By Lee Mantini RN, MHScN, LTC Best Practice Coordinator - South East, RNAO
Friendly Manor Nursing Home, Deseronto
Conflict in the workplace is a reality in long-term care and we cannot shy away from it. So how can we effectively prevent and manage it? No workplace will ever be totally conflict-free. The goals are to proactively have preventative measures in place, and to effectively manage conflict when it does occur. This is what the leadership at Friendly Manor wanted to do.
‘Our mission is to provide seamless care and services in a safe and secure environment within a culture of continuous improvement,’ explained Rebecca VanSteenbergen, ADOC. With this in mind, Rebecca and Sylvia Jackson, the RAI MDS Coordinator, reached out to me, the Long-Term Care Best Practice Coordinator for Friendly Manor. They wanted to address conflict in the workplace, in order to promote a healthier work environment.
I was invited to take part in their Health and Safety Week activities. I explained the different types of conflict and the pros and cons of conflict in the workplace. With a large group of staff, we reviewed the individual and team best practice recommendations for managing and mitigating conflict. We discussed the importance of reflecting on their behaviours and the impact that their behaviours can have on others. We also reviewed the six steps to conflict resolution that are outlined in a short YouTube video by Dr. Jennie Byrne, an adult psychiatrist.
Next, we arranged to do the Managing and Mitigating Conflict in Health Care Teams gap analysis with the managers from various departments. Completing the gap analysis helped to determine which best practice recommendations they were already meeting and which ones they could work on. Part way through the gap analysis, the group had an ‘ah ha!’ moment.
The managers realized that individually, they were repeatedly documenting and managing the same types of conflict, in their own ways. They had not been communicating this to the other managers. They decided to develop a template to record the types of conflict, their conflict resolution approaches and the outcomes. Each manager is now responsible for documenting reported conflicts on the template. Using this template has helped guide discussion with the staff reporting conflict. Managers encourage staff to share their perspectives, and their stressors and feelings. This has helped managers gain a better understanding of the underlying causes of conflict. Staff and management work together, to come up with a plan for resolving conflicts.
A new Managers’ Quality Improvement meeting was started. This inter-professional meeting provides a regular opportunity for managers to share their conflict data. Common conflict issues are identified and approaches that have proven to be effective for conflict prevention and management are discussed.
‘We now understand the importance of tracking our workplace conflicts. The new template has proven to be effective for gathering data, and for addressing conflict in a timely and consistent manner,’ says Rebecca. ‘We found that close to 50 percent of all conflicts occurred among approximately 5% of our staff. Based on this data, we decided to speak with these staff members individually.’
The individual discussions took place prior to and after an educational session on bullying and violence in long-term care, provided by the well-known speaker John Keating. This learning session gave staff the opportunity to reflect on bullying behaviours. By the end of the session, some attendees were quite moved. Some acknowledged that they had been a bully. It was a very powerful learning experience. One hundred percent of attendees provided positive feedback on the session.
‘Completing the Conflict gap analysis has been one of the most beneficial processes I have been involved in’, says Rebecca. ‘As an ADOC in one of the most heavily regulated sectors of healthcare, focusing on team work, self-refection and conflict resolution are so important. Identifying gaps and constantly working together to fill the gaps, so we can improve resident care and our work environment, is definitely top priority. We feel more united now as managers. The management silos have been taken down. We definitely communicate more openly with each other. We even have lunch together on a regular basis.’
Attitude and behaviour change does not happen overnight. It is common to slip back into old habits. The leadership at Friendly Manor recognizes that there will continue to be challenges with staff conflict. They understand the importance of continuing to improve everyone’s knowledge and skills related to conflict prevention and management, even their own. Becoming creative problem solvers through collaborative brainstorming, recognizing and addressing conflict triggers, and monitoring the effects of conflict resolution strategies will be an ongoing process.
Cloke & Goldsmith, 2011 explain that, ‘there is no single tried and true response to conflict that will work for everyone, always and everywhere. There are no simple step-by-step formulas or methods… All you can do is find your own way by moving into your conflicts… then seeing what works and what does not and being courageous enough to alter your approach as you go.’
-About Friendly Manor-
Friendly Manor is a 60-bed long-term care home situated in the small town of Deseronto, in Southeastern Ontario.
To request copies of documents developed, or for further information, please contact The LTC Best Practices Program at LTCBPP@RNAO.ca
Source: Kenneth Cloke & Joan Goldsmith, 2011, Resolving conflicts at work: Ten strategies for everyone on the job, p. xxxi
- Managing and Mitigating Conflict in Health-Care Teams BPG
- LTC toolkit – Managing and Mitigating Conflict
- Toolkit: Implementation of Best Practice Guidelines
- Conflict Resolution in 6 Simple Easy Steps by Dr. Jennie Byrne