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Nursing Today: Transition and Trends Edition: 7th Test Bank – Zerwekh Chapter 13: Conflict Management MULTIPLE CHOICE A newborn has several congenital anomalies incompatible with living beyond a month He cannot retain formula, and his temperature drops when he is removed from the warmer Two nurses who alternate caring for the baby argue about whether or not to attempt bottle feedings and whether he should be removed from the warmer to be held What is the origin of the conflict described? a b c d Ethical values Nursing role concerns Personal goals for advancement Personality differences ANS: A This situation depicts personal issues based on two separate sets of ethics or values regarding the infant‟s care One nurse places value on nutritional needs and the other on the need for bonding DIF: Cognitive Level: Analysis REF: p 267 OBJ: Identify common factors that lead to conflict TOP: Conflict management MSC: NCLEX®: Safe, effective care environment—management of care Of the following common areas of conflict between nurses and their patients and families, which is most easily resolved? a b c d Issues of concern about quality of care Issues surrounding treatment decisions Issues of family involvement 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 This is something that the nurse can directly address, whereas issues of treatment decisions, family involvement, and quality of parental care often require more discussion and intervention DIF: Cognitive Level: Comprehension REF: p 268 OBJ: Discuss five methods to resolve conflict TOP: Conflict management MSC: NCLEX®: Safe, effective care environment—management of care What is the best strategy for resolving the conflict in a situation in which two staff nurses request the same vacation weeks? a b c d Accommodation Collaboration Competition 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 winwin outcome DIF: Cognitive Level: Analysis REF: p 269 OBJ: Discuss five methods to resolve conflict TOP: Conflict management MSC: NCLEX®: Safe, effective care environment—management of care 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 b c d Deal with issues, not personalities Require the aides to reach a compromise Weigh the consequences of each possible solution 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 Issues tend to be more concrete, whereas personalities involve emotional issues DIF: Cognitive Level: Analysis REF: p 272 OBJ: Discuss techniques to use in dealing with difficult people TOP: Conflict management MSC: NCLEX®: Safe, effective care environment—management of care One of your peers, a staff nurse, is a “potshot artist.” She 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 the individual, saying that she is wrong c Coldly withdraw from the individual group confirmation or denial of criticism raised by the d Obtain 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 DIF: Cognitive Level: Application REF: p 274 OBJ: Discuss techniques to use in dealing with difficult people TOP: Conflict management MSC: NCLEX®: Safe, effective care environment—management of care A staff nurse who has worked on the unit for months voices the following concerns to another nurse: “The clinical nurse leader of the unit often follows me into the supply room, where she stands blocking the doorway and chats She makes opportunities to mention my good looks, muscular physique, or strength in the context of daily work She says things like, „You‟re so handsome, no wonder your patients like you.‟ As she talks to me, she frequently touches me on the arm, the shoulder, chest, or the hair, and if I‟m sitting, she touches my leg Yesterday, she 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 her I just want her to leave me alone! What should I do?” What is the best reply? be quite so honorable Date her and see if you get better a “Don‟t assignments.” her with a description of her behavior and tell her that you want b “Confront her to stop.” directly to the human relations office at the agency and tell them what c “Go you just told me.” your lawyer and get advice ASAP, in case she decides to turn the d “Contact 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 DIF: Cognitive Level: Analysis REF: p 282 OBJ: Identify situations of sexual harassment in the workplace and discuss possible solutions TOP: Conflict management MSC: NCLEX®: Safe, effective care environment—management of care When a nurse manager uses employment seniority to resolve a scheduling conflict between two nurses, this is an example of a _ strategy a b c d Win-win Win-lose Lose-lose 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 DIF: Cognitive Level: Comprehension REF: p 269 OBJ: Discuss five methods to resolve conflict TOP: Conflict management MSC: NCLEX®: Safe, effective care environment—management of care The nurse manager understands that the first step in attempting to resolve an interpersonal conflict between two nurses is to: a b c d Determine the facts related to the situation Schedule a meeting time for resolution Have an accurate understanding of the problem or conflict Have the determination to resolve the conflict ANS: C 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 DIF: Cognitive Level: Comprehension REF: p 272 OBJ: Discuss five methods to resolve conflict TOP: Conflict management MSC: NCLEX®: Safe, effective care environment—management of care During a staff meeting, an upset nursing assistant tells the group that she thinks 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 the group that this type of conversation needs to be handled b Tell privately c Consider transferring the upset nursing assistant to another unit the feelings of the upset nursing assistant and make a plan to d Acknowledge meet with her ANS: D Conflict negotiation 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 Acknowledging the nursing assistant‟s feelings is the first step in this process DIF: Cognitive Level: Application REF: p 272 OBJ: Discuss five methods to resolve conflict TOP: Conflict management MSC: NCLEX®: Safe, 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 b c d “That sure sounded like a put-down to me.” “How dare you accuse me of not putting away the linen!” “So, you think you know everything, eh?” “Why 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 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 DIF: Cognitive Level: Analysis REF: p 272 OBJ: Discuss solutions and alternatives in dealing with anger TOP: Conflict management MSC: NCLEX®: Safe, effective care environment—management of care MULTIPLE RESPONSE The staff nurse understands that which of the following are effective ways to deal with a sexual harassment issue in the workplace? Select all that apply a b c d e f Tell the person to stop Tell your best friend about the incident File a formal grievance Explain the situation to your spouse Play along with the person and document the activities 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 (for example, family members, friends, your personal physician, your minister) that this is happening and how you are dealing with it DIF: Cognitive Level: Comprehension REF: p 282 OBJ: Discuss five methods to resolve conflict TOP: Conflict management MSC: NCLEX®: Safe, effective care environment—management of care 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 of 26-week termination of pregnancy by a physician e Consideration because of mother‟s health schedules posted with new staff members having to work at least f Vacation 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 DIF: Cognitive Level: Application REF: p 267 OBJ: Identify common factors that lead to conflict TOP: Conflict management MSC: NCLEX®: Safe, effective care environment—management of care What is important for the nurse manager to understand about resolving conflict in the workplace? Select all that apply that most new graduates use competition as a form of conflict a Realize response role socialization reduces negative conflict behaviors among nursing b Effective staff of collaboration to solve conflict issues is an important strategy to c Use encourage d Thinking like a nurse promotes role socialization and reduces conflict managers need to create working environments that facilitate e Nurse professional practice self-esteem fosters entitlement-type behavior which promotes f High 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