Conflict with a Nursing Manager
A Conflict with the Boss
My conflict experience occurred upon accepting a clinical educator position of an intermediate unit. A new manager was also appointed at the time, creating many process changes for the staff of the unit. The new manager came from outside the facility, did not know the hospital’s policies and procedures, and used a different management style than previous managers. She also transitioned the clinical educator’s position into an assistant position, decreasing the time spent with new hires and continuing education. The manager approached staff about issues at the nurses’ station and in patient rooms in front of other staff members and with patients and families present. Having rapport with the staff and feeling the negativity of the unit, the staff approached me with concerns instead of the manager allowing me to communicate issues and buffer the situation. I discussed concerns with the manager about approaching staff privately, listening to concerns, and empowering staff. The manager ended the discussion abruptly, stating she was functioning as her director requested and would remove me and anyone else from the unit if she was met with disagreement.
The new manager was exercising coercive power by threatening to eliminate staff that challenge her actions (Mason, Leavitt, & Chafee, 2012, p. 70). Staff attempted to communicate concerns though the clinical educator as they did not feel the manager was approachable. Mason et al. (2012) mentions it is essential to possess effective communication skills to advocate for problem solutions (p. 105). Lack of concern, respect, listening, and communication fostered a negative atmosphere for the unit.
Looking Back and Learning from It
Initially, I would reflect on the situation, focusing on the big picture. Mason et al. (2012) suggests that providing a more objective perspective can increase nurses’ credibility (p. 72). I would focus on the successes of the unit, promoting positivity, and fostering communication among all staff. I would round on staff, providing time for discussion of concerns and successes, actively listening and providing feedback. The manager and director would be provided with the same opportunity for discussion, active listening, and respect. Mason et al. (2012) states “effective communication depends on effective listening” (p. 106). Functioning as a role model, I would hope the respect would be reciprocated.
Persuasion would be key to gaining acceptance of change and understanding by the manager. Perkins mentions three ways to persuade: facts and reasoning, speaker credibility, and emotional appeal (as cited in Mason et al., 2012, p. 105). I would provide objective information and communicate stated needs of the staff. Current and past successes of the unit and strategies used to obtain positive outcomes would be presented. Emotional appeal would be utilized by visioning the future of the unit with a respected and supportive management team.
How Would I Approach it if I was a...
As an educator today, I would approach the conflict as an educational need. Educators must embrace the need for change and prepare fellow nurses with the knowledge to adequately engage in conflict resolution. Mason et al. (2012) states “preparing staff to be competent in conflict engagement can have a dramatic impact on the bottom line” (p. 120).
Nursing leaders must ensure processes are in place for conflict resolution and promote nursing involvement. Leaders must mentor and role model proper conflict engagement and possess such skills as active listening, agreement management, offering assistance, and managing closure (Mason et al., 2012, p. 119). Nurse leaders are essential in advocating for increased attention to conflict among healthcare professionals (Mason et al., 2012, p. 118).
Practice-based nurses are central to conflict. Nurses suffer conflicts daily that involve patient and family members. Practicing nurses must continue to build their skill set, acquiring competence in collaboration. Collaboration is the only conflict response that leads to long-term solutions (Mason et al., 2012, p. 119).
Facilitation Staff-Management Relationships
Ways to assist in facilitating staff-management relationships:
• Communicate effectively
• Remain available to staff
• Involve staff in decision making
• Retain clinical skills
• Support staff in conflict
• Ensure workload is balanced
• Help staff clinically
• Advocate for patients
• Promote problem solving
• Show respect for each discipline
How Did the Environment Change?
The work environment did change slightly over time, but mostly due to a drastic turnover of experienced staff. The staff nurses that challenged the manager transferred to different areas of the hospital and new staff were silent. The director of critical care made it clear that she selected the manager for her assertive personality and ability to eliminate troublesome employees. I eventually left as well due to restructuring of my educator position and the minimal emphasis on new staff orientation which was my passion at the time. The intermediate medical surgical unit eventually was eliminated and absorbed into the ICU setting.
The manager attempted to show more support to unit staff. Schmalenberg and Kramer (2009) mention that managerial behaviors of a supportive nurse manager include scheduling, providing direct patient care, direct activities, emergency care, and providing resources. The manager was a regular presence on the unit, assisted with patient care when needed, and found additional staff when shortages occurred. Schmalenberg and Kramer (2009) state leadership behaviors of a supportive manager consist of orienting physicians to collegiate behaviors, supporting team cohesiveness, conflict management assistance with physicians, maintaining organizational values, supporting autonomous staff decision making. Although the staff struggled with the manager’s leadership style, she did show support when challenged with physician issues.
Mason, D. J., Leavitt, J. K., & Chaffee, M. W. (2012). Policy & politics in nursing and health care (6th ed.). St. Louis, Missouri: Elsevier Saunders.
Maceri, S. L. (2006). What a nurse wants, what a nurse needs. Nursing Management, 37(9), 59-60.
Schmalenberg, C., & Kramer, M. (2009). Nurse manager support: How do staff nurses define it?. Critical Care Nurse, 29(4), 61-69.