Section 2: COMMUNICATION SKILLS

2.1 Conflict Resolution

Why is conflict resolution an important skill?

In a setting where the health of a patient is reliant not only on good communication
between the patient and their health care professional, but also between health care
professionals amongst themselves, anything which interferes with the communication
process is potentially deleterious to the proper care of the patient.

The Health Professional may be presented with scenarios describing conflict between
a patient and a health professional, or conflict between patients, which needs to be
mediated by another healthcare professional. These scenarios will examine the Health
Professional's attitudes and skills with regard to mediation of disagreements and
efficient conflict resolution.
How can conflict be resolved?

At a professional level the following general pointers should be taken into account:

* Focus on the Problem: It is important to focus on the relevant issues surrounding

a problem in order to find a solution. Focusing on how the problem arose in the first
place and how it can be solved is more important than issues such as who is to blame.
* The Team Approach: United we stand divided we fall - Usually, the first course
of action in a conflict situation is to attribute blame. This does not solve the problem.
It singles out one group or person, instead of uniting people as a team to solve the
problem.
* Compromise: Often the parties involved in a conflict situation will have to reach
a compromise each party will have to yield some ground to reach a solution that is
acceptable to everyone.
* The Win-Win Situation: For effective conflict resolution it is important that all
parties involved feel satisfied with the solution.

The following examples illustrate some of these issues. The preferred answers
emphasise:

* Explaining the situation (usually to a patient) so that any misunderstanding

between conflicting parties may be resolved.
* Being impartial: Not taking sides is crucial in solving a conflict situation between
two parties.
 * Suggesting solutions, which are acceptable to both parties, but may involve some
compromise by each (as explained above).

Example: 1

Category: Conflict resolution

Scenario:

You are a nurse caring for two elderly male patients. One of the patients spends most
of the day reading books. The other patient has a small portable radio, which he
listens to all day. The patient reading the books is not happy about the constant noise,
complaining that he cannot concentrate. He has spoken to the man with the radio, who
has paid no heed to his requests for some peace and quiet. The man complains to you.
What do you say?

Choices:

a) You ignore the situation and hope that they will resolve the problem.

b) You threaten to report the complaining man to the clinical nurse consultant.

c) You explain to both patients that they have to be considerate of each other, and ask
the man with the radio to turn down the volume.

d) You tell the man with the radio that you have to confiscate it, if he does not turn
down the volume.

e) You tell the man reading the books to read out loud.

Answer:

The preferred answer is (c)

Discussion:

This is a conflict situation between two patients. As a nurse you have the choice
whether to ignore the situation or to help resolve the conflict. By choosing to ignore
the situation, both patients' wellbeing and comfort are being compromised. Answer (c)
is the preferred answer. It is far better to speak in a polite and friendly manner to both
parties concerned and to negotiate a compromise between the patients, which will
ensure a comfortable hospital environment, than to ignore the problem (a), or
aggravate it (e). Threatening the man (b) will not resolve the issue in the short term
and choice (d) is not appropriate either as you have no right to confiscate personal
property.

Example: 2

Category: Conflict resolution

Scenario:

You are a young nurse in the children's ward at a public hospital. You are in charge of
a ward with six boys, between the ages of eight and thirteen years. One boy's has had
his tonsils removed and is in some discomfort. His mother has informed you that her
son is constantly being teased and bullied by all the other boys. How best should you
handle the situation?

Choices:

a) You ignore the mother's complaint, as the child might be over-reacting.

b) You tell the other boys to stop bullying the child, or you will make sure that they
will not get their meals that evening.

c) You tell the mother that bullying does not happen in hospitals and that her child
might be lying.

d) You tell the mother that this problem does not fall within your job description.

e) You explain to all the boys in the room that the boy being teased is not well, just
like them, and has a right to be left in peace in order to fully recover.

Answer:

The preferred answer is (e).

Discussion:

In this situation your diplomatic people-skills are required. The emotional wellbeing
of one of your patients is being seriously compromised. Answer (e) is the preferred
answer, because you are not just reprimanding the other boys, but hopefully enlisting
their cooperation and understanding. Answer (d) is incorrect because by taking no
action the boys comfort and recovery are compromised. Choice (a) and (c) indicate
that you do not believe the child or its mother. Without adequate grounds and
investigation this is certainly inappropriate. Choice (b) constitutes entirely
inappropriate behaviour.

Example: 3

Category: Conflict Resolution

Scenario:

You are a nurse in a maternity ward. Under your care is a young woman who has
given birth to twins. Not only the adoring husband, but many relatives and friends are
constantly bringing her flowers. Sharing the room with the young woman are two
other ladies. One of them suffers from hay fever. As a result of the many flowers she
is constantly showing signs of hay fever. She is complaining about her reaction to the
many flowers. How do you handle the situation?

Choices:

a) You remove all the flowers from the room and inform the mother of the twins that
she may not receive any more flowers.

b) You tell the patient suffering from allergies, that there is actually nothing you can
do, as everyone is allowed to receive flowers in hospital.

c) You ignore the complaints of the patient with hay fever and hope the mother of the
twins will not receive any more floral gifts.

d) You offer the patient medication to alleviate the allergies.

e) You discuss the situation with the patient receiving the flowers and ask if the
flowers can be kept at home for her by her family.

Answer:

The preferred option is (e).

Discussion:

In this case, the wellbeing of all patients is your prime responsibility. Every patient in
the hospital environment has the right to feel comfortable. Although there is no rule
about receiving flowers in hospital, they are in this case however causing a great
discomfort to one of your patients. Option (a) is too drastic as there is no discussion
with the patient concerned. Choices (b) and (c) do nothing to help the patient with
allergies, while choice (d) is only a short term measure. Option (e) is the most fair and
democratic approach as it explains the situation to the mother of the twins and tries to
find a solution that proves to be most beneficial for all parties concerned.