Conflict generators:
competition increased workload multiple role demands threats to safety and security scarce resources cultural differences ethical conflicts invasion of personal space
Bullying:
Targets one individual
- attempt o exert power over another person
- have devastating effects on the individual and the team
Workplace Incivility:
Disrespect among staff and providers
Co-workers: most common source
Moral Distress:
Personal and professional ethics are violated
Conflict Resolution MYTHS:
Win-Lose-Draw
Fixed Pie myth
Devaluation myth
Conflict Resolution:
Problem resolution
Negotiating Informally
Formal Negotiation
Problem Resolution:
IDENTIFY the problem/issue
Generate POSSIBLE SOLUTIONS
EVALUATE suggested solutions
CHOOSE the best solution
Is the problem resolved?
If YES, end the process…. If NO, repeat the process
Negotiating informally:
Scope the situation
Set the stage
Conduct the negotiation
Agree on a resolution
Conducting a negotiation:
Manage emotions Set ground rules Clarify the problem Make an opening move Continue the negotiations Agree on a resolution
Collective BARGAINING:
economic issues
manage issues
practice issues
Bargaining: PRO:
- protects the workers rights
- grievance procedure available
- higher pay
- empowering
Bargaining: CON:
- creates management-staff barriers
- add rules and regulations
- drains management’s time
WRAP-UP
- CONFLICT is inevitable
- it is not necessarily a negative experience
- growth may emerge from positive conflict management
Change:
natural phenomenon
- macro changes
- micro changes
PROCESS OF CHANGE: Comfort zone
unfreezing (Comfort zone)
change (Discomfort zone)
refreezing (New zone)
return to new comfort zone
Resistance to Change:
technical concerns
psychosocial needs
position and power
RECEPTIVITY to change:
- recognize differences in preferences for certainty
- speak to people’s feelings
- stories-drama-statistics
Resistance:
Recognize resistance
Lowering resisitance:
- information dissemination
- Disconfirmation od currently held beliefs
- Psychological safety
- Command
Dictating Change:
Effective
Sense of urgency
Change may be rapid but without a lasting commitment
Active resistance to change:
Attacks the ideas
refuses to change
Argues with changes
Organizing resistance of others
Passive resistance to change:
Avoid discussion
Ignoring the change
Refusing to commit to change
Agreeing to but not acting
Overcoming Resistance:
Point out similarities
Express approval
Recognize competence and skills
Provide reassurance
Strategies:
Suggest new opportunities Express values of contributions Ensure involvement Provide opportunities for expression Allow time for practice Provide a climate of acceptance
Phases of PLANNED change:
- Design the change
- Plan the implementation
- Implement the change
- Integrate the change
Design the change:
What is the purpose Is the change necessary Is the change technically correct Will this work Is there a better way
PLAN the implementation:
Why is there resistance
Is the resistance justified
What can be done to prevent or overcome resistance
IMPLEMENT the change:
What is the magnitude
What is the complexity
What is the pace
What is the current stress level
INTEGRATE the change:
Is the change integrated into everyday operations
Are the people comfortable with it
Is it well accepted
Types of Healthcare Organizations:
Private: Non-profit (religious organizations)
Publically supported: county hospitals, health depts.
Private: For-profit (Majority of hospitals today)
Organizational culture:
Shared values, beliefs, and assumptions
3 levels:
Artifact: visible characteristics (mood)
Exposed beliefs: goals and philosophy
Underlying assumptions: commitment to pt outcomes
Organizational SAFETY:
preventing minimal harm
Aspects:
- willingness to acknowledge
- vigilance in detect/eliminate errors
- openness to questioning existing systems and change them to prevent errors
Organizational CARE ENVIROMENTS:
Excellence: Strive to be better
Meaningfulness: Being clear of the purpose
Regard: understanding the work people do & value it
Learning and growth: Mentors and opportunities
Organizational GOALS:
Survival Growth Profit Status Dominance
Structure of Organization:
TRADITIONAL: Hierarchical structure: ladder approach: people on the bottom far outnumber the people on top
CEO Managers Staff Nurses Techs Aids, housekeepers, maintenance
MODERN: team approach
Organizational PROCESSES:
how things get done
Formal: policies and procedures
Informal: not discussed, hidden rules, workarounds
Organizational POWER:
ability to influence others despite resistance
- actual or potential
- intended or unintended
Power SOURCES:
Authority- person in control
Reward- if you do this, I’ll give you…
Control of Information
Coercion
Organizational Power: POSESSION
managers
patients
assistants and techs
RN
Organizational EMPOWERMENT:
Self-determination
Meaning
Competence
Impact
Nursing Empowerment:
Decision making: resources, support, info.
Autonomy: based on one’s knowledge
Manageable workload: reasonable
Reward and recognition: appreciation, raises
Fairness: consistent and equitable treatment of all staff
Shared Governances:
Practice council
Unit Budgeting, scheduling
Committees
Peer Review
Encourage:
Professional organizations
Collective bargaining
Educational advancement
Communication:
give information
several levels
different factors
requires active listening skills
Factors affecting communication:
emotional state #1 outside distractions cultural background superficial listening individual attitudes regarding communication
Communication: Assertiveness:
allow ppl to stand up for themselves
respects the rights of others
clearly states individual’s position
uses “I” statements
Communication: Interpersonal:
most daily communication personal gain and construct personal knowledge establish relationships intimate level dynamic and ongoing senders and receivers
Communication BARRIERS:
- low health literacy
- cultural diversity
- cultural competence of healthcare providers
- lack of interprofessional communication education among providers
Communication: information systems
Electronic forms:
EMR: electronic med record- health information from facility or provider
EHR: electronic health record- summary of EMR and shared among facilities
personal or professional
must be clear- concise- courteous
avoid abbreviations
write and read before sending