Conflict Resolution

Whether answering a phone call from an angry patient, dealing with an irate specialist, or having to mediate between members of staff, having some basic skills in conflict resolution will take a lot of stress out of your day.

 

 

The virtues of moderation, peace-able-ness, graciousness, and meekness no longer exist in our  society. Whether it's at traffic lights, at the football, or at work, most of us are geared toward wanting to come out on top--wanting to get our own way--wanting to win. And years of medical education where we've been barked at by theatre nurses and midwives, and bullied by consultants has taught us that looking good--never admitting we don't know an answer--and preserving our pride at the expense of others--is the only way to survive.

 

While these strategies might work in hospitals and operating theatres, in the real world they are completely unsuitable. Actually they are childish. The "God complex" we have as doctors does us and our patients more harm than good.

 

Last week I had a message from a manager of a large company--with whom we have a contract to supply medical care (work cover) for injured staff--that she felt we were providing a substandard service. As soon as I received the message I "saw red". I had given up countless lunch hours, stayed back late after work--to give these injured workers the very best medical care I could. I was aware that this manager was new and that she often bullied our office staff. She has no medical training and the issue this time had happened because I had put a sling and finger splint on a woman with an injury she thought was trivial (actually it was a significant crush injury to a finger). The details are only peripheral. My response and lack of expertise (or inclination) in conflict resolution caused a problem. I phoned while I was so angry I could hardly speak. I told her to put her concerns in writing and I would have my lawyers address them. I said how dare she make a comment about my treatment of a patient under my care. I said I would be making a formal complaint to her manager. etc etc etc.

 

This story illustrates how NOT to manage a conflict. But it is common and as doctors we have got away with being bullies and believing we are right. No one wins in this way: I nearly lost my employer the contract: I spent the next week without sleep and wishing I'd been more mature.

 

The first step in mastering conflict resolution is to want resolution and a win-win situation more than you want to win a fight. You need to change your world view: Success is defusing a highly charged situation into one where your  client feels they have been heard and respected. Success is waving the white flag and negotiating peace when the battle lines have been drawn.

 

An old proverbs says "with all the things you get--get understanding!" And a man writing in AD 40 said " everyone should be quick to listen, slow to speak and slow to become angry, because nothing good comes out of getting angry." These sayings highlight two important principles of conflict resolution:
1. Aim to understand the other person before you aim to make yourself understood
2. Learn to manage your emotions

 

Think about conflict resolution like you would a critical aspect of medicine--it is as essential to your work as is the scalpel to a surgeon. Think of these skills as something you will be valued for--a skill you can master and you can add to your repertoire.

 

Some tips for successful conflict resolution include:

 

1. Wait till you've calmed down before entering a discussion
2. Avoid the desire to punish or blame.
3. If you are angry, ask yourself "what buttons on me has Mrs Smith pushed to get me feeling so angry?" And "what do I need to do to let go of this anger quickly?" You see if you have let yourself get angry, then you have completely lost control of the situation and yourself.
4. Try writing your thoughts on a piece of paper--most of our anger is irrational and writing things down can put things in perspective
5. Give the other person  all the time they need to speak
6. While they are speaking, engage in active listening--your aim is to understand things from their point of view
7. Summarise and reflect back the important parts of what they have said in a way that honors them
8. Acknowledge the other person's injured feelings, e.g. "I see this has been hard for you." or "What your saying is that you felt really hurt by what I said." or "I'm terribly sorry you felt that way."
9. It's ok to clarify what they are saying (this can help them hear what they are saying). For example a patient might be upset about having to pay for a long consultation and say, "that's ridiculously expensive," you can help clarify by asking, "compared to what?"
10. Find out what their needs are e.g. "What's the outcome you're looking for in all this?"
11. State simply and clearly what your needs/ goals are
12. Ask them what they think a good solution would be
13. Negotiate/ brainstorm a solution together

Have a look at the conflict resolution network:
http://www.crnhq.org/pages.php?pID=12#skill_1 This website has some excellent suggestions and resources. But like any skill worth having, they're not learnt overnight.

 

Know what pushes your buttons and learn to adapt. Your anger is no one elses fault!!