Conflict is a disagreement in values, beliefs, goals, or interests between people or groups — or within one person. Conflict is unavoidable in health care, where people with different roles, workloads, and priorities depend on each other under time pressure. Conflict itself is neither good nor bad; the outcome depends on how it is managed.

• Functional (constructive) conflict — brings problems into the open, stimulates new ideas, improves decisions, and leads to change.
• Dysfunctional (destructive) conflict — wastes energy, lowers morale and trust, increases turnover, and harms teamwork and client safety.

Too little conflict can also be a problem: it may signal groupthink, in which the team suppresses doubts to maintain harmony.

Types of conflict

Common sources: scarce resources (staff, beds, equipment), unclear roles or overlapping responsibilities, interdependence, different values or goals, poor communication, differences in leadership style or authority, change, and incivility.

Conflict process (stages; Pondy, Filley)

1. Latent (antecedent) conditions — conditions exist (short staffing, unclear roles)
2. Perceived — people become aware of the disagreement
3. Felt — emotions develop (anger, anxiety)
4. Manifest — open behavior (arguing, withdrawal, sabotage)
5. Resolution or suppression
6. Aftermath — the result shapes future relationships; unresolved conflict returns

Conflict-handling modes (Thomas–Kilmann) — based on assertiveness (concern for own interests) and cooperativeness (concern for others' interests).

Related strategies

• Smoothing — emphasizing points of agreement and downplaying differences to calm emotions; useful short term but may leave the root problem unresolved (a form of accommodation).
• Confrontation — directly and openly addressing the problem with the people involved; the foundation of collaboration.
• Forcing — the use of authority or rules to end the conflict (a form of competing); fast, but underlying feelings and causes remain.

Negotiation — a give-and-take process to reach agreement. The widely used principled negotiation approach:

• Separate the people from the problem — attack the issue, not the person
• Focus on interests, not positions — ask why each side wants what it wants
• Generate options for mutual gain before deciding
• Use objective criteria (policy, evidence, acuity data)
• Know your BATNA — best alternative to a negotiated agreement — so you do not accept a poor deal

Third-party help

• Facilitation — a neutral person keeps discussion structured, summarizes points, and ensures that everyone is heard
• Mediation — a neutral mediator helps the parties reach their own agreement
• Arbitration — a third party hears both sides and makes a binding decision

Collaboration and coordination. Interprofessional collaboration is teamwork in which professionals share goals, respect each other's expertise, and share responsibility for outcomes. The IPEC Core Competencies for Interprofessional Collaborative Practice (current version 2023) organize collaboration around values and ethics, roles and responsibilities, communication, and teams and teamwork. Coordination tools include regular unit meetings, interdisciplinary rounds, task forces for cross-department problems, clear role descriptions, and shared goals.

Steps for managing a conflict (manager or peer)

1. Stay neutral and listen to each side — separately if emotions are high, then together; this is the first step.
2. Define the problem in objective terms — separate facts, feelings, and positions.
3. Identify interests and common goals — usually safe client care and a fair workload.
4. Generate options together and evaluate them against objective criteria.
5. Agree on a solution, who does what, and a date to review it.
6. Follow up and reinforce the agreement.

Choosing a mode

• Client safety at stake now → competing (stop the unsafe action) and discuss later.
• Ongoing unit problem affecting many people (for example, assignment fairness or a new electronic record) → collaborating, often through a staff task force that includes all viewpoints.
• Two nurses arguing about a minor supply issue at 0700 → avoid or postpone until after morning medications.
• Limited equipment needed by two teams at the same time → compromise on a schedule, then address the root resource problem.

Handling nurse–provider conflict

• Focus on the client and the data, use SBAR and assertive language, and escalate through the chain of command if a safety issue remains.
• Use the DESC script for recurring interpersonal problems: Describe the behavior, Express your concern, Suggest (or Specify) an alternative, state the Consequences.

Incivility and bullying (lateral violence) are forms of dysfunctional conflict. Address them early, directly when safe, and through policy; managers must act on reports.

• Staff nurse: address disagreements directly and respectfully with the person involved first; avoid gossip; use assertive communication; participate in solutions; escalate safety concerns.
• Charge nurse: intervene early in team conflicts during the shift; make fair assignments; defuse situations; document and report as needed.
• Nurse manager: diagnose the source (often structural — unclear roles, scarce resources), create policies and forums for resolution, mediate, use task forces for intergroup problems, and hold staff accountable for professional behavior.
• Interprofessional team member: contribute nursing assessment data, which draws on continuous direct observation of the client, and respect other disciplines' expertise.
• Everyone keeps the focus on safe, quality client care as the shared goal.

• The ANA Code of Ethics (2025 revision) calls on nurses to maintain respectful relationships with colleagues and to create ethical work environments; bullying and incivility conflict with these obligations.
• Many facilities have codes of conduct addressing disruptive behavior; accreditation standards expect leaders to maintain a culture of safety.
• Collective bargaining agreements (where a union exists) include formal grievance procedures, which must be followed for contract disputes.
• Conflict resolution must never compromise client confidentiality or safety; do not discuss colleagues' conflicts in front of clients.
• Resolution processes must be fair, consistent, and free of discrimination or retaliation.

Case 1 — Assignment dispute. Two nurses repeatedly argue about who receives the heaviest clients. Morale is falling.

Correct action: the manager meets with each nurse, then both together, identifies the shared interest (fair workload, safe care), and works with staff to create an acuity-based assignment method.

Why: collaborating addresses the root cause and produces a win–win; forcing a rule would end the argument but not the resentment.

Case 2 — Unsafe practice in progress. A nurse sees a colleague about to hang blood without a second verification.

Correct action: stop the action immediately (competing) — "Stop, we need to verify this unit together first." Discuss the concern privately later.

Why: when client safety is at immediate risk, there is no time for collaboration.

Case 3 — Change and generational tension. After a new electronic health record is introduced, experienced nurses and newer nurses clash about workflows.

Correct action: form a task force with members from both groups to identify problems and propose workflow fixes; share results with all staff.

Why: functional conflict can drive improvement when different perspectives are combined.

Case 4 — Accommodating. A nurse realizes during a disagreement about wound care that the wound care nurse's evidence is stronger.

Correct action: accommodate — accept the other approach.

Why: accommodating is appropriate when you are wrong or the issue matters more to the other party.

• Believing all conflict is harmful — well-managed conflict improves decisions.
• Choosing collaboration in an emergency — when harm is imminent, act first.
• Confusing compromise (each side gives up something) with collaboration (both sides' full interests are met).
• Using avoidance for important, recurring problems — they return larger.
• Taking sides or deciding before hearing both parties.
• Negotiating from positions rather than interests.
• Confusing mediation (the parties decide) with arbitration (the third party decides).
• Assuming a conflict between two people is always "personal" — the source is often structural (roles, resources, leadership differences).

• Conflict can be functional (innovation) or dysfunctional (low morale, poor care)
• Types: intrapersonal, interpersonal, intragroup, intergroup, organizational
• Collaborating = high assertiveness + high cooperation = win–win, best for important issues when time allows
• Competing for emergencies and safety; accommodating to preserve relationships; avoiding for trivial issues; compromising under time pressure
• First step as a mediator: listen neutrally to both sides
• Principled negotiation: people vs problem, interests not positions, mutual-gain options, objective criteria
• Mediation = parties decide; arbitration = third party decides
• Smoothing downplays differences and may leave causes unresolved
• IPEC domains: values and ethics, roles and responsibilities, communication, teams and teamwork
• Task forces with all stakeholders resolve cross-department problems