Appendix D Conflict Management Strategies
Managing Conflict
Conflict is not uncommon on interprofessional teams, especially when there are diverse perspectives from multiple staff regarding patient care. Nurse leaders must be prepared to manage conflict to support the needs of their team members.
When conflict occurs, the DESC tool can be used to help resolve conflict by using “I statements.” DESC is a mnemonic that stands for the following[1]:
- D: Describe the specific situation or behavior; provide concrete data.
- E: Express how the situation makes you feel/what your concerns are using “I” statements.
- S: Suggest other alternatives and seek agreement.
- C: Consequences stated in terms of impact on established team goals while striving for consensus.
The DESC tool should be implemented in a private area with a focus on WHAT is right, not WHO is right. Read an example of a nurse using the DESC tool in the following box.
Example of Using the DESC Tool[2]
Situation: A physician became angry at a nurse who was inserting a patient’s Foley catheter and yelled at the nurse in front of the patient and other team members. The nurse later addressed the physician in a private area outside the patient’s room using the DESC tool and “I statements”:
D: “I noticed you got angry at me when I inserted the patient’s Foley catheter.”
E: “I’m concerned how you addressed that issue in front of the patient and three other staff members. It made me feel bad in front of the patient and my colleagues.”
S: “In the future, if you have an issue with how I do things, please pull me aside privately to discuss your concern.”
C: “Our organization has a policy for managing communication challenges among team members if we can’t agree on this alternative.”
- AHRQ. (2020, January). Pocket guide: TeamSTEPPS. https://www.ahrq.gov/teamstepps/instructor/essentials/pocketguide.html ↵
- AHRQ. (2020, January). Pocket guide: TeamSTEPPS. https://www.ahrq.gov/teamstepps/instructor/essentials/pocketguide.html ↵
According to [1]
Patient-centered care, also known as person-centered care has become an increasingly popular term in healthcare over the last decade. This is not a new concept for nurses, as our core commitment to patients is to provide the best care possible. However, the term has grown in popularity in an attempt to meet the challenges in healthcare. As nurse leaders, person- centered care can and should extend beyond the "patient" but should also include all stakeholders, including those that are impacted by policy and leadership decisions. An essential reminder of keeping the "persons" in mind when planning will go a long way to achieving optimal outcomes (Exercise 7.1.1).
Exercise 7.1.1
Sample Questions to consider when leading person-centered decisions
- Who are our primary stakeholders?
- Who will benefit from this decision?
- Who will need to be included in this discussion?
- Why are we making this change?
- Is there another way to complete this?
- What are our priorities?
- How can we do with well?
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