Registered Nurses' Association of Ontario

Background

Why this is important?
 
  • The increasing prevalence and subsequent impact of interpersonal conflict in health-care settings necessitates the requirement for organizations to have a process to manage conflict that may occur.
  • Interpersonal conflictive interactions among members of the health-care team create subtle unpleasant experiences that result in negative attitudes and behaviours.
    • This can create a stressful work environment with negative consequences such as:
      •  job dissatisfaction
      • weak organizational commitment
      • lack of involvement
      • low morale
      • poor working relationships
      • a diminished sense of well-being
      • emotional exhaustion
      • a lack of trust and sense of support in the workplace
      • absenteeism
      • burnout
      • and turnover.
  • Research indicates that interpersonal conflict within the health-care system is present globally.
  • It is important that organizations and individuals address the management of interpersonal conflict through a guided process which includes education and accountability to prevent recrimination and negativity.
  • Effectively managed, interpersonal conflict can produce positive benefits as there has been a strong emphasis upon constructive aspects of conflict in organizations.
  • Unaddressed interpersonal conflict can interfere with the personal well-being of the individual result in negative co-worker relationships; undermine safe patient care/outcomes; and be disruptive to the organization.

Definitions

  • For the purposes of this guideline, interpersonal conflict is defined as: “…a dynamic process that occurs between interdependent individuals and/or groups as they experience negative emotional reactions to perceived disagreements and interference with the attainment of their goals.”
  • Research illustrates three main types of interpersonal conflict:
    • Relationship conflict exists when there are interpersonal incompatibilities among individuals, including irritation about personal taste, interpersonal style, different personal values, or other non work-related preferences.
    • Task conflict exists when there are disagreements about the content of tasks being performed, including differences in viewpoints, ideas and opinions.
    • Process conflict focuses on disagreements about how to accomplish a task, which is responsible for a task, or the delegation of duties and resources
  • Negative behaviours are distinct from interpersonal conflict as described below:
    • Bullying has been characterized as a constellation of repeated acts by one or more individuals, undertaken with an intention to cause harm and create a hostile work environment
    • Workplace Incivility is a form of organizational deviance, characterized by behaviours that violate respectful workplace norms. It is not necessarily meant to harm.
    • Horizontal violence embodies an understanding of how oppressed groups direct their frustrations and dissatisfactions towards each other as a response to a system that has excluded them from power
    • Ostracism refers to the experience of feeling ignored, left out or excluded by coworkers.
    • Recent studies have found that nurses identify their managers and nursing colleagues as the most common source of conflict, with nursing colleagues being the most stressful type.

Conceptual Model

  • The Conceptual Model of the Antecedents and Consequences of Conflict organizes and guides the discussion of the recommendations. The model includes the following:
    • Conflict antecedents (including individual characteristics, interpersonal factors and organizational factors);
    • Perceived conflict;
    • Conflict management style; and
    • Conflict consequences (including the effects of conflict on individuals, interpersonal relationships, and the organization).
  • To view the Conceptual Model of the Antecedents and Consequences of Conflict click here.
Healthy Work Environment
Managing and Mitigating Conflict in Health-care Teams
Background Information