Conflict is unavoidable in the NHS or any other workplace. When managed effectively, it can be a constructive, transformative force that leads to consistent improvements.
However, when conflict management processes are lacking, minor disagreements can become disruptive and emotionally charged, creating a negative working atmosphere.
Conflict management in nursing is key to maintaining morale, productivity and patient care standards. Read on to learn more about conflict in the workplace and what conflict management processes NHS staff should look out for when searching new jobs in nursing.
Potential causes of conflict in NHS workplaces
In nursing, conflict can arise through interactions with colleagues, management, patients or their visitors. Though the dynamics are different with each, the causes are often remarkably similar.
Research from ACAS identified the five most common causes of conflict in front-line NHS workplaces as:
- Personality clashes: 34%
- Poor performance management: 9%
- Clash of values: 7%
- Heavy workload/lack of resources: 7%
- Stress: 7%
NHS Trust managers reported that most conflicts occurred between staff members on the same team (69%), while conflict between staff and managers was also a relatively common occurrence (20%).
In cases concerning the latter, nurses and other NHS staff often reported feeling victimised by managers looking to address perceived performance issues. Poor direction and a lack of clear objective were also common factors.
How does conflict affect those in nursing jobs?
Left unmanaged, conflict can have a severe effect on ward operations and morale.
When surveyed about the cost of recent workplace conflict, NHS Trust managers cited the following effects (ACAS):
- Wasted management and staff time: 60%
- Reduced productivity due to lower motivation: 36%
- Health costs/staff absence (e.g. due to stress): 31%
- Slower/poorer decision quality (e.g. due to compromised communication): 28%
- Compromised the quality of patient care/experience: 19%
- Increased staff turnover: 9%
When asked about time wasted, 43% of managers said the most recent incident they dealt with took more than six months to resolve.
While compromised patient care was mentioned by less than one-fifth of NHS Trust managers, research has identified a correlation between NHS staff wellbeing and patient care standards. In extreme cases, human error caused by conflict has been cited as contributing to patient fatalities.
Quantifying the effect of conflict on job satisfaction, motivation, emotional labour and risk of burnout is much harder. Conflict can manifest in feelings of stress, agitation, anger, disappointment and misrepresentation that often go unnoticed.
It is clear that unmanaged conflict can sour a nurse's working environment and make it a less appealing place to be employed.
What conflict management measures should NHS staff expect when looking for new jobs in nursing?
To avoid these negative effects, NHS staff should try to find out more about the conflict management measures in place when reviewing nursing job vacancies.
The employer should be able to demonstrate a proactive approach towards conflict management that ensures any incidents are dealt with promptly, consistently and comprehensively.
These are some of the specific factors that should be considered when looking for jobs in nursing:
Managers should take the lead in resolving conflicts, with the aim being to intervene with an informal warning at the earliest possible stage.
If a manager is known for being hands-off, this might indicate that unacceptable behaviour is being unintentionally reinforced, leaving conflict to boil over later on.
The employer should be following the ACAS Code of Practice on Disciplinary and Grievance Procedures, and provide details of their own procedures as part of an employee handbook or contract of employment.
They may even be part of a collective agreement, similar to the 'Maintaining High Professional Standards in the Modern NHS' applied to doctors and dentists.
The employer should also have an escalation procedure in place for cases that cannot be addressed with an informal warning.
This is likely to take the form of a written warning followed by a disciplinary or grievance hearing, which should work as follows:
- Employees are given ample written notice
- Employees have the right to be accompanied by a colleague or trade union official
- Employers must provide evidence relating to the allegations to employees
- Employers should state their case and give employees a chance to respond
- A decision on the outcome must be communicated in writing
- Employees should be able to appeal this decision
Candidates should be made to feel confident that these processes are in place when looking for nursing job vacancies. If the employer is unable to demonstrate their commitment to staff wellbeing, it is time to look for alternative jobs in nursing.