Conflict and confrontations

Conflict in the health care industry is inevitable. Working in a field with so many inter-personal interactions and differing opinions; dissent is to be expected. In a crisis orientated field such emergency medicine, where time-urgency is the norm, this is especially true (1).

The clinical condition of the patient is a primary source of stress for health care providers. The family of the patient can provide another source of pressure. A number of other factors can increase the emotion behind interactions in the work-place: shift-work, fatigue, staff-shortages, overcrowding, time pressure, exit block, workplace hierarchy, bias, poor communication skills, task over-load or the next call or patient(s) waiting.

Avoiding confrontation is also not an option. It is often impossible to avoid. “The problem with conflict is not its existence, but rather its management.” (2)

Personally, I hate conflict. I would prefer there to be no conflict. Should problems arise, I prefer amicable solutions. However, in reality, disagreements can become heated, tempers and voices raised. Amongst all the emotive language and ego, it is easy to lose sight of the patient.

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There has to be some middle ground. Somewhere between the two extremes, somewhere between daisies and volcanoes.

In no way an expert on this topic myself, I’m sharing wisdom from numerous more enlightened souls…

Initial approach to a disagreement in the workplace

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Be mindful. Recognizing the situation is the first step in finding a solution. Count to 10 if need be. Don’t fight fire with fire. Losing your cool worsens the situation.

Listen to understand, not to be understood.

Don’t listen to reply. Don’t focus on the disagreement or the other person, rather focus on the issue at hand (3). Acknowledge that the other party, and their opinion, is valued. Maintain eye contact: a vital component to listening actively. Try to understand their perspective, their point of view. This will give you insight into the problem, and can help in formulation of a solution. Don’t jump to conclusions about the other party’s intentions (3). Always assume the best. We are all here for the benefit of the patient.

If a mutually acceptable solution cannot be reached, or the issue cannot be resolved on an individual level, escalate the matter. The patient comes first. Being an advocate for your patient, you need to promote the care that is in best interest of your patient. Involving your senior may be the next step. The more urgent the issue, the more you may need to advocate for the patient. Just remember to do so politely, firmly and calmly.

Another tip is to pick your battles. Some issues that do not have life-or-death consequences are best tackled in the light of day. You will likely need to work with this individual again in the future. Addressing your concerns once you have had a good rest, and time to blow off steam, is a viable and diplomatic option.

Conflict Resolution

Some disputes cannot be resolved immediately, and may require further strategies for problem-solving. Mediation is an option. At some stage of your career you might be required to resolve or mediate workplace conflict.

The following link is a video with some valuable tips for Conflict Resolution from MindTools.com (4)

https://www.youtube.com/watch?v=pLg4LQinDxU

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As much as as conflict can be disruptive and destructive, it can also be stimulus for positive change. It can provide both the incentive and initiative for finding creative solutions to workplace problems (5). Highly developed organizations are able to assimilate new approaches that are the result of well managed work-place disputes.

Conflict resolution

References

(1) Strauss RW, Garmel GM, Halterman M. Chapter 8. Conflict Management. In: Strauss RW, Mayer TA. eds. Strauss & Mayer’s Emergency Department Management New York, NY: McGraw-Hill; 2014.

(2) Ahuja J, Marshall P. Conflict in the emergency department: Reatreat in order to advance. CJEM. 2003; 5 (6): 429-433

Picture reference: Wisegeek. (2017). Why is Switzerland Regarded As a Neutral Country? [Online]. Avail from http://www.images.wisegeek.com/swiss-flag-with-matterhorn-in-the-background.jpg [Accessed 11/1/2017]

(3) Wholistic Stress Control Institute, Inc. Distributed by the State Wellness Program, a program of the Employee’s Benefits Council. [online] Avail from http://www.citizensnyc.org/sites/default/files/public-attachments/workshop/conflict_resolution.pdf [Accessed 7/6/2017]

(4) MindTools.com. (2015). Conflict Resolution/Using the “Interest-Based Relational” Approach [Online]. Avail from: http://www.mindtools.com/pages/article/newLDR_81.htm  [Accessed 7/6/2017]

(5) Garmel GM. Conflict resolution in emergency medicine. In: Adams JG, Barton ED, Collings J, et al, eds. Adams Emergency Medicine. Philadelphia, PA: Saunders/Elsevier; 2008.

 

Post by @QuirkyMD

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