Chapter 13: Conflict Management Zerwekh 9th ED

6. A staff nurse who has worked on the unit for 6 months voices the following concerns to another nurse: "The clinical nurse leader of the unit often follows me into the supply room and stands blocking the doorway and chats. The nurse leader makes opportunities to mention my good looks, muscular physique, or strength in the context of daily work, saying things like: 'You're so handsome; no wonder your patients like you.' The nurse leader frequently touches me on the arm, the shoulder, chest, or the hair, and if I'm sitting, touches my leg. Yesterday, the nurse leader patted my arm and said, 'You know, if we were dating, I might be able to give you lighter assignments.' I don't want to date the nurse leader. I just want to be left alone! What should I do?" What is the best reply? a. "Don't be quite so honorable. Go on a date and see if you get better assignments." b. "Confront the nurse leader with a description of the behavior and state that you want the behavior to stop." c. "Go directly to the human relations office at the agency and tell them what you just told me." d. "Contact your lawyer and get advice ASAP in case the nurse leader decides to turn the tables and accuse you of advances."

ANS: B There are two ways to deal with sexual harassment in the workplace: informally by confrontation and formally through a grievance procedure, keeping a record of all confrontations and statements in writing. The best first step is to confront the person directly. Then, if there is no stopping of the behavior, go to the human relations office and explain the situation. At this point, there is no need to contact a lawyer because the human relations office can handle the sexual harassment issue. PTS: 1 DIF: Cognitive Level: Analysis REF: p. 300 OBJ: Identify situations of sexual harassment in the workplace and discuss possible solutions. TOP: Conflict management MSC: NCLEX®: Safe and effective care environment—management of care

16. A nurse feels angry over a patient assignment and feels that assignments always include the "bad ones." What is the best way to control this anger? a. Ignore the negative feelings. b. Talk about other coworkers behind their backs. c. Face this anger and determine what is being felt. d. Refuse to speak to any coworkers for fear of lashing out.

ANS: C The nurse should face the anger and determine what is being felt. Ignoring angry feelings, talking about coworkers behind their backs, and ignoring others will not help to resolve the anger. PTS: 1 DIF: Cognitive Level: Application REF: pp. 297-300 OBJ: Discuss techniques to use in dealing with difficult people. TOP: Dealing with difficult people MSC: NCLEX®: Safe and effective care environment

11. Which action by the nurse has a potential for creating role conflict? a. Arguing that the nurse on the next shift is responsible for weighing a patient b. Failing to discuss differences with a coworker the nurse is angry with c. Placing the nurse's personal achievement over that of coworkers d. Trying to change another nurse's personality

ANS: A Arguing with another nurse about whose responsibility it is to weigh a patient is an example of a role conflict. Failing to discuss differences is a communication conflict. Placing personal achievements about those of others is goal conflict. Trying to change another nurse's personality is personality conflict. PTS: 1 DIF: Cognitive Level: Application REF: p. 287 OBJ: Identify common factors that lead to conflict. TOP: Conflict MSC: NCLEX®: Not applicable

2. Which of the following are common factors of conflict encountered in nursing? (Select all that apply.) a. Ambiguous boundaries around work responsibilities b. Unclear communication to family members about visiting hours c. Nursing assistant placing personal achievement above everything d. Chief of medicine demanding that the nurse/patient ratio be increased e. Consideration of 26-week termination of pregnancy by a physician because of mother's health f. Vacation schedules posted with new staff members having to work at least one day during all holidays

ANS: A, B, C, D, E, F All of these areas are potential factors that can precipitate conflict in a nursing situation—roles, communication, goals, personalities, and conflicting ethics and values. PTS: 1 DIF: Cognitive Level: Application REF: p. 287 OBJ: Identify common factors that lead to conflict. TOP: Conflict management MSC: NCLEX®: Safe and effective care environment—management of care

7. What actions can a nurse implement into daily practice to reduce conflict? (Select all that apply.) a. Deal with issues and not personalities. b. Worry about themselves and no one else. c. Communicate openly. d. Listen actively. e. Sort out issues.

ANS: A, C, D, E To reduce conflict, nurses can implement the following actions into their daily practice: deal with issues and not personalities, communicate openly, listen actively, and sort out issues. PTS: 1 DIF: Cognitive Level: Application REF: pp. 288-290 OBJ: Discuss five methods to resolve conflict. TOP: Conflict resolution MSC: NCLEX®: Safe and effective care environment

14. What can staff nurses do to reduce conflict with patients and families? a. Allow nurses to enforce what they feel comfortable with. b. Keep treatment decisions between the patient and health care team only. c. Do not allow family to participate in patient care. d. Maintain consistency in enforcing rules and policies.

ANS: D To reduce conflict with patients and families, the nurse can maintain consistency in enforcing rules and policies. Allowing each nurse to enforce rules they are comfortable with, keeping treatment decisions between the patient and the health care team, and not allowing family to participate in care may increase conflict. PTS: 1 DIF: Cognitive Level: Application REF: pp. 288-290 OBJ: Identify common factors that lead to conflict. TOP: Conflict MSC: NCLEX®: Safe and effective care environment

7. To resolve a scheduling conflict, a nurse manager is using employment seniority. The nurse manager interprets this as a. a win-win strategy. c. a lose-lose strategy. b. a win-lose strategy. d. a compromise.

ANS: B This is an example of a win-lose strategy, which underpins competition as the method of resolving the conflict. The person with the more seniority wins, and the one with the lesser seniority loses the scheduling issue. Compromise or bargaining is a modified win-lose strategy. In this instance, there is no compromise as the nurse manager uses seniority to resolve the conflict. Avoidance is a lose-lose strategy for conflict resolution, which is unassertive and uncooperative. Win-win strategies involve collaboration and problem solving, which lead to cooperation and objectivity. PTS: 1 DIF: Cognitive Level: Analysis REF: p. 289 OBJ: Discuss five methods to resolve conflict. TOP: Conflict management MSC: NCLEX®: Safe and effective care environment—management of care

4. What are some positive results that can come from conflict? (Select all that apply.) a. Disturbing issues are brought out, which may lead to more serious conflict. b. Groups cohesiveness may increase as individuals resolve issues. c. Results of conflict can be constructive. d. Groups can learn from each other. e. Talking about issues can avert serious conflict.

ANS: B, C, D, E Positive aspects of conflict include group cohesiveness may increase as individuals resolve issues, results of conflict can be constructive, and groups can learn from each other and talking about issues can avert serious conflict. PTS: 1 DIF: Cognitive Level: Analysis REF: pp. 288-289 OBJ: Identify common factors that lead to conflict. TOP: Conflict MSC: NCLEX®: Safe and effective care environment

4. On the unit in which you work, one nurse's aide is usually pleasant and helpful; the other is often abrasive and angry. What is the most important basic guideline to be observed by a nurse who must resolve a conflict between the two nurse's aides? a. Deal with issues, not personalities. b. Require the aides to reach a compromise. c. Weigh the consequences of each possible solution. d. Encourage ventilation of anger and use humor to minimize the conflict.

ANS: A Dealing with the issues and not the personalities is one of seven important key behaviors in managing conflict. Whereas issues tend to be more concrete, personalities involve emotional issues. Although weighing the consequences is one of the seven key behaviors, it does not apply to this situation which involves the behaviors of the nurse's aides. Asking parties to compromise may not always be the best approach in resolving the conflict. Although encouraging ventilation of anger and using humor are successful approaches, it is important to always deal with the issue at hand and not the personality of the person. PTS: 1 DIF: Cognitive Level: Analysis REF: p. 288 | p. 290 OBJ: Discuss techniques to use in dealing with difficult people. TOP: Conflict management MSC: NCLEX®: Safe and effective care environment—management of care

2. Of the following common areas of conflict between nurses and their patients and families, which does the nurse interpret as the most easily resolved? a. Issues of concern about quality of care b. Issues surrounding treatment decisions c. Issues of family involvement d. Issues about quality of parental care

ANS: A Families typically are concerned with how well their loved one is being attended to. Conflict often arises out of concerns related to quality of care. Whereas this is something that the nurse can directly address, issues of treatment decisions, family involvement, and quality of parental care often require more discussion and intervention. PTS: 1 DIF: Cognitive Level: Analysis REF: p. 288 OBJ: Discuss five methods to resolve conflict. TOP: Conflict management MSC: NCLEX®: Safe and effective care environment—management of care

1. A newborn has several congenital anomalies incompatible with living beyond 1 month. The newborn cannot retain formula, and the temperature drops when the newborn is removed from the warmer. Two nurses who alternate caring for the baby argue about whether or not to attempt bottle feedings and whether the newborn should be removed from the warmer to be held. What is the origin of the conflict described? a. Ethical values c. Personal goals for advancement b. Nursing role concerns d. Personality differences

ANS: A This situation depicts personal issues based on two separate sets of ethics or values regarding the newborn's care. One nurse places value on nutritional needs and the other on the need for bonding. This conflict is not personality driven among the two nurses. The role of the nurse is to care for the newborn. They both want to care for the newborn, so they are meeting their nursing role; however, the conflict is based on an ethical issue about feeding and bonding. PTS: 1 DIF: Cognitive Level: Analysis REF: p. 287 OBJ: Identify common factors that lead to conflict. TOP: Conflict management MSC: NCLEX®: Safe and effective care environment—management of care

13. A nurse is aware that an area of conflict between nurses and patient's families is quality of parental care. Which action would not help the nurse reduce conflict? a. Become frustrated with the parents for lack of participation in care b. Model positive parenting techniques c. Encourage parents to meet other parents d. Give out information about parenting classes

ANS: A To reduce conflict that nurse can model positive parenting techniques, encourage parents to meet other parents and give out information about parenting classes. The nurse should avoid becoming frustrated with parents because this will likely cause conflict. PTS: 1 DIF: Cognitive Level: Application REF: pp. 288-290 OBJ: Identify common factors that lead to conflict. TOP: Conflict MSC: NCLEX®: Safe and effective care environment

1. What action(s) by the staff nurse is an effective way to deal with a sexual harassment issue in the workplace? (Select all that apply.) a. Tell the person to stop. b. Tell your best friend about the incident. c. File a formal grievance. d. Explain the situation to your spouse. e. Play along with the person and document the activities. f. Threaten the person with a sexual harassment lawsuit.

ANS: A, B, C, D There are two ways to deal with sexual harassment workplace conflict, informally and formally through a grievance procedure. Start with the most direct measure. Ask the person to STOP! Tell the harasser in clear terms that the behavior makes you uncomfortable and that you want it to stop immediately. In addition, put your statement in writing to the person, keeping a copy for yourself. It is also important to tell other people (e.g., family members, friends, your personal physician, your minister) that this is happening and how you are dealing with it. PTS: 1 DIF: Cognitive Level: Application REF: pp. 300-302 OBJ: Discuss five methods to resolve conflict. TOP: Conflict management MSC: NCLEX®: Safe and effective care environment—management of care

12. Which of the following scenarios shows an ethical conflict? a. A nurse who consistently speaks poorly of another nurse for always being "grumpy" b. A nurse who has a hard time respecting 'no codes' on young patients c. A nurse who refuses to run a systems check on the glucometers because "it's night shift's duty" d. A nurse who forgets to alert family members to a change in visiting hours

ANS: B A nurse who has a hard time respecting "no codes" on young patients is experiencing an ethical conflict. A nurse who speaks poorly of another nurse has a personality conflict. A nurse who refuses to run controls on a glucometer has a role conflict. A nurse who forgets to alert family members to a change in visiting hours has a communication conflict. PTS: 1 DIF: Cognitive Level: Analysis REF: p. 287 OBJ: Identify common factors that lead to conflict. TOP: Conflict MSC: NCLEX®: Safe and effective care environment

3. What is the best strategy for resolving the conflict in a situation in which two staff nurses request the same vacation weeks? a. Accommodation c. Competition b. Collaboration d. Avoidance

ANS: B Collaboration is the strategy that involves confrontation and problem solving. Needs, feelings, and desires of both parties are considered to create a win-win outcome. Avoidance is a lose-lose strategy for conflict resolution, which is unassertive and uncooperative. Competition is a win-lose situation in which the use of force or the use of power occurs. Accommodation is the lose-win situation in which one person accommodates the other at his or her own expense but often ends up feeling resentful and angry. PTS: 1 DIF: Cognitive Level: Analysis REF: p. 288 | p. 290 OBJ: Discuss five methods to resolve conflict. TOP: Conflict management MSC: NCLEX®: Safe and effective care environment—management of care

10. Considering the following terms used to label different styles of handling anger—the Sherman tank, the sniper, the constant complainer, and the clam. Which of the following comments would you expect a Sherman tank to make? a. "That sure sounded like a put-down to me." b. "How dare you accuse me of not putting away the linen!" c. "So, you think you know everything, eh?" d. "Why do we always have to rotate shifts?"

ANS: B Sherman tanks attack individuals and have a strong need to prove to themselves and to others that their view of a situation is right. Their comments are abusive and abrupt and can be intimidating. Snipers take "potshots" at others and are not as openly aggressive as Sherman tanks. Constant complainers do just that—they complain but offer no solution. Clams also behave like their name—they clam up and refuse to respond when you need an answer or want to talk. PTS: 1 DIF: Cognitive Level: Analysis REF: p. 292 OBJ: Discuss solutions and alternatives in dealing with anger. TOP: Conflict management MSC: NCLEX®: Safe and effective care environment—management of care

6. Which of the following statements by the nurse about unresolved conflict is true? (Select all that apply.) a. "Conflict makes nursing staff more productive." b. "Conflict reduces productivity among staff." c. "Conflicts wastes time." d. "Conflict waste energy." e. "Conflict increases teamwork."

ANS: B, C, D Unresolved conflict reduces productivity, decreases teamwork, and wastes time and energy. Nursing staff are not more productive with unresolved conflict, and this type of conflict does not increase team work. PTS: 1 DIF: Cognitive Level: Application REF: p. 288 OBJ: Discuss five methods to resolve conflict. TOP: Conflict resolution MSC: NCLEX®: Safe and effective care environment

3. What is important for the nurse manager to understand about resolving conflict in the workplace? (Select all that apply.) a. Realize that most new graduates use competition as a form of conflict response. b. Effective role socialization reduces negative conflict behaviors among nursing staff. c. Use of collaboration to solve conflict issues is an important strategy to encourage. d. Thinking like a nurse promotes role socialization and reduces conflict. e. Nurse managers need to create working environments that facilitate professional practice. f. High self-esteem fosters entitlement-type behavior that promotes conflict.

ANS: B, C, D, E New graduates use compromise and avoidance as primary means of conflict resolution based on current research. High self-esteem is often found in empowering workplace environments where successful positive conflict resolution occurs. Effective role socialization, positive professional practice environments, using collaboration, and thinking like a nurse are noted in effective conflict resolution situations. PTS: 1 DIF: Cognitive Level: Application REF: pp. 288-290 OBJ: Identify common factors that lead to conflict. TOP: Conflict management MSC: NCLEX®: Safe and effective care environment—management of care

15. A nurse is frustrated about being scheduled on a holiday that had been requested off, but a new nurse with less seniority was given the holiday off. Which action by the nurse shows accommodation? a. The nurse works out a schedule change with the new nurse. b. The nurse doesn't bring the issue to the attention of the new nurse but feels angry and frustrated. c. The nurse works the holiday while the new nurse has the day off. d. The nurse requests to have the day before the holiday off.

ANS: C Accommodation occurs when the nurse decides to work the holiday while the new nurse has the holiday off. Collaboration occurs when the nurses work out a schedule change. Avoidance occurs when the nurse doesn't bring the issue to the attention of the new nurse but feels angry and frustrated. Compromise occurs when the nurse requests to have the day before the holiday off. PTS: 1 DIF: Cognitive Level: Application REF: p. 290 OBJ: Discuss five methods to resolve conflict. TOP: Conflict resolution MSC: NCLEX®: Safe and effective care environment

8. The nurse manager is attempting to resolve an interpersonal conflict between two nurses. Which action below should be done first? a. Determine the facts related to the situation. b. Schedule a meeting time for resolution. c. Have an accurate understanding of the problem or conflict. d. Have the determination to resolve the conflict.

ANS: C The first step is to make sure that the nurse manager has an accurate understanding of the problem of conflict. The quality of the outcome of resolving a problem depends on proper recognition and identification of the problem or issue. This assessment is best addressed by determining the nature of the differences and the reasons for them. After this has been achieved, the next steps would be identifying the conflicting facts and developing ways to implement a plan for resolution. PTS: 1 DIF: Cognitive Level: Application REF: p. 288 | p. 290 OBJ: Discuss five methods to resolve conflict. TOP: Conflict management MSC: NCLEX®: Safe and effective care environment—management of care

17. Which statement by the nurse is true regarding sexual harassment? a. "Sexual harassment no longer occurs in the workplace." b. "Sexual harassment is only caused by men." c. "The most common sexual harassment complaint is inappropriate remarks and touching." d. "Nothing can be done to prove sexual harassment."

ANS: C The most common sexual harassment complaint is inappropriate remarks and touching. The statements that "sexual harassment no longer occurs in the workplace," "sexual harassment is only caused by men," and "nothing can be done to prove sexual harassment" are false. PTS: 1 DIF: Cognitive Level: Analysis REF: pp. 300-302 OBJ: Identify situations of sexual harassment in the workplace and discuss possible solutions. TOP: Sexual harassment in the workplace MSC: NCLEX®: Safe and effective care environment

18. A female nurse is experiencing sexual harassment in the workplace by a male nurse. Which action should this nurse take to stop the sexual harassment? a. Ignore the comments made by the male nurse. b. Laugh about the comments. c. Tell the male nurse to stop. d. Begin to sexually harass the male nurse.

ANS: C The nurse should take the most direct route and tell the male nurse to stop. Ignoring the comments, laughing at them, or sexually harassing the male nurse will not stop the harassment. PTS: 1 DIF: Cognitive Level: Application REF: pp. 300-302 OBJ: Identify situations of sexual harassment in the workplace and discuss possible solutions. TOP: Sexual harassment in the workplace MSC: NCLEX®: Safe and effective care environment

5. A nurse is caring for an older adult patient when conflict regarding treatment arises between the family and the health care provider. What can the nurse do to resolve this conflict? (Select all that apply.) a. Defend the health care provider's treatment and try to explain it to the family. b. Try to convince the family that the health care provider knows what is best for the patient. c. Allow the family to participate in the decision-making process for their loved one. d. Encourage the family to speak directly to the health care provider regarding treatments. e. Clarify the health care provider's order with the family.

ANS: C, D, E The nurse should avoid defending the health care provider's treatment and convincing the family that the health care provider knows what is best. Instead the nurse should allow the family to participate in the decision-making process, encourage the family to speak directly to the health care provider regarding treatments, and clarify orders with the family. PTS: 1 DIF: Cognitive Level: Analysis REF: pp. 288-290 OBJ: Identify common factors that lead to conflict. TOP: Conflict MSC: NCLEX®: Safe and effective care environment

9. During a staff meeting, an upset nursing assistant tells the group that the other nursing assistants are given easier patient assignments and are always given their choice of days off. What approach by the nurse manager would be effective to resolve this conflict? a. Attempt to persuade the upset nursing assistant to calm down. b. Tell the group that this type of conversation needs to be handled privately. c. Consider transferring the upset nursing assistant to another unit. d. Acknowledge the feelings of the upset nursing assistant and make a plan to meet with her.

ANS: D Acknowledging the nursing assistant's feelings is the first step in conflict resolution. This process requires dealing with issues, not personalities, by communicating openly, listening actively to the complaints, sorting out the issues, identifying key themes of the discussion, and weighing the consequences and options to resolve the conflict. Transferring the upset person avoids dealing with the conflict. PTS: 1 DIF: Cognitive Level: Application REF: p. 288 | p. 290 OBJ: Discuss five methods to resolve conflict. TOP: Conflict management MSC: NCLEX®: Safe and effective care environment—management of care

5. One of your peers, a staff nurse, is a "potshot artist." This nurse often makes you the butt of innuendo or teasing digs. You are fed up and decide to take action the next time it happens. What strategy should be considered as an effective way of dealing with a "sniper?" a. Clam up and allow the individual to fully ventilate her concern. b. Confront and tell the individual he or she is wrong. c. Coldly withdraw from the individual. d. Obtain group confirmation or denial of criticism raised by the individual.

ANS: D When confronting the sniper, it is important to involve the rest of the staff to get a group consensus of denial or confirmation. Remember to always expose the sniper's attack by saying, "That sounded like a put-down to me." Clams tend to withdraw from the individual. Confronting the individual and telling them they are wrong is how a Sherman tank would approach the situation because they have a strong need to be right. PTS: 1 DIF: Cognitive Level: Application REF: p. 294 OBJ: Discuss techniques to use in dealing with difficult people. TOP: Conflict management MSC: NCLEX®: Safe and effective care environment—management of care