When a problem has grown too big, too com- plex, or too heated, a more elaborate process may be required to resolve it. On evaluating Case 1, the nurse manager decided that the tensions between Team A and Team B had become so great that negotiation would be necessary.
The process of negotiation is a complex one that requires much careful thought before- hand and an equal amount of skill in its implementation (Box 8–2). The following is an outline of the most essential aspects of negotiation using Case 1 to illustrate how it can be done.
Scope the Situation
To be successful, it is important to thorough- ly understand the entire situation. Walker and Harris (1995, p. 42) suggest asking yourself the following three questions:
1. What am I trying to achieve? The nurse manager in Case 1 is concerned about the tensions between Team A and Team B. She wants the members of these two teams to be able to work together in a cooperative manner, which they are not doing at the present time.
2. What is the environment in which I am operating? The members of Teams A and B were openly hostile to each other. The overall climate of the organization, howev- er, was a benign one. The nurse manager knew that teamwork was encouraged and that her actions to resolve the conflict would be supported by administration.
3. What problems am I likely to encounter?
The nurse manager knew that she had allowed the problem to go on too long.
104 ❖ Essentials of Nursing Leadership and Management
Even physicians, social workers, and visi- tors to the unit were getting caught up in the conflict. Team members were actively trying to get other staff to take sides, mak- ing clear they felt that “if you are not with us, you are against us.’’ This made people from other departments very uncomfort- able because they had to work with both teams. The nurse manager knew that reso- lution of the conflict would be a relief to many people.
It is important to ask one additional question in preparation for negotiations:
4. What does the other side want? In this sit- uation, the nurse manager was not certain what either team really wanted. She real- ized that she needed this information before she could begin to negotiate.
Set the Stage
When a conflict such as the one between Teams A and B has gone on for some time, the opposing sides are often unwilling to meet to discuss the problem. If this occurs, it may be necessary to confront them with direct state- ments designed to open communications
between the two sides and challenge them to seek resolution of the situation. At the same time, it is important to avoid any implication of blame, because this provokes defensiveness rather than willingness to change.
To confront Teams A and B with their behavior toward one another, the nurse man- ager called them together at the end of the day shift. “I am very concerned about what I have been observing lately,” she told them. “It appears to me that instead of working togeth- er, our two teams are working against each other.” She continued with some examples of what she had observed, taking care not to mention individual names and not blaming anyone for the problem. She was also pre- pared to take responsibility for having allowed the situation to deteriorate before taking this much-needed action.
Conduct the Negotiation
As indicated earlier, conducting a negotiation requires a great deal of skill. Many conflicts become very emotional. Past experience may affect feelings about a current conflict. You or another individual involved in the conflict may be holding a grudge against someone who caused problems in the past (Barnes, 1998). Painful memories of unresolved previ- ous conflicts may cause difficulty in making a clear-headed appraisal of the current situa- tion. Recognizing the effect of these emotions is essential to negotiating effectively (Barnes, 1998). When faced with a highly emotional situation, do not respond with even more emotion. Instead, find out why emotions are so high and refocus the discussion on the issues (Shapiro & Jankowski, 1998). Without effective leadership to prevent personal attacks, confrontation and negotiation can actually worsen the situation. With effective leadership, the conflict may be resolved.
1. Set Ground Rules. Members of Teams A and B began flinging accusations at each other as soon as the nurse manager made her statement. The nurse manager stopped this quickly and said, “First, we need to set some ground rules for this discussion.
Everyone will get a chance to speak, but not all at once. Please speak for yourself, not for others. And please do not make personal remarks or criticize your cowork- ers. We are here to resolve this problem, not to make it worse.’’ She had to remind the group of these ground rules several
❖
BOX 8–2
THE INFORMAL NEGOTIATION PROCESS
❖
Scope the situation. Ask yourself . . .—What am I trying to achieve?
—What is the environment in which I am operating?
—What problems am I likely to encounter?
—What does the other side want?
❖
Set the stage.❖
Conduct the negotiation.—Set the ground rules.
—Clarify the problem.
—Make your opening move.
—Continue with offers and counteroffers.
❖
Agree on the resolution of the conflict.times during the meeting. Teaching others how to negotiate often creates a more col- laborative environment in which the nego- tiation will take place (Schwartz & Pogge, 2000).
2. Clarification of the Problem. The nurse manager wrote a list of problems raised by team members on the board in the confer- ence room. As the list grew longer, she asked the group, “What do you see here?
What is the real problem?’’ The group remained silent. Finally, someone in the back of the room said, “We don’t have enough people, equipment, or supplies to get the work done.” The rest of the group nodded in agreement.
3. Opening Move. Once the problem is clari- fied, it is time to obtain everyone’s agree- ment to discuss the matter and seek a way to resolve the conflict. In more formal negotiations, you may make a statement about what you wish to achieve. For example, if you are negotiating a salary increase, you might begin by saying, “I am requesting a 10 percent increase for the following reasons. . . .’’ Of course, your employer will probably make a counterof- fer, such as, “The best I can do is 3 per- cent.’’ These are the opening moves of a negotiation.
4. Continue the Negotiations. The discussion should continue in an open, nonhostile manner. Each side’s concerns may be fur- ther explained and elaborated. Additional offers and counteroffers are common. As the discussion continues, it is usually help- ful to emphasize areas of agreement as well as disagreement so that both parties are encouraged to continue the negotiations (Tappen, 2001).
Agree on a Resolution of the Conflict After much testing for agreement, elaboration of each side’s positions and concerns, and making offers and counteroffers, the people involved should finally reach an agreement.
The nurse manager of Teams A and B led them through a discussion of their concerns related to working with severely limited resources. The teams soon realized that they had a common concern and that they might be able to help each other rather than compete with each other. The nurse manager agreed to become more proactive in seeking more
resources for the unit. “We can simultaneous- ly seek new resources and develop creative ways to use the resources we already have,”
she told the teams. Relationships between members of Team A and Team B improved remarkably after this meeting. They learned that they could accomplish more by working together than they had ever achieved sepa- rately.
Formal Negotiation:
Collective Bargaining
There are many varieties of formal negotia- tions, from real estate transactions to interna- tional peace treaty negotiations. One of the more formal negotiation processes of special interest to nurses is collective bargaining.
Collective bargaining is a formal negotiation, a process that is governed by law and con- tracts (called collective bargaining agree- ments).
Collective bargaining involves a formal pro- cedure governed by labor laws such as the National Labor Relations Act. Nonprofit healthcare organizations were added to the organizations covered by these laws in 1974.
Once a union or professional organization has been designated as the official bargain- ing agent for a group of nurses, a contract defining such important matters as salary increases, benefits, time off, unfair treatment, and promotion of professional practice is drawn up. This contract then governs employee–management relations within the organization.
Case 3 is an example of how collective bar- gaining agreements can influence the outcome of a conflict between management and staff in a healthcare organization.
C a s e 3 : C o l l e c t i v e B a r g a i n i n g
The chief executive officer (CEO) of a large home health agency in a southwestern resort area called a general staff meeting.
She reported that the agency had grown rapidly and was now the largest in the area. “Much of our success is due to the professionalism and commitment of our staff members,” she said. “With growth come some problems, however. The most serious problem is the fluctuation in patient census. Our census peaks in the winter 106 ❖ Essentials of Nursing Leadership and Management
❖ months when seasonal visitors are here and
troughs in the summer. In the past, when we were a small agency, we all took our vacations during the slow season. This made it possible to continue to pay every- one his or her full salary all year. However, with the pressures to reduce costs and the large number of staff members we now have, we cannot continue to do this. We are very concerned about maintaining the high quality of patient care currently pro- vided, but we have calculated that we need to reduce staff by 30 percent over the sum- mer in order to survive financially.”
The CEO then invited comments from the staff members. The majority of the nurses said they wanted and needed to work full-time all year. Most supported families and had to have a steady income all year. “My rent does not go down in the summer,” said one. “Neither does my mortgage or the grocery bill,” said another.
A small number said that they would be happy to work part-time in the summer if they could be guaranteed full-time employ- ment from October through May. “We have friends who would love this work schedule,” they added.
“That’s not fair,” protested the nurses who needed to work full-time all year.
“You can’t replace us with part-time staff.”
The discussion grew louder and the partici- pants more agitated. The meeting ended without a solution to the problem.
Although the CEO promised to consider all points of view before making a decision, the nurses left the meeting feeling very con- fused and concerned about the security of their future income. Some grumbled that they probably should begin looking for new positions “before the ax falls.”
The next day, the CEO received a tele- phone call from the nurses’ union represen- tatives. “If what I heard about the meeting yesterday is correct,” said the representa- tive, “your plan is in violation of our col- lective bargaining contract.” The CEO reviewed the contract and found that the representative was correct. A new solution to the financial problems caused by the seasonal fluctuations in inpatient census would have to be found.
A collective bargaining contract is a legal doc- ument that governs the relationship between
management and staff represented by the union (which, for nurses, may be the nurses’
association or another healthcare workers’
union). The contract may cover some or all of the following:
•
Economic issues: salaries, shift differen- tials, length of the workday, overtime, hol- idays, sick leave, breaks, health insurance, pensions, severance pay.•
Management issues: promotions, layoffs, transfers, reprimands, hiring and firing procedures.•
Practice issues: adequate staffing, standards of care, code of ethics, other quality-of-care issues, staff development opportunities.Concerns over issues such as restructuring and lower levels of RN staffing have increased interest in unionization recently (Murray, 1999).