Running head: CONFLICT PAPER 1

Conflict Paper
Kathy Le
California State University, Stanislaus

Conflict Paper
Disruptive behavior is defined as any behavior that undermines communication, team

performance, patient care, and patient safety (Addison & Luparell, 2014, p. 67). Nurses will

experience this behavior at some point in their careers, which can range from verbal abuse to

physical assault. Consequences of this behavior will lead to job dissatisfaction, decreased

productivity, and poor patient care. Nurses must learn how to intervene in order to defer the

disruptive behavior. This paper covers an overview of conflict and the impact of conflict,

describes an example of conflict, and proposes three resolutions to the example.

Overview
There are many types of conflict or disruptive behaviors nurses may not be aware of. The

main types of disruptive behavior are incivility, lateral violence, bullying, and cyberbullying

(Weiss & Tappen, 2015). Incivility is rude, intimating, and insulting behavior (Sommer et al.,

2013, p. 63). This can include sarcasm, rude jokes, dirty looks and teasing. Lateral violence
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includes verbal abuse, undermining activities, sabotage, gossip, withholding information, and

ostracism (Sommer et al., 2013, p. 63). Bullying is threatening behavior aimed upon a specific

individual. For example, an old nurse may make unfair room assignments for a new nurse.

Cyberbullying is when the bullying behavior takes place online (Sommer et al., 2013). These

behaviors may be considered the norm at certain healthcare settings because it has escalated too

far. The workplace will ultimately suffer from poor communication between staff, decreased

productivity, and shortages in staff from turnover. It will result in a negative, toxic environment

and no one will want to go to work. The patients will also be dissatisfied with the service and

may end up writing letters of complaints. This will leave the staff feeling more stressed about

their workplace. Nurses must be educated about these types of conflict, acknowledged it, and

proceed to resolve it.

Conflict negativity impacts both patients and nurses. The patient will have decreased

safety, satisfaction, and care. When conflict arises, the nurse would focus more on the conflict

rather than safety measures. For example, a nurse may be arguing with another nurse instead of

helping a fall risk patient transfer into a wheelchair. Patients will also become upset about the

nurse spending time arguing instead of performing patient care. Patients get very frustrated

when he or she experiences the nurse falling behind on all the patient care. They will complain

about how the staff is incompetent of providing timely care. The patient will feel uncared for

and remember the terrible care for possibly his or her whole life. The nurses will have poor

communication, decreased productivity, decreased job satisfaction, and absenteeism.

Communication will be poor because the nurses are too busy undermining and arguing with each

other. The nurses will have less productivity because they dont have anyone to help him or her

with their patient load. They will start dreading going work and eventually stop going. Conflict

is definitely a factor that can drive nurses away from the workplace. Nursing itself is already a
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difficult job; the staff shouldnt be difficult too. Constant conflict in the workplace is lose-lose

situation for both patients and nurses.

Case Study
During my pediatric and maternal clinical rotation, I noticed a distant separation between

the labor and deliver staff and the postpartum staff. The labor and delivery nurses all have

blonde hair or blonde highlights. They do not welcome any newcomers into their group, and

seemed deeply offended when nursing students came to work with them. They have their own

clique and will distribute disruptive behavior throughout the birthing center. During a specific

clinical day, a patient was showing the signs of hemorrhaging after her delivery. The labor and

delivery nurse did not give the protocol medications for hemorrhaging to the patient. Instead,

she quickly discharged the patient to the postpartum staff. The labor and deliver nurse gave a

SBAR to the postpartum nurse basically saying that everything was fine. She has left out the fact

that the patient was showing signs of hemorrhaging. The postpartum staff then had to handle the

hemorrhaging patient while the labor and deliver nurse when back to sitting around her computer

station. I was very upset about this matter, so I talked to a postpartum nurse about how

unbelievable that situation was. The postpartum nurse said that it happens all the time and that it

is very frustrating. She said that the labor and delivery nurses are known for being rude, mean,

and lazy. The postpartum nurse said that she does not trust or like interacting with the labor and

delivery nurse. The postpartum nurses are being bullied and sabotaged by the labor and delivery

nurses.
Proposed Response
A realistic strategy for dealing with clique behavior is to identify the disruptive behavior,

be part of the solution, and eliminate exclusion (Powers, Norman, & Whitcomb, 2014). The first

step in confronting conflict is identifying it. Most of the time cliques evolve from long-term

employees. They are more likely to gain strong influence among the unit and develop clique
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behavior. Clique behavior includes withholding information, limiting access to equipment,

assigning inequitable in tasks and meal breaks based on favoritism, advancing through popularity

versus performance-based career development, and delivering inconsistent and inequitable

disciplinary action to particular staff members (Power et al., 2014, p. 41). The next step is to

suggest a solution to stop the clique behavior. Modeling the expected behavior or educating the

staff about appropriate behavior can do this. The final step is to eliminate exclusion by

empowering the staff. The staff will then be able to report the clique behavior without retaliation

fears. This will help prevent the reoccurrence (Power et al., 2014). The labor and delivery

nurses are definitely showing signs of clique behavior by withholding information and

sabotaging. The postpartum nurse should apply this framework to end the clique behavior within

the birthing center. She can identify the behavior, but needs to work on the solution and

empowerment step. She should talk to the nurse manager about the disruptive behavior and ask

for the nurse managers opinion on a solution. The postpartum nurse and the nurse manager can

collaborate on a solution together. Whichever solution they choose will be implemented and

enforced. The nurse manager should also empower the other nurses on the floor, so they can feel

more inclined to report the behavior. This empowerment of the postpartum nurses will decrease

the formation of clique behavior and prevent recurrence.

Another strategy is to initiate a communication skills training program (Saxton, 2012).

The training focuses on leadership, communication skills, conflict resolution, adapting to

change, teamwork, and trust (Saxton, 2012, p. 605). The study suggests that at least two days of

training will increase the self-efficacy in nurses to stand up to the disruptive behavior. The

results of the study state that the nurses had improved ability to report disruptive behavior

because of the communication training (Saxton, 2012). The postpartum nurse can suggest this

training to the nurse manager and present all the evidence-based research. The research will
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show the nurse manager that the training would be beneficial to their current situation. The

community skills training wont be a tiresome process because it only lasts two days. It should

be held as a mandatory educational training class. The communication skills training will help

the birthing center nurses adapt to change, built teamwork, and build trust. It will also teach the

postpartum nurses better communication skills toward confronting conflicts and conflict

resolution. These new conflict resolution skills will help prevent the disruptive behavior because

they will always be able to speak up against the disruptive behavior and resolve the conflict.
Creating a policy that defines acceptable and unacceptable behavior in the workplace

will also be an effective strategy (Plonien, 2016). An example of a policy is the Medial Staff

Code of Professional Behavior from Stanford University Hospital (Plonien, 2016, p. 109). It

describes inappropriate behavior and gives examples for such behaviors. It also states that the

behavior is considered demeaning and offensive in the workplace. The policy holds all the staff

members to the same standards. It improved patient outcomes and satisfaction levels. It also

created a healthy work environment for the staff (Plonien, 2016). The postpartum nurse should

report to the nurse manager about the disruptive behavior. Then the postpartum nurse should

present the research about implementing a professional behavior policy. She should also explain

how effective the policy is in decreasing the disruptive behavior in the workplace and how much

their unit needs it. The nurse manager should then collaborate with the nurse about the policy

and get it approved by the facility. Once the policy gets approved, everyone will be expected to

follow the policy. If they do not follow the policy then they will suffer the consequences listed in

the policy. Enforcing this policy will prevent recurrence.

Overall, this paper addresses what constitutes as disruptive behavior and the impacts of

conflict. It also includes an example of disruptive behavior and three proposed strategies to

resolving it. The most meaningful part of this paper is realizing that a major part of conflict
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resolution involves empowerment. It only takes one empowered individual to make a difference.

He or she will have to gather up the courage to report the problem and help propose a solution.

The steps to resolving the conflict may seem tedious but it is worth it in the end. All the research

shows that preventing clique behavior, promoting communication training, and enforcing

policies will create a healthy work environment.

References
Addison, K., & Luparell, S. (2014). Rural Nurses' Perception of Disruptive Behaviors and

Clinical Outcomes: A Pilot Study. Online Journal Of Rural Nursing & Health Care,

14(1), 66-82. doi:10.14574/ojrnhc.v14i1.300

Plonien, C. (2016). Bullying in the Workplace: A Leadership Perspective. AORN Journal,

103(1), 107-110. doi:10.1016/j.aorn.2015.11.014

Powers, C., Norman, L., & Whitcomb, K. (2014). Is clique behavior sabotaging your nursing

team?. Nursing Management, 45(11), 38-43.

doi:10.1097/01.NUMA.0000452000.49343.60
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Saxton, R. (2012). Communication skills training to address disruptive physician behavior.

AORN Journal, 95(5), 602-611. doi:10.1016/j.aorn.2011.06.011

Sommer, S., Johnson, J., Roberts, K. Redding, S.R., & Church, L. (2013) Nursing Leadership

and Management Review Module (6th ed.). (pp. 63) Retrieved from www.atitesting.com

Weiss, S and Tappen, R. M. (2015) Essentials of nursing leadership and management (6th

Edition). (pp. 179) F.A. Davis Company, Philadelphia

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