resolve such a
conflict. The collaborating strategy requires that the concerns of both conflicting parties must be
analyzed and a middle solution that can help solve the conflict is arrived at which satisfies both
parties. This strategy is very assertive and cooperative in nature. In compromising strategy, it
requires that a solution is arrived at by looking at the concerns of both parties and addressing
them while neglecting others as much as necessary and finding a middle-ground position. This
strategy is moderately assertive and moderately cooperative (AANAC, 2014).
The other form of conflict that can occur in the nurse work environment is the conflict
between workers and the management. This may result out of several factors and this will affect
quality service delivery to the clients. Poor management skills applied by the managers can result
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to conflict between the managers. For instance, supervision is a very common activity in any
work environment, however the way the supervision is carried out will determine the attitude
that the nurses will develop towards the work. Thorough supervision will result to poor
relationship between the management and the workers because the workers will feel that the
management does not have trust on them that they can deliver the expectation of the
management. Another very common cause of conflict between them management and the
workers is equality. All workers are equal as long as they are under one supervisor; none of them
is more superior that the other and therefore they should all receive the same treatment (Porter-
O’Grady, 2012). Accommodating is one of the strategies that can help solve such a conflict.
Lack of engagement of staff workers in managing them and taking care of their concerns can
cause conflicts between the management and the staff. if the management cannot manage such
conflicts there are very high chances of soldering by workers. This requires that individuals
overlook their own concerns to satisfy the concerns of the others. This strategy basically relies on
generosity and selfless that is followed by choosing to do what one could not have preferred to
do under normal circumstances. Another strategy that can help deal with such conflicts is the
competing strategy one seeks for own concerns at the expense of others by using appropriate
power to win the position and defend something that is believed to be correct (College of Nurses
of Ontario, 2009). It is assertive and uncooperative.
Nurse leadership is purely responsible for the management and resolution of conflicts in a
work environment. Subordination of individual needs for the best interest of the client’s health
should be a driving force for conflict resolution in a working environment. Nurse leadership
requires proper inquiry to the cause of the conflict that comes out of client’s behavior in client-
nurse conflict. The nurse needs to assess the cause of the conflict and design the appropriate
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solution for the conflict. Nurses are required in their professional practice to promote respectful
work environment, mentor, and support and integrate new staff members into the practice
setting. In order to function effectively as a team nurses need to have a positive collegial
relationship (College of Nurses of Ontario, 2009). This relationship can result from good
communication, mutual acceptance and understanding, use persuasion pother than coercion and
balance of personal emotions in a work environment. The management is purely responsible for
soldiering of workers and therefore they have a fully responsibility of preventing the occurrence
of such conflicts in a work environment. Management can promote quality practice by
establishing good communication networks between the management and the staff and among
the staff workers. A fair and efficient reporting system will help the nurses report their
dissatisfaction before it results into a conflict. Open communication will promote an atmosphere
in which individuals share freely identify the cause of the conflict and finding appropriate
solution before it escalates.
References
AANAC(2014). Nursing Leadership: Management & Leadership Styles. AANAC extras.
Retrieved from WWW.AANAC.ORG
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Akerjordet, K. & Severinsson, E. (2010). The state of the science of emotional intelligence
related to nursing leadership: an integrative review. J Nurs Manag 18(4): 363–82
Curtis, E., Vries,J. & Sheerin, F. (2011). Developing leadership in nursing: exploring
core factors. British Journal of Nursing, 2011, Vol 20, No 5. Dublin College of Nursing
and Midwifery.
College of Nurses of Ontario, (2009). Conflict Prevention and Management. Practice guideline.
Gerardi, D. (2010). Using mediation techniques to manage conflict and create healthy work
environments. AACN Clinical Issues, 15(2), 182-195.
Henry, J., & Ginn, G.O. (2010). Violence prevention in healthcare organizations within a total
quality management framework. Journal of Nursing Administration, 32(9),
479-486.
Khanaki, H. and Hassanzadeh, N. (2010). Conflict Management Styles: The Iranian General
Preference Compared to the Swedish. International Journal of Innovation, Management
and Technology, Vol. 1, No. 4, October 2010. ISSN: 2010-0248
Lobrber, M. & Savic, B. (2011).Perceptions of managerial competencies, style, and
characteristics among professionals in nursing. Croat Med J. 2011; 52: 198-204.
Porter-O’Grady, T. (2012). Constructing a conflict resolution program for health care. Health
Care Management Review, 29(4), 278-283.
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Royal College of Nurses. (2011). Bullying and harassment at work: A good practice guide for
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