Introduction
In most professions, a temporary staffing shortage is normal, and only a minor inconvenience is experienced in many circumstances. However, a nursing staff shortage is fatal since it will almost certainly result in greater patient care errors and higher patient morbidity rates. In addition, the nursing practice constantly faces staff shortages caused by an aging workforce, cost-cutting measures, an aging patient population, and increased patient complexity and need (Blouin & Podjasek, 2019). These can place stress on working conditions for nurses and affect patient care and overall outcomes.
On any given day, a nurse practice leader will solve problems related to bedside care, patient safety, budget constraints, and staffing shortages. Staff shortages will often put more pressure on the practice nurse leader because funding and budgetary constraints are solely on the organization’s management. Insufficient staffing often causes friction between a practice nurse leader and the organization’s administration because the leader must deal with nurses who work long hours under extremely strenuous conditions. Communicating and negotiating the nurses’ concerns with top management can always result in a push and pull and concessions. These compromises may often not bode well with the nurses who must bear with high patient-to-nurse ratios, burnout, dissatisfaction, and sometimes violence by patients. Therefore, a nurse practice leader must strive to bring both parties on board to achieve a common goal while maintaining a satisfied and happy workforce and a functioning organization.
Potential Barriers that Create Conflict
Insufficient staffing in healthcare is a principal contributor to job-related stress and employee turnover. Nurses in understaffed hospitals can lack a sense of control over their rapidly increasing workload, which becomes a burden to a practice nurse leader (Blouin & Podjasek, 2019). The workload and increased stress can lead to poor work performance and strained relationships between the nurses, the leaders, and the administration. Although several factors, such as budget constraints, nurses approaching retirement age, and a shortage of newly trained nurses, contribute to a staffing shortage, the blame is often placed on the administration. Inadequate communication or links between the nurses and the administration can quickly become a conflict as a lack of action is perceived as ignorance of the plight of nurses.
Amidst these debacles, patients suffer the most because their welfare will be compromised. According to Cho et al. (2019), inadequate staffing is linked with greater missed care, endangering patient safety and nurse outcomes. When a healthcare facility is understaffed, fewer nurses must perform the same amount of work, which usually results in long shifts. Longer working hours with little to no relief can cause a breakdown in the nurses’ mental, emotional, and physical health, which is essential for optimal performance and concertation. In addition, the lack of focus can lead to medical errors, a lack of engagement and missed nursing care, an increased rate of in-hospital mortality, patient dissatisfaction, higher readmissions, and more adverse events.
Common Reaction Mode
Based on the Thomas-Kilmann Instrument (TKI), I would characterize my common reaction mode to conflict as collaborating. My approach often entails expanding a range of options to achieve a win-win outcome. In the TKI model, my reaction mode is cooperative since I usually focus on others’ needs and mutual relationships. I believe optimal nurse staffing will be essential to delivering high-quality, cost-effective care with an increasing focus on value-based care. My ideal solution would be to give the nurses a long-term benefit in exchange for a valuable short-term compromise.
An example of collaborating in conflict resolution was the 113-day lockout of the National Hockey Association (NHL) and the NHL Players’ Association (NHLPA). When face-to-face negotiations broke down, a federal mediator named Scot Beckenbaugh kept the two parties apart and engaged in shuttle diplomacy (Program on Negotiation Staff, 2022). He went to each side in turns to find out what areas they were willing to budge on. Finally, the mediator reached an agreement that hinged on player pensions. The arrangement permitted NHL players, whose careers are sometimes brief, to make a short-term compensation concession in exchange for financial security for the long term (Program on Negotiation Staff, 2022). The deal offers a valuable strategy for business negotiators in all fields to resolve complex disagreements. Besides, it broadens individuals’ scope by looking for long-span tradeoffs.
Appropriate Reaction Mode
Compromising is the most appropriate way of addressing the nurse staffing conflict with the administration. It seeks a reasonable and mutually acceptable solution that satisfies both parties while retaining some assertiveness and cooperation. In some circumstances, reaching a compromise may entail dividing the difference between the two sides, making compromises, or looking for an immediate middle ground (Drakulevski et al., 2020). For example, a compromise would be ideal because budget constraints may result from factors beyond the organization’s control. However, the organization can make some exceptions to fulfill part of the staffing problem.
In return for the administration hiring part of the requested nurses, the practice nurses lead can communicate and educate the employees on adequate staffing ratios. It entails establishing a retention plan that focuses on career development and communication to encourage nurses to stay longer in their current employment. If the organization decides to compensate for the shortage with temporary helpers, the practice nurse leader can ensure they are adequately trained to be as competent as practicing nurses. The goal should be to help the organization fill the staffing gap while operating optimally to finance other organizational activities.
Self-Reflection
My conflict resolution approach appears biased towards the collaborating mode because I always strive to achieve a win-win. People sometimes perceive me as aggressive, argumentative, and uncooperative, which may accompany increased assertiveness. Occasionally, I would easily give in and compromise since collaboration takes too long, yet I need immediate solutions. However, collaborating has often helped me build trust and relationships. I have realized that one needs exceptional active listening skills and patience to negotiate and get what one needs. At the end of a negotiation, both sides get what they want, and negative feelings are minimized. As a future advanced practice leader, I would analyze scheduling patterns by looking at the workload per shift to identify peaks and drops in productivity. It will help me review daily routines to ensure employees are working smart and use the productivity analysis to advance my course during negotiations for more staff.
Conclusion
Many healthcare facilities are understaffed due to increased voluntary termination, an aging patient population, hiring freezes, and budget cutbacks. As a result, the nursing staff shortage has caused greater patient care errors and higher patient morbidity rates, as well as stress on nurses’ working conditions. My preferred approach to resolving the nursing staff deficit is the collaborating mode. However, a compromise conflict negotiation would be ideal for the staff shortage because factors beyond the organization’s control can influence budget cuts.
References
Blouin, A., & Podjasek, K. (2019). The continuing saga of nurse staffing. The Journal of Nursing Administration, 49(4), 221-227.
Cho, S.-H., Lee, J.-Y., You, S., Song, K., & Hong, K. (2019). Nurse staffing, nurses prioritization, missed care, quality of nursing care, and nurse outcomes. International Journal of Nursing Practice, 26(1), 1-6.
Drakulevski, L., Nakov, L., & Taneva-Veshoska, A. (2020). Conflict management styles among managers in Macedonian organizations. Journal of Corporate Governance, Insurance, and Risk Management (JCGIRM), 1(1), 146-156.
Pogram on Negotiation Staff. (2022). A business negotiation case study: Ending the NHL lockout. Harvard Law School. Web.