CONFLICT RESOLUTION
Preparation
Conflict is inevitable among members of any team, but especially during high stress situations, such as sometimes occur in health care. As a health care leader, you will be called upon to resolve conflict on your team and within your organization. Not only will you have to manage conflict that occurs with you directly, but you will also have to handle conflict situations where you were not involved and not present.
Before beginning this assignment, complete the Vila Health: Conflict Resolution media simulation.
Conflict Resolution
VILA HEALTH ® ACTIVITY
Introduction
Pediatric ICU Hallway
The CNO’s Office
Conclusion
Introduction
Conflict Resolution
A train wreck near an elementary school has caused a chemical cloud to be released, and many children have come to the ER for treatment. Nurses are working together to handle the sudden influx of so many patients, but as with any stressful situation, conflict arises between some of them.
As you observe the various scenes, consider how conflicts arise and whether they’re handled appropriately.
Pediactric ICU Hallway
Many of the children who were exposed to a chemical cloud after a train wreck near the school have been stabilized in the ER. But that means the demand for beds in the PICU is growing. The death of a child opens one bed up, but the room has not yet been cleaned by housekeeping.
Donald Trask, an ICU nurse who has been pulled into the PICU, takes out his frustrations of the day on Gabriela Herrera, a housekeeper who he sees in the hall.
Donald Trask, RN – Intensive Care Unit: Hey … are you from housekeeping?
Gabriela Herrera – Housekeeper: Yeah.
Donald: We called for you over half an hour ago. You need to get going on that room.
Gabriela: What room? What are you talking about?
Donald: We had a kid who didn’t make it, but now we need the room cleaned so we can get another kid out of the ER and into the PICU.
Gabriela: Oh. I didn’t know you called. I wasn’t sent up here to prep the room; I was just doing my normal pick-up of dirty linens on this floor.
Donald: This is a little more important than picking up the laundry, don’t you think?
Gabriela: That’s not the point. I have my own jobs to do. If my supervisor sends me up here to sanitize the room, that’s one thing, but you can’t just grab me in the hall to get a room prepped. That’s not how we do it.
Dondald: It may not be how you do things south of the border, but here, the patient comes first, not your break.
Brittany Clinton, RN – Surgical Nurse: Is everything okay here?
Gabriela: No, it’s really not okay. I’m up here collecting linens and this pendejo tells me I’m supposed to go prep a room for a new patient. Which is fine if it’s my supervisor who tells me to do it, but I can’t just drop what I’m supposed to be doing. You guys need to call housekeeping and have them send someone up. I’m going to finish my assigned work.
Brittany: I understand.
Donald: Glad you do, Mary Sunshine, but we still have kids down in the ER waiting for beds up here.
Brittany: Okay … grab some sheets and you and I can prep the room.
Donald: Sorry … I’m here to be a nurse, not a housekeeper. You can do what you want, but I’m not interested in doing housekeeping’s work for them.
Brittany: It takes five minutes. Oh, whatever, I’ll do it.
Pediactric ICU Hallway
It’s been several days since the train derailment. As the chief nursing officer, Jackie Sandoval, works through the various issues demanding her attention, one stands out. Gabriela Herrera has filed a complaint about Donald Trask’s rudeness, and now Jackie will attempt to find out what happened.
Jackie invites Phoebe Hemsworth, the PICU nurse manager, and Gabriela to her office so that Gabriela can describe the incident in the PICU on the day of the derailment.
Jackie Sandoval, Chief Nursing Officer: Hi, Gabriela. I’ve read your complaint, but could you give me a nutshell description of what happened?
Gabriela Herrera – Housekeeper: Sure. It was the day of the derailment and the whole hospital was short-handed. Everyone had to go above and beyond—and we all were. But this particular nurse … he treated me like I was his personal maid. I was up on the PICU collecting dirty linens and he starts all this, “oh, housekeeping…” like I don’t even deserve a name.
Jackie: Mmm hmmm. Okay, go on.
Gabriela: Well, he tells me that they had a kid die and they needed the room prepped for the next kid. Which … I mean, that’s not my favorite job, particularly when it’s related to a death, but I know it’s part of what I’m supposed to do. The problem is—and I told this nurse—we’re not supposed to take assignments off the floor. The nurses are supposed to call it in and then we get sent out to do whatever. And that’s what I told him, but he’s all, “I don’t care what they do where you’re from, here you have to do what I tell you.” I’m not ashamed to be Mexican-American, but for his information, I was born right here in Minneapolis. I was really offended by his attitude.
Phoebe Hemsworth, RN – Intensive Care Unit: Gabriela, I am sorry you were spoken to that way. We were short-handed and Donald may have been stressed by all the things we were getting hit with, but that’s no excuse.
Gabriela: I get that. He just doesn’t have to treat me like I’m some lazy jerk. It was his attitude as much as anything else. The other nurse – she was fine. She understood what I was telling her about having to go through my supervisor.
Phoebe: Well, I would offer to speak to the nurse in question, but he’s not one of mine, Jackie. He was pulled onto the floor because we were so short staffed, but he isn’t usually one of my nurses.
Jackie: Understood. I’ll contact his supervisor and set up a time to talk. Gabriela, you followed procedures. I know that when we’re working under stress, we sometimes forget common courtesy, but that’s no excuse.
Gabriela: Thank you. The only reason I reported this was the disrespect. I probably would have helped Brittany—she was the one who actually prepped the room—if I hadn’t been so angry. The way it was, though, I just wanted to get out of there as fast as I could… Thanks for listening, though. That means a lot.
Phoebe expresses her thoughts about the housekeeping situation as well as some broad observations about the team’s functionality.
Phoebe: I didn’t really want to say this while she was here, but Donald was a lot ruder than even Gabriela explained.
Jackie: Do you know why?
Phoebe: He’d been in a foul mood the whole time he was in my unit. He didn’t want to be there and he made sure everyone knew it. It almost felt like he was lashing out at Gabriela because of his frustration at being assigned to the PICU at all.
Jackie: I was actually the one who pulled him to help provide coverage for you. I didn’t realize how inflexible he was going to be.
Phoebe: It happens. Other than Donald, though, everyone worked together very well. It was nice to see them actually working through some of the issues that came up earlier — Stephen and Brittany in particular. I wasn’t sure pairing them was a good idea, but by the end of the shift, they were actually really clicking.
Jackie: Good! It’s nice to hear about the successes as well as the failures.
To further support your understanding of the simulation and challenges associated with employee performance and engagement in health care, respond to the following questions:
Question: How did barriers and conflicts affect the team’s strength?
Feedback: The most obvious barrier is cultural with Donald and Gabriela each slighting the other’s culture. Beyond that, barriers between nurses based on roles (Donald and Brittany) and between nurses and housekeeping affected Vila Health’s ability to quickly get a child transferred out of the ER, a very stressful environment for the patient and family, into a room so treatment and monitoring could continue. We also see evidence of organizational cynicism and bullying which suggest a lack of high-performance work practices at Vila Health.
Question: What could HR do to improve communication and cooperation?
Feedback: Providing training on organizational compassion, collaboration, and workplace bullying will help, but HR also must ensure that Vila Health has policies in place that hold employees accountable for their words and actions. HR can also improve communication and cooperation through education about stress and its impact on patient care and safety. Even though the scenario is not a true interdisciplinary team, the skills necessary for effective collaboration would have made a positive difference in this situation. Finally, HR should review the events using a whole systems approach to identify root causes for the shortage of workers that day.
Question: What models might be applicable to prevent these types of employee interactions?
Feedback: There are several models that may fit, including the Theory of Human Caring, organizational compassion model, and mindfulness interventions. HR professionals must choose the best models based on the organization’s current culture and strategic business needs and implement them utilizing a whole systems perspective.
Conclusion
You have completed this activity! As you saw, teams can encounter many types of conflicts, both internal and external. How did barriers and conflicts affect the team’s strength? What could Phoebe, the nurse manager, have done to improve communication and cooperation? What could her team members have done?
Powerpoint
Create a PowerPoint deck with speaking notes for a presentation you would give to hospital leadership to prepare them to handle situations such as the one in the Vila Health: Conflict Resolution simulation. When you have created your PowerPoint deck, create an audio recording in which you present the information in your PowerPoint deck.
You are free to organize your presentation in whatever way you like. The following outline describes one way to structure your PowerPoint presentation:
Cover slide: One slide that includes the name and number of the course, the name of the assignment, submission date, and your name and contact information.
Introduction slide: One slide that provides a brief overview of conflict resolution as it relates to the incident described in the Vila Health simulation. This is the elevator speech of the simulation and captures an overview in a list format. Provide two short paragraphs in the speaking notes to support the points made in the list.
Background slide: One slide that explains the background of the incident described in the Vila Health simulation.
Analysis of the situation: A section of two slides that explains how a lack of cultural competence can compound already stressful situations and impede collaboration.
Describe the communication techniques that were used in this simulation that should be avoided in situations that involve diverse cultures.
Communication slide 1: One slide that lists at least two communication strategies that leadership can use to help the organization resolve conflicts like the one in the simulation. These should be communication strategies that hospital leadership should promote within the organization going forward to resolve conflict like this in the future.
Communication slide 2: One slide that explains the role of relationships in communication.
You may wish to discuss relationships between leaders and followers and leaders overseeing teams.
Communication slide 3: One slide that explains the role of communication in teamwork and collaboration.
Application of literature to the case study: One slide that recommends strategies that could be implemented to improve the relationships between nursing and housekeeping in the Vila Health simulation.
Summary: One slide that sums up the situation in the Vila Health simulation.
References: This section should list, in APA format, the scholarly references used to support the communication strategies for conflict resolution and the role of relationships in communication.
