Don’t Resolve Conflict Alone

Although a sense of camaraderie remains strong among healthcare professionals who have battled COVID side-by-side for the past 20+ months, resilience is wearing thin, according to nursing coach Phyllis Quinlan, PhD, RN, NPD-BC.

She says tensions are at a fever pitch among some healthcare teams, especially in facilities where leaders did not take a strong stand against incivility and bullying before COVID hit.

Tension in the perioperative practice setting is a concern among AORN members, based on a recent membership survey in which respondents noted that resolving conflict is an issue in their respective practice settings.

Periop Today sought Quinlan’s advice on how perioperative nurses should attempt to resolve conflict on the job.

“Don’t take matters into your own hands when faced with disagreement, abuse or outright bullying,” Quinlan advises.

She clarifies the different types of conflict a nurse may be experiencing on the job today …

• Patient or family abuse, including frustration, disrespectful communication, and anger
• Staff incivility characterized by negativity, complaining, and unwillingness to lend a hand
• Bullying abuse that is underhanded, happens in secret, and inflicts serious damage

Any one of these scenarios leading to conflict requires support from team leaders and human resources taking a unified stand, Quinlan says. She cautions that “if a nurse tries to address the issue alone, the situation will most likely only escalate.”

Bullying is on the Rise

This potential escalation is especially likely when dealing with a bully, who is a master of turning the blame to the person they are bullying, she says.

“Unfortunately, the same bullies working in healthcare before the pandemic are now empowered to strike as the strains of persistent emergency response from the COVID pandemic has worn nurses down, putting them at a greater risk of becoming a bully’s victim,” Quinlan warns.

To know if you are facing conflict that is rooted in bullying, ask yourself about the nature of the encounters you are experiencing:

• Does the person target you in private when no one is around to overhear?
• If you speak up against them, do they lay the blame on you?
• If you threaten to get help, do they tell you no one will believe you?

If you can say yes to any of these questions, Quinlan says you are being bullied and you need support now.

Leadership Needs to Step Up

While the focus has been on patient and family support through the pandemic, which remains important, “leaders also need to shift their focus to protecting the mental well-being of each staff member,” Quinlan stresses.

She suggests these three actions perioperative nurses and leaders should implement together to prevent conflict rooted in incivility and bullying:

1. Be Vocal

Leaders should reiterate their facility’s zero-tolerance policy on incivility and bullying to all staff and members of the perioperative team.

“Staff nurses should be familiar with these policies to identify when they are being abused and need to seek support,” she adds.

2. Modify Rounding Approaches

She recommends leaders take time to observe teams in action to identify any clues that bullying and incivility could be occurring under the radar.

“Take time to check in with individual team members and ask if bullying or incivility is occurring, Quinlan stresses to leaders.

To staff nurses, she encourages them to speak up if they are experiencing incivility and bullying before it spirals out of control.

3. Advocate Time for Healing

“Resilience is a powerful tool to prevent nurses from falling victim to bullying or even inflicting conflict themselves due to burnout,” Quinlan suggests.

She says leaders need to put an emphasis on staff to take time for mental and physical healing, with time off, if possible. “Encourage your nurses to incorporate wellness into their daily lives through mindfulness, exercise, and other forms of self-care.”

Quinlan provides coaching to help nurses stay strong in mind, body, and spirit, and to advance professionally. As an AORN member, you can schedule a 90-minute complimentary coaching session with her.

AORN is working with several professional nursing associations to take a united stand against incivility and bullying. Learn more about these efforts.