Case Scenario
A Nurse Manager's Role in Resolving Conflict
Situation:
As the nurse manager of a 30-bed surgical unit, AM facilitates the unit's daily interdisciplinary rounds (IDR) during which multiple disciplines convene to collaborate and discuss effective treatment interventions and discharge plans for each patient. The IDR participants include the unit nurses, physicians, physical therapists, dieticians, and care coordinators. During the discussion of a specific patient who for the last couple of days has been having breakthrough postoperative pain, the primary nurse suggests increasing the dose of the patient's pain medication or treating the patient with additional pain medication because the patient's current pain medication, Percocet, has not been controlling the patient's pain throughout the day. This is the second shift the primary nurse has cared for the patient; thus, the nurse has witnessed the patient's breakthrough pain on more than one occasion. The physician disagrees with the primary nurse's suggestion and indicates the current pain management regimen should be more than enough to control the patient's pain. The physician refuses to add another pain medication to the patient's treatment plan and requests to move on to discuss the next patient. What should AM do as the facilitator of the IDR meeting?
Approach
Having been a nurse manager for over 10 years, AM has facilitated many IDR meetings and experienced all types of conflict situations in the work environment. Fortunately, AM is well-versed in various styles of conflict management and has implemented different styles to resolve conflict, depending on the situation. In this particular example, the unit IDR meeting is running over on time, with more than half of the patients still requiring discussion. As such, AM has decided to utilize the compromising style of conflict management that seeks to find a middle ground between involved parties.
Outcome
To resolve most conflicts, AM typically prefers utilizing the collaborating style of conflict management that focuses on having all participants provide their perspectives on the situation to come up with a mutual resolution. Nonetheless, as time is not permitting, AM decides to employ the compromising style to facilitate IDR flow. AM interjects the conversation, reiterates the patient's more than one instance of breakthrough pain and suggests the physician reassess the patient's pain status after IDR. The decision to either increase the patient's pain medication dosage or add another pain reliever to treat the patient's breakthrough pain can be determined after patient reassessment.
Discussion Questions (the first question is about the above Case scenario; the other two are not)
1. What type of conflict best describes the listed situation? Name another conflict management style AM could have utilized to manage the situation. List two healthcare-related consequences that could occur from poorly managed conflicts
2. Discuss the application of complexity leadership and the contributing influence on quality and safety. Describe 2 factors that most influence spread, sustain, and scale and how you might modify those factors as they relate to quality and safety.