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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).
The Pros and Cons of
108 ❖ Essentials of Nursing Leadership and Management and it does not even have to be a negative
experience if it is handled skillfully by every- one involved. In fact, conflict can stimulate people to learn more about each other.
Resolution of a conflict, when it is done well, can lead to improved working relationships, more creative methods of operation, and higher productivity.
C R I T I C A L T H I N K I N G E X E R C I S E
A not-for-profit hospice center in a small community received a generous gift from the grateful family of a client who had died recently. The family asked only that the money be “put to the best use possible.’’
Everyone in this small facility had an opinion about the best use for the money. The administrator wanted to renovate their old, run-down headquarters.
The financial officer wanted to put the money in the bank “for a rainy day.’’ The chaplain wanted to add a small chapel to the building. The nurses wanted to cre- ate a food bank to help the poorest of their clients. The social workers wanted to buy a van to transport clients to healthcare providers. The staff agreed that all the ideas had merit, that all of the needs identified were important ones.
Unfortunately, there was only enough money to meet one of them.
The more the staff members discussed how to use this gift, the more insis- tent each group became that their idea was best. At their last meeting, it was evi- dent that some were becoming frustrated and others were becoming angry. It was rumored that a shouting match between the administrator and the financial offi- cer had occurred.
1. In your analysis of this situation, identify the sources of the conflict that is developing within this facility.
2. What kind of leadership actions are needed to prevent the escalation of this conflict?
3. If the conflict does escalate, how could it be resolved?
4. Which idea do you think has the most merit?
5. Why did you select the one you did?
6. Try role-playing a negotiation among the administrator, the financial offi- cer, the chaplain, a representative of the nursing staff, and a representative of the social work staff. Can you suggest a creative solution?
S T U D Y Q U E S T I O N S
1. Debate the question of whether conflict is constructive or destructive. How can good leadership affect the outcome of a conflict?
2. Give an example of how each of the eight sources of conflict listed in this chapter can lead to a serious problem or conflict. Then discuss ways to prevent the occurrence of conflict from each of the eight sources.
3. What is the difference between problem resolution and negotiation? Under what circumstances would you use one or the other?
4. Identify a conflict (or potential conflict) in your clinical area and explain how either problem resolution or negotiation could be used to resolve it.
R E F E R E N C E S
Barnes, G.P. (1998). Successful Negotiating. Franklin Lakes, N.J.: Career Press.
Browne, M.M., & Kelley, S.M. (1994). Asking the Right Questions: A Guide to Critical Thinking.Englewood Cliffs, N.J.: Prentice-Hall.
Ehrlich, H.J. (1995). Prejudice and ethnoviolence on cam- pus. Higher Education Extension Service Review, 6(2), 1–3.
Gottlieb, M., & Healy, W.J. (1990). Making Deals: The Business of Negotiating. New York: New York Institute of Finance.
Ketter, J. (1994). Protecting RN’s with the Fair Labor Standards Act. American Nurse, 26(9), 1–2.
McElhaney, R. (1996). Conflict management in nursing administration. Nursing Management, 27(3), 49–50.
Murray, M.K. (1999). Is healthcare reengineering result- ing in union organizing of registered nurses? J Nurs Adm, 29(10), 4–7.
Qureshi, P. (1996). The effects of threat appraisal.
Nursing Management, 27(3), 31–32.
Sanon-Rollins, G. (2000). Surviving conflict on the job.
Nursing Spectrum Career Fitness Guide (pp.
6767–6868). Barrington Ill.: Gannett.
Schwartz, R.W., & Pogge, C. (2000). Physician leader- ship: Essential skills in a changing environment.
American Journal of Surgery, 180(3), 187–192.
Shapiro, R.M., & Jankowski, M.A. (1998). The Power of Nice.New York: John Wiley & Sons.
Tappen, R.M. (2001). Nursing Leadership and Management: Concept and Practice.Philadelphia: F.A.
Davis.
Tjosvold, D., & Tjosvold, M.M. (1995). Psychology for Leader: Using Motivation, Conflict, and Power to Manage More Effectively. New York: John Wiley &
Sons.
Trossman, S. (1999). Stress!—It’s everywhere! And it can be managed. American Nurse, 31(4), 1–2.
Vayrynen, R. (1991). New Directions in Conflict Theory:
Conflict Resolution and Conflict Transformation.
London: Sage.
Walker, M.A., & Harris, G.L. (1995). Negotiations: Six Steps to Success. Upper Saddle River, N.J.: Prentice- Hall.
Walsh, B. (1996, June 3). When past perfect isn’t. Forbes ASAP,p. 18.
Wenckus, E. (1995, February 21). Working with an inter- disciplinary team. Nursing Spectrum,pp. 12–14.
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111
People and the Process of Change
O U T L I N E Change
A Natural Phenomenon Macro and Micro Change The Process of Change Resistance to Change Sources of Resistance Recognizing Resistance Lowering Resistance
Leading the Implementation of Change Designing the Change
Planning the Implementation Implementing the Change Integrating the Change Conclusion
O B J E C T I V E S
After reading this chapter, the student should be able to:
• Describe the process of change.
• Recognize resistance to change and identify possible sources of resistance.
• Suggest strategies to reduce resistance to change.
• Assume a leadership role in implementing change.
C H A P T E R 9
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When asked the theme of a recent nursing management conference, a top nursing executive thought for a moment and then replied, “Change,