Professional Documents
Culture Documents
Emily Borges, Andrew Cox, Lauren Kalanta, Alex Santella, and Jay Sparks
Nursing assignments are time-consuming, complex, and often lead to conflict amongst
staff (van Oostveen, Braaksma, & Vermeulen, 2014). They can directly influence nurses,
crucial for ensuring the safety and quality of patient care and job satisfaction for nurses. There
are many strategies for managing conflict (Johansen, 2012). This paper looks at the different
types of conflict and then analyzes a conflict resolution website to determine its quality and
credibility. A specific example of a nursing assignment is discussed and resolution for this
support system to improve nursing assignment outcomes. These factors will aid in nursing
assignment conflict.
Background
How is it determined which nurses are assigned to take care of patients while in the
hospital? Typically it has been the responsibility of the charge nurse to create the nursing
assignments. Assigning the responsibility of care for several people is no easy task. How many
patients is too many? Certainly some patients may require more care than others, while other
patients may have a greater health risk requiring further attention. Assignments that are decided
by the charge nurse can create conflicts within the nursing staff.
people that either causes harm or may cause harm (Yoder-Wise, 2015). There are several types of
conflict as well as different modes of conflict resolution that will be discussed. Types of conflict
2015). Intrapersonal conflict involves a confrontation within a person in which the way they
think or act differs from ones sense of self (Yoder-Wise, 2015). Interpersonal conflict involves a
NURSING ASSIGNMENT CONFLICT 3
difference of opinion, priority, or approach between two separate individuals or more (Yoder-
Wise, 2015). Organizational conflict occurs when there is a disagreement about policies and
When discussing how conflict is dealt with in their personal lives, the group consensus
centers around a collaborative approach. The group members agree that when dealing with
conflict, they try to incorporate the viewpoints from all parties to maximize benefits for all,
resulting in a win-win situation. On the other hand, the group members agree that when in the
position of student nurse, they tend to use the conflict style of avoidance. The group collectively
feels that they are taken advantage of as a student nurse. Rather than helping the student nurse
practice important skills like dressing changes and medication administrations, staff nurses often
delegate simple tasks such as checking vital signs and glucose. When the conflict of being given
only simple tasks arises, the group members feel that they are less experienced and they do not
want to overstep their boundaries by declining. Instead, they avoid the conflict and become
frustrated.
In order to improve the groups conflict resolution style, the members need to learn how
to face conflict with confidence rather than avoiding it. The group members should evaluate why
nursing assignments will increase safety and quality of care as well as improve job satisfaction
There is a difference between the conflict resolution styles in their personal lives and in
their roles as student nurses. Vocalizing the difference can help the group members express their
concerns when taking on the student nurse role. This process of self-reflection in a group setting
helps build confidence for when a conflict arises next. When facing a future conflict with a staff
nurse, the group members will be assertive and respectful. They will lay out clear expectations
NURSING ASSIGNMENT CONFLICT 4
from the beginning of the shift by stating, I am a student nurse and I can perform almost all
nursing skills with the supervision of a registered nurse, except hanging blood products. I would
like to practice as many skills as possible today with your patience, supervision, and guidance.
Strict criteria was used to evaluate the website prior to incorporating it into this paper.
University of Marylands online article Evaluating Web Sites: A Checklist served as a tool for
evaluating its credibility (University of Maryland Libraris, 2014). The website nursingworld.org
was selected to explore different types of conflict resolution in healthcare. Its credibility was
analyzed using a checklist from University of Maryland Libraries (2014). This website is run by
the American Nurses Association (ANA) (American Nurses Association, n.d.). The American
well as advances the nursing profession by fostering high standards of nursing practice,
promoting a safe and ethical work environment, bolstering the health and wellness of nurses, and
advocating on health care issues that affect nurses and the public (American Nurses
Association, n.d.). Nursingworld.org was chosen for this project because of the massive amount
of valuable information available on this website. This information includes conflict resolution
strategies, interviews with working nurses, and conflict management modules for nurses and
nurse managers to engage in. The information is structured as a comprehensive program that
nurses can participate in (American Nurses Association, n.d.). This provides the authors with a
deeper understanding of conflict resolution and the available resources for resolving conflicts in
the nursing profession. By investigating conflict and evidence-based resolution for nursing
assignments, it is envisioned that balanced aryland Libraries, 2014). This tool provides a
comprehensive checklist for assessing websites. Using this tool led the authors of this paper to
NURSING ASSIGNMENT CONFLICT 5
determine that nursingworld.org is a valid and credible website. It has a clear author, the ANA,
which is a non-profit organization with the goal of advancing the nursing field (American Nurses
Association, n.d.). Additionally, the information is clear, up to date, and all of the information
During clinical, student nurses experience and observe an array of conflicts with nursing
staff. One conflict that is commonly witnessed is when patients are being assigned to nurses at
the beginning of shift. Patient assignments determine the course of the day depending on the
type of patient the nurse is taking care of. Oftentimes nurses complain, request a different
This was the case for a nurse who was assigned to the psychiatric patients within the
Emergency Department for several consecutive shifts in a row. The nurse complained after the
assignment had been made, stating aloud, This isnt fair. I have had this assignment the last
three shifts. It is as if they do not value my critical thinking or skills in different areas by always
assigning me with the psychiatric patients. The assumption being made is that the charge nurse
has been conducting patient assignments unfairly. This not only creates interpersonal conflict
between the charge nurse assigning the patients and the nurse assigned to them, but to the other
nurses who may be perceived as having an easier or more sought after assignment. In this
scenario, it wasnt until later in the nurses shift during a demanding period that they then vented
their displeasure of their assignment to the charge nurse. Unfortunately, this avoidance towards
an issue resulted in assumptions being made. The charge nurse was then placed in a position of
In order to successfully resolve conflict, those involved must first be able to understand
and process the stages of conflict (Yoder-Wise, 2015). This process involves navigating through
the phases of frustration, conceptualization, action, and outcomes (Yoder-Wise, 2015). During
the stage of conceptualization, conflict may be interpreted differently with each nurse focusing
on different results (Yoder-Wise, 2015). It may also be interpreted as a battle for control, which
can lead to frustration and feeling a loss of control (Yoder-Wise, 2015). Nurses, as like any other
human being, are prone to differences of perspective. Conceptualization based on ones own
beliefs and feeling serves as the basis for future frustration (Yoder-Wise, 2015). Conflict derived
frustration tends to be prominent when nurses feel that their goals are being blocked or that their
input is not acknowledged (Yoder-Wise, 2015). This emotional and initial response to conflict
A nursing leader should be able to uphold the hospitals values and goals by
understanding the culture of the work environment (Siebert & Chiusano, 2015). This can be done
by analyzing the environment and taking action in order to resolve or avoid conflict. Use of
assertive communication that does not give way to emotions or place blame is an appropriate
method when taking action towards conflict resolution (Yoder-Wise, 2015). Using first person
perspective when speaking places the focus on the intended statement rather than the opposing
person (Yoder-Wise, 2015). Taking action by way of clear communication leads to the final
acknowledge the conflict, typically involves a lose-lose situation for both parties and is not an
NURSING ASSIGNMENT CONFLICT 7
effective strategies to achieving resolution but at the sacrifice of one party leading to a win-lose
Collaborating and effectively communicating is vital when resolving conflict and may
prevent conflict from occurring at all (Siebert & Chiusano, 2015). For example, an in depth look
into staff disatisfaction at Childrens Hospital Boston revealed that acknowledging staff concerns
created a positive change in the attitudes of the nurses and the overall work environment
(Marine, Meehan, Lyons, & Curley, 2013). Taking into consideration the input of all staff
members and collaborating to reach a resolution can help charge nurses when assigning patients.
computer-generated nursing assignments (Sir, Dundar, Steege, & Pasupathy, 2015; van Oostveen
et al., 2014). These computerized systems assess how many nursing care hours each patient will
need and assigns them an acuity score (Sir et al., 2015). It then generates an assignment
recommendation based on patient census, survey-based perceived workload, and patient acuity
scores. In their study, van Oostveen et al., found that a 30% time reduction was achieved when
patients were assigned using a computerized decision support system (2014). They provide a
balanced assignment and decrease the perceived workload (Sir et al., 2015; van Oostveen et al.,
2014). This will lead to increased job satisfaction as well as improved quality and safety of care
In the previous personal example, the nurse initially used avoidance as his
communication style. Clear communication should have been used for a better outcome (Yoder-
Wise, 2015). Going through the stages of conflict, it would be natural for the nurse to feel an
initial frustration. He should have then conceptualized why he was assigned this patient again
NURSING ASSIGNMENT CONFLICT 8
and the best course of action for resolving his frustration. During the action phase, the nurse
should have approached the charge nurse and used respectful and assertive communication to
talk about the assignment. The nurse and the charge nurse could have then collaborated to come
avoid this conflict altogether (van Oostveen et al., 2015). Since these systems take perceived
workload from nursing surveys into account, it is likely that consecutive assignments to the
psychiatric patients would be tagged as being high acuity. If it was not already tagged, it could be
added to the system. The nurse would not have received this assignment again and the conflict
would not have taken place. His frustration would have been avoided, leading to increased job
satisfaction and higher quality patient care (van Oostveen et al., 2014).
when creating nursing assignments that may not seem fair. The website, nursingworld.org, has
been found to be reliable and consistent towards promoting professional conflict resolution
strategies in the nursing profession. Communication and collaboration are crucial towards
resolving conflicts in the nursing profession (Siebert & Chiusano, 2015). In personal experience,
reduce the conflicts that result from the charge nurse creating nursing assignments (Sir et al.,
2015; van Oostveen et al., 2014). This will decrease conflict, resulting in greater job satisfaction,
improved quality of care, and improved nursing staff retention (van Oostveen et al., 2014). When
References
Allen, S. B. (2015). The Nurse-Patient Assignment: Purposes and Decision Factors. Journal of
http://www.nursingworld.org/MainMenuCategories/CertificationandAccreditation/Continui
ng-Professional-Development/Conflict-Engagement
Johansen, M, L. (2012) Keeping the peace: Conflict management strategies for nurse managers.
Marine, K., Meehan, P., Lyons, A., & Curley, M. (2013). Inequity of patient assignments: Fact or
NURSING ASSIGNMENT CONFLICT 10
Siebert, S. & Chiusano, J. (2015). Understanding the charge nurse's role in staffing. American
Sir, M. Y., Dundar, B., Steege, L. M. B., & Pasupathy, K. S. (2015). Nursepatient assignment
models considering patient acuity metrics and nurses perceived workload. Journal of
University of Maryland Libraries. (2014). Evaluating web sites: A checklist. Retrieved from
http://www.lib.umd.edu/binaries/content/assets/public/usereducation/evaluating-web-sites-
checklist-form.pdf
van Oostveen, C. J., Braaksma, A., & Vermeulen, H. (2014). Developing and testing a
Yoder-Wise, P. S. (2015). Leading and managing in nursing. St. Louis, MO: Elsevier Mosby.