Conflict in Communication Lecture Notes PDF

Conflict in Communication Dr. Samia Alharrasi [email protected]  Objectives Upon completion of this section, you should be able to: 1. Discuss disruptive behavior and its types. 2. Discuss Conflict: Definition, nature, antecedences causes, types. 3. D...

Conflict in Communication Dr. Samia Alharrasi [email protected]  Objectives Upon completion of this section, you should be able to: 1. Discuss disruptive behavior and its types. 2. Discuss Conflict: Definition, nature, antecedences causes, types. 3. Discuss and understand conflict resolution and de- escalation. 4. Understand workplace violence. 5. Discuss and identify the anger management process.  Four Main Concepts in This Lecture  Disruptive Behavior  Conflict  Violence  Anger  What is a DISRUPTIVE BEHAVIOR? Situations in which lack of civility or lack of respect occurs within a professional relationship as frequently as weekly and is repeated over time OVERT COVERT Rudeness ; Verbal abuse Withholding needed information Intimidation Withholding help Put-downs Assigning excessively heavy Angry outbursts workloads Yelling Refusing to perform tasks Blaming Impatience Criticizing Unwilling to answer questions Sexual harassment Not returning calls Physical confrontations Speaking in arrogant tone  Interpersonal Sources of Conflict in the Workplace Getting pressured to give more time , attention or Different information than you are able to give , role ambiguity, expectations differences in language, having your feeling or opinion discounted Being asked to do things in conflict with your personal Threats to self or professional moral values Differences in Differences in education, experience, responsibility or rewards (payment) role hierarchy Lack of support from leadership/administration Clinical situation Emphasis on rapid decision making; complex care constraints interventions, stressful workload  Conflict Disagreement arising from differences in attitudes, values, or needs, in which the action of one frustrates (prevents) the ability of the other to achieve their expected goals. Conflict resolution Maintaining Not necessarily is a LEARNED safety for self negative process and client is paramount (vital).  Nature of conflict A concrete  Conflict situations do not have (explicit) content to make realistic sense to you, but they feel real to the client problem issue and need to be dealt with. Unresolved conflict interfere Relationship or  with meeting goals. process issues  Causes of Conflict Lack and poor communication is the main cause Psychological causes Differences in Personality Stress due to Cultural belief values clashes multiple system demands  Types of Conflicts Interpersonal Conflict occurs between two or more people conflict Intrapersonal Opposing feelings within an individual conflict It damages employee relations and hinders Dysfunctional organizational progress. It can involve conflict behavior such as aggression, hostility, or lack of respect toward others Conflict might happen between Client Client Client vs. Health Team Health Team Health Team  CONFLICTS WITHIN THE TEAM 11 Physician-to- nurse Inter- Peer-to-peer professional (same profession) With With superiors Conflicts subordinates  Conflict Antecedents 12 Poor/ ineffective communication is one of several factors cited in the literature as underlying cause of conflict which may lead to: Disagreements Injured Unsafe care feelings  Why work for conflict resolution? Unresolved conflict… obstructs quality and safety of client care emotional exhaustion, leading to burnout weakens the therapeutic relationship decreased job satisfaction, increase absenteeism May lead to legal actions Principles of conflict resolution Identify conflict issue Acknowledge you have the capacity to resolve Listen to the patient’s perspective Acknowledge you have Use “I” sentence , Avoiding “You” heard by validating No blame approach Separate issue from people involved Stay focused on issue Clarify, know and control your own responses Use no blame approach. Listen to others’ alternative Identify options solutions Negotiate & agree on Summarize and follow solution through  CONFLICT RESOLUTION STEPS 15 Identify Causes of conflict Set Goals (immediate, specific, measurable) Implement Solutions (high quality, mutually acceptable)  Conflict Resolution 1. Have a clear understanding of your own personal response. Recognize your own “triggers” or “hot buttons”. What words or patient actions trigger an immediate emotional response in you? These could include having someone yelling at you or speaking to you in an angry tone of voice. 2. Know the context (circumstances) in which the situation occurs. CONFLICT RESOLUTION: Prepare for the Encounter ❑Do not respond in the heat of the moment. ❑Plan what you have to say: purpose, content, organization, word choice. ❑Consider not only what is important to you but what is important to the other person. ❑Rehearse out loud what you are going to say. ❑Select a time and place when you can both discuss the matter privately.  Violating client’s personal space Speaking in a threatening tone Providing unsolicited advice Behaviors of a Judging, blaming, criticizing Healthcare provider That Offering false reassurances Create Anger Portraying self as “I know best” expert in Others Authoritarian, sarcastic, or accusing tone Using hot button words Failing to provide health information in a timely manner to stressed individuals Situations that Clients who dismiss what they say may cause Clients who ask for more personal Healthcare information provider to Clients who sexually harass become angry Family members who make unrealistic with clients: demands CONFLICT RESOLUTION: 1. Develop an effective conflict management style Thomas-Kilmann Conflict Mode Instrument (TKI) Used when the cost of addressing the Avoidance conflict is higher than the benefit of resolution (withdraw) I lose-You lose situation; unassertive and uncooperative. Used when the issue is more important to the other person Accommodation I lose-You win situation; unassertive and cooperative Used when there is need for a quick decision, but leads to problems in the Competition long term I win now, but then lose – You lose situation; assertive and uncooperative. CONFLICT RESOLUTION: Develop an effective conflict management style Each party gives a little and gains a little It is only effective when both parties Compromise hold equal power eventually becomes an I lose – You lose situation; moderate in both assertiveness and cooperativeness. A solution – oriented response in which we work together cooperatively to solve the problem. Mutually agreeable solution. Collaboration Most effective style for genuine resolution. I win – You win situation; assertive and cooperative. TECHNIQUES FOR CONFLICT DE-ESCALATION The 3 Ps of conflict de-escalation:  Position: Face patient but remain closer to the exit, making eye contact only 60% of the time.  Posture: Relax your stance with uncrossed arm; rotate and relax your shoulders  Proximity: Stay 1.5 -3 feet away.  Intervene early and assertively. Avoidance worsens the conflict. 22 Describe the “We seem to disagree about the best way to teach the patient about his behavior limitations in activity.” Express your “He seems to be getting confused about our two different approaches.” concern Specify a “Let’s talk about how we might be able to work more effectively course of action together.” Obtain “What is the most important point you Consensus want to teach him?” You examine a crying child’s inner ears and note that the eardrums are red. You reported to your supervisor that the child may have an ear infection. When a child is crying, the A drums often swell and redden. How about checking again when the child is calm? Learning Response Of course! they are red when the child is crying. B Didn’t you learn that in nursing school? I haven’t got time to answer such basic Put-down Response questions!  RESPONDING TO PUT-DOWNS 24 Recognize a Does the comment make me defensive? Does it embarrass me? put-down Does the comment help me learn? Respond verbally “I found your comment very disturbing in an assertive and insulting…” manner as soon as “I feel what you said as an attack. possible That wasn’t called for by my actions.” If talking directly did not help, FOLLOW agency’s policy and REPORT the problem. DOCUMENTATION IS A KEY STEP!  What would you say?... 25 You are preparing pain medication for Ms. Azza, 65 years old with diabetes when Dr. Ahmed interrupts you. He says that he needs you immediately in Bed 9 to assist with NGT insertion. You are already 15 minutes late and you know that Ms. Azza vomits in response to prolonged pain. You replied that you will be able to help Dr. Ahmed in 10 minutes, during which time you would have administered Ms. Azza’s pain medication. Dr. Ahmed, already on his way to Bed 9, turns around and states loudly, “When I say I need assistance, I mean now. I am a busy man; in case you didn’t notice.” What would be your response to Dr. Ahmed?  Workplace violence  Is an expression of anger by others manifested as a threat or attacks either physical or psychological.  Behaviors include; aggression expressed as a verbal abuse, harassment, bullying, pushing, hitting, attack with weapon.  Violence is classified as an occupational hazard.  Globally, nurses are at higher risk because of direct contact with distressed people.  Conflict can escalate to violent threats or actions. THE ANGER MANAGEMENT PROCESS Defuse the strength of an emotion by Talk about it talking the emotion through with someone Therapeutic Sometimes the most effective action is communication skills simply to listen A priority is to maintain a safe Containment environment for yourself and all clients Evaluation Immediate debriefing  THE ANGER MANAGEMENT PROCESS: 1. Recognize signs of anger Stages of Anger Anxiety ❑ Mild: feels tension, irritability. Acts argumentative, sarcastic (mocking), or is difficult to please ❑ Moderate: observably angry behaviors such Anger as motor agitation and loud voice ❑ Severe: shows acting out behaviors, cursing, using violent gestures but is not yet out of control Aggression ❑ Rage: behaving in an out-of-control manner, physically aggressive toward others or self  THE ANGER MANAGEMENT PROCESS: 2. Defuse Anger Abusive people want to provoke REMEMBER! confrontations as a means of controlling you. ❑ Maintain self-control; remember, if you lose control, you lose! If you become defensive, you lose! ❑ Do not respond to insults ❑ Avoid arguing, saying no, or hurrying ❑ Help the client express anger in an acceptable manner  THE ANGER MANAGEMENT PROCESS: 2. Defuse Anger ❑Don’t take client’s behavior personally ❑Use empathy in your communication. ❑Acknowledge both the issue and their feelings about the issue. “I’m sorry you are hurting so much.” ❑Lower your voice and speak more slowly ❑Provide a neutral, accepting, interpersonal environment ❑Appear calm, relax, talk in low tone, monotone  THE ANGER MANAGEMENT PROCESS: 3. Be assertive and setting limits “Azza, I want to help you solve this, but if you continue to raise your voice, I’m going to have to leave you. Which do you want?” “Yelling at me won’t solve this. I will not argue with you. Come back when you can talk calmly and I will try to help you.”  THE ANGER MANAGEMENT PROCESS: 4. Prevent escalation of Anger ❑ As the client voice rises, lower yours. ❑ If eye contact seems confrontational, break eye contact ❑ Focus only on defusing anger or potential violence For Any Question [email protected]