Vila Health ® Activity
Conflict Resolution
Introduction
Pediatric ICU Hallway
The CNO’s Office
Conclusion
Welcome to St. Anthony Medical Center
A train wreck near an elementary school has caused a chemical cloud to be released, and many children have come to the ER for treatment. Nurses are working together to handle the sudden influx of so many patients, but as with any stressful situation, conflict arises between some of them.
As you observe the various scenes, consider how conflicts arise and whether they’re handled appropriately.
Pediatric ICU Hallway
St. Anthony Medical Center
Many of the children who were exposed to a chemical cloud after a train wreck near the school have been stabilized in the ER. But that means the demand for beds in the PICU is growing. The death of a child opens one bed up, but the room has not yet been cleaned by housekeeping.
Donald Trask, an ICU nurse who has been pulled into the PICU, takes out his frustrations of the day on Gabriela Herrera, a housekeeper who he sees in the hall.
Donald Trask, RN – Intensive Care Unit: Hey … are you from housekeeping?
Gabriela Herrera – Housekeeper: Yeah.
Donald: We called for you over half an hour ago. You need to get going on that room.
Gabriela: What room? What are you talking about?
Donald: We had a kid who didn’t make it, but now we need the room cleaned so we can get another kid out of the ER and into the PICU.
Gabriela: Oh. I didn’t know you called. I wasn’t sent up here to prep the room; I was just doing my normal pick-up of dirty linens on this floor.
Donald: This is a little more important than picking up the laundry, don’t you think?
Gabriela: That’s not the point. I have my own jobs to do. If my supervisor sends me up here to sanitize the room, that’s one thing, but you can’t just grab me in the hall to get a room prepped. That’s not how we do it.
Dondald: It may not be how you do things south of the border, but here, the patient comes first, not your break.
Brittany Clinton, RN – Surgical Nurse: Is everything okay here?
Gabriela: No, it’s really not okay. I’m up here collecting linens and this pendejo tells me I’m supposed to go prep a room for a new patient. Which is fine if it’s my supervisor who tells me to do it, but I can’t just drop what I’m supposed to be doing. You guys need to call housekeeping and have them send someone up. I’m going to finish my assigned work.
Brittany: I understand.
Donald: Glad you do, Mary Sunshine, but we still have kids down in the ER waiting for beds up here.
Brittany: Okay … grab some sheets and you and I can prep the room.
Donald: Sorry … I’m here to be a nurse, not a housekeeper. You can do what you want, but I’m not interested in doing housekeeping’s work for them.
Brittany: It takes five minutes. Oh, whatever, I’ll do it.
Answer the following questions:
In the first scene , a conflict arises between Donald, an ICU nurse, and Gabriela, a housekeeper. In McKibben’s article on conflict management, the author discusses the importance of avoiding the seven C’s before approaching conflict: commanding, comparing, condemning, challenging, condescending, contradicting, and confusing (McKibben, 2017). Which of these seven C’s were violated in the exchange between Donald and Gabriela? How did this impact their work and the care environment?
Your response:
This question has not been answered yet.
Feedback:
Several of the seven C’s were violated, including commanding, comparing, condemning, challenging, and condescending. Donald commanded Gabriela to clean the room as soon as he knew she was from housekeeping. Gabriela commanded Donald to call someone else. Donald condemned Gabriela for picking up the linens instead of cleaning the room. Both were condescending when they called each other names. Donald was again condescending (and was comparing) when he indicated he was a nurse, not a housekeeper. Both challenged each other throughout the exchange.
The CNO’s Office
St. Anthony Medical Center
It’s been several days since the train derailment. As the chief nursing officer, Jackie Sandoval, works through the various issues demanding her attention, one stands out. Gabriela Herrera has filed a complaint about Donald Trask’s rudeness, and now Jackie will attempt to find out what happened.
Jackie invites Phoebe Hemsworth, the PICU nurse manager, and Gabriela to her office so that Gabriela can describe the incident in the PICU on the day of the derailment.
Jackie Sandoval, Chief Nursing Officer: Hi, Gabriela. I’ve read your complaint, but could you give me a nutshell description of what happened?
Gabriela Herrera – Housekeeper: Sure. It was the day of the derailment and the whole hospital was short-handed. Everyone had to go above and beyond—and we all were. But this particular nurse … he treated me like I was his personal maid. I was up on the PICU collecting dirty linens and he starts all this, “oh, housekeeping…” like I don’t even deserve a name.
Jackie: Mmm hmmm. Okay, go on.
Gabriela: Well, he tells me that they had a kid die and they needed the room prepped for the next kid. Which … I mean, that’s not my favorite job, particularly when it’s related to a death, but I know it’s part of what I’m supposed to do. The problem is—and I told this nurse—we’re not supposed to take assignments off the floor. The nurses are supposed to call it in and then we get sent out to do whatever. And that’s what I told him, but he’s all, “I don’t care what they do where you’re from, here you have to do what I tell you.” I’m not ashamed to be Mexican-American, but for his information, I was born right here in Minneapolis. I was really offended by his attitude.
Phoebe Hemsworth, RN – Intensive Care Unit: Gabriela, I am sorry you were spoken to that way. We were short-handed and Donald may have been stressed by all the things we were getting hit with, but that’s no excuse.
Gabriela: I get that. He just doesn’t have to treat me like I’m some lazy jerk. It was his attitude as much as anything else. The other nurse – she was fine. She understood what I was telling her about having to go through my supervisor.
Phoebe: Well, I would offer to speak to the nurse in question, but he’s not one of mine, Jackie. He was pulled onto the floor because we were so short staffed, but he isn’t usually one of my nurses.
Jackie: Understood. I’ll contact his supervisor and set up a time to talk. Gabriela, you followed procedures. I know that when we’re working under stress, we sometimes forget common courtesy, but that’s no excuse.
Gabriela: Thank you. The only reason I reported this was the disrespect. I probably would have helped Brittany—she was the one who actually prepped the room—if I hadn’t been so angry. The way it was, though, I just wanted to get out of there as fast as I could… Thanks for listening, though. That means a lot.
Phoebe expresses her thoughts about the housekeeping situation as well as some broad observations about the team’s functionality.
Phoebe: I didn’t really want to say this while she was here, but Donald was a lot ruder than even Gabriela explained.
Jackie: Do you know why?
Phoebe: He’d been in a foul mood the whole time he was in my unit. He didn’t want to be there and he made sure everyone knew it. It almost felt like he was lashing out at Gabriela because of his frustration at being assigned to the PICU at all.
Jackie: I was actually the one who pulled him to help provide coverage for you. I didn’t realize how inflexible he was going to be.
Phoebe: It happens. Other than Donald, though, everyone worked together very well. It was nice to see them actually working through some of the issues that came up earlier — Stephen and Brittany in particular. I wasn’t sure pairing them was a good idea, but by the end of the shift, they were actually really clicking.
Jackie: Good! It’s nice to hear about the successes as well as the failures.
Answer the following questions:
In the second scene, Gabriela meets with Jackie, the chief nursing officer. Jackie listens to Gabriela’s complaint regarding the incident with Donald. Jackie acknowledges Gabriela’s concerns and explains the follow-up actions she will take with Donald’s direct supervisor. Gabriela appears satisfied with the outcome. Review the Jit, Sharma, and Kawatra article on servant leadership and conflict resolution. Were the best practices identified in this article followed?
Your response:
This question has not been answered yet.
Feedback:
As identified by Jit, Sharma, and Kawatra (2016), a common conflict resolution approach used to resolve subordinate-to-subordinate conflict is to listen, discuss, and understand the conflict. In this scene, Jackie read the report and also listened to Gabriela restate what happened. Jackie also listened to additional information provided by Phoebe. However, Jackie did not meet with Donald individually. Instead, she stated she would discuss the matter with Donald’s supervisor. Jit, Sharma, and Kawatra also identified two other best practices: having the two individuals meet face-to-face or meeting with each person individually. Jackie did not use either of these approaches. Depending on the meeting with Donald’s supervisor, Jackie may decide to also meet with Donald and/or bring Gabriela in to meet with Donald face-to-face.
Conclusion
You have completed this activity! As you saw, teams can encounter many types of conflicts, both internal and external. How did barriers and conflicts affect the team’s strength? What could Phoebe, the nurse manager, have done to improve communication and cooperation? What could her team members have done?
Conflict Resolution Scoring Guide
CriteriaNon-performanceBasicProficientDistinguishedProvide a brief overview of conflict resolution as it relates to a conflict situation.Does not provide a brief overview of conflict resolution as it relates to a conflict situation.Provides an overview of conflict resolution as it relates to a conflict situation, but the overview is incomplete or otherwise flawed.Provides a brief overview of conflict resolution as it relates to a conflict situation.Provides a brief overview of conflict resolution as it relates to a conflict situation and describes the conflict situation clearly and succinctly.Explain how a lack of cultural competence can compound already stressful situations and impede collaboration.Does not explain how a lack of cultural competence can compound already stressful situations and impede collaboration.Identifies but does not explain how a lack of cultural competence can compound already stressful situations and impede collaboration.Explains how a lack of cultural competence can compound already stressful situations and impede collaboration.Explains how a lack of cultural competence can compound already stressful situations and impede collaboration, providing background details.Explain communication techniques that should be avoided in situations that involve diverse cultures.Does not explain communication techniques that should be avoided in situations that involve diverse cultures.Describes but does not explain communication techniques that should be avoided in situations that involve diverse cultures.Explains communication techniques that should be avoided in situations that involve diverse cultures.Explains communication techniques that should be avoided in situations that involve diverse cultures, providing context to the techniques.Discuss communication strategies that hospital leadership should promote within the organization to resolve conflicts.Does not discuss communication strategies that hospital leadership should promote within the organization to resolve conflicts.Lists but does not discuss communication strategies that hospital leadership should promote within the organization to resolve conflicts.Discusses communication strategies that hospital leadership should promote within the organization to resolve conflicts.Discusses communication strategies that hospital leadership should promote within the organization to resolve conflicts and provides rationale for the strategies.Explain the role of relationships in communication and the role of communication in teamwork and collaboration.Does not explain the role of relationships in communication and the role of communication in teamwork and collaboration.Identifies but does not explain the role of relationships in communication and the role of communication in teamwork and collaboration.Explains the role of relationships in communication and the role of communication in teamwork and collaboration.Analyzes the role of relationships in communication and the role of communication in teamwork and collaboration.Recommend strategies that could be implemented to improve the relationships between nursing and housekeeping.Does not recommend strategies that could be implemented to improve the relationships between nursing and housekeeping.Explains strategies that could be implemented to improve the relationships between nursing and housekeeping.Recommends strategies that could be implemented to improve the relationships between nursing and housekeeping.Recommends strategies that could be implemented to improve the relationships between nursing and housekeeping and identifies obstacles to implementing them.Adhere to the rules of grammar, usage, and mechanics.Does not adhere to the rules of grammar, usage, and mechanics.Errors in grammar, usage, and mechanics inhibit readability and comprehension and detract from good scholarship.Adheres to the rules of grammar, usage, and mechanics.Exhibits strict and nearly flawless adherence to the rules of grammar, usage, and mechanics.Apply APA style and formatting to scholarly writing.Does not apply APA style and formatting to scholarly writing.Applies APA style and formatting to scholarly writing incorrectly and/or inconsistently, detracting noticeably from good scholarship.Applies APA style and formatting to scholarly writing.Applies APA style and formatting to scholarly writing. Exhibits strict and nearly flawless adherence to stylistic conventions, document structure, and source attributions.
