Mitigating Conflict in Acute Care: Benefits of Utilizing a Legal Nurse Consultant

The acute care setting is a complex arena, especially with today’s healthcare changes. These complexities can often lead to conflict. Nurses that work in these areas often have specialized training for various competencies, but conflict competencies are often overlooked. Healthcare is thought to be synonymous with healing and well-being. But evidence suggest that this feeling of safety does not extend to nurses. Healthcare professionals face nonfatal assaults more than any other workforce. (Papa, A., & Venalla, J., 2013) In fact, working in a healthcare facility is considered the third most dangerous job in the United States. (Baker, et.al., 2014) The acute care setting is especially problematic. On average, four conflict events happen in each operation. (Overton, A., & Lowery, A., 2013). The Joint Commission Standard 02.04.01 states that “the hospital manages conflict between leadership groups to protect the safety and quality of care.” (Scott, C., & Derardi, D., 2011, p. 70.). Sentinel event alert 57 notes that leaders in the healthcare industry have failed to create an effective safety culture. (Ulrich, B., 2017) Conflict has been linked to more than 2/3 of all Joint Commission Sentinel events. (Baker, et.al., 2014)

Methods

This capstone project sought to explore this topic. Based on Peplau’s theory of Interpersonal relationships, understanding of one’s own behavior influences the ability to interact with patients as the nurse becomes more self-aware. A survey was developed using the Thomas Kilman theory of conflict mediation. This tool identifies five conflict styles: competing, collaborating, compromising, avoiding, and accommodating. (Waite, R., & McKinney, N., 2014)

A convenience sample was chosen as the research method to study conflict styles in 25 acute care nurses working in a day surgery area.

Results

Collaboration was identified as the most used conflict style, followed by accommodating, then compromising then avoiding and lastly competing. Providing nurses with an opportunity to develop self-awareness of their conflict style is the first step in creating dialogue for nurses to talk about conflict in healthcare.

Nursing Implications

The value in identifying a problem evident in current nursing practice cannot be understated. Nurses at the bedside feel this conflict often.Recognizing that conflict is inevitable but knowing that according to Morton Deutsch’s theory of Constructive Conflict, a team can be successful if they rely on the ideas that success is based on 1. interdependence among goals of the people involved in a given situation and 2. type of action the people involved take. (Coleman, P.T., & Deutsch, M., 2014) The legal nurse consultant can serve to provide expertise in the areas of mediation, as the training between the legal and medical arenas provide a unique opportunity for improvements to be made in conflict competency.