Theresa Brown, an oncology nurse, was worried about her patient,
a middle-aged man scheduled for a stem cell transplant,
was experiencing textbook symptoms of a heart attack.
Nurse Brown ordered an EKG.
When the attending physician, known for his explosive impatience,
heard about the patient's chest pain, his response to the EKG results was
this doesn't concern me, and pushed the report aside.
All the while tapping at his smartphone, Nurse Brown knew that if she
challenged the doctor's assessment she would incur the wrath of the doctor, but
if she didn't say anything, the patient could die.
Nurse Brown decided to challenge the doctor by asking to delay the surgery.
At that point the doctor, a large imposing man,
pushed his face into hers and demanded why to her challenge.
It's because of situations like this that at St. Francis Medical Centers doctors and
nurses are on a first name basis in the operating room.
When people use titles to address others,
they're unconsciously deferring to the other person.
The Mayo Clinic also realizes that debate, conflict, and confrontation
are necessary to make optimal decisions, particularly in life or death situations.
To foster positive debate, Mayo instituted a program called
Plus One that allows nurses or clinical staff to add
one person to the patient-doctor-nurse relationship at any time.
Most people have been raised to believe that conflict and disagreement are bad and
strain relationships.
We've been told to get along and go along.
However, this approach is really bad advice when it comes to decision-making.
Let's distinguish two types of conflict, relationship conflict and task conflict.
Relationship conflict is personality-based conflict and
it negatively affects group performance.
Task conflict refers to disagreements about the work to be done,
not attacks on the people.
Task conflict may help group performance.
For example, in one study, top management teams in 109 US hospitals
with moderate amounts of task conflict were the most effective.
However, when improperly handled,
task conflict can quickly escalate into relationship conflict.
Let's suppose you notice that your team is suffering from relationship conflict.
Tensions are high and grudges are being carried.
What can you do?
Let's use Wagemen and Donnenfeld's four-pronged approach.
Step one, team re-design.
When you first notice conflict and
tensions are high, examine the structure of the team.
What is the environment like?
Are the work tasks equitably distributed?
How many people are on the team?
Who do they report to?
I was on a task force in which tension was high and
there was a distinct lack of trust.
One member was acting in a passive-aggressive fashion,
coming late to meetings and forgetting key documents.
As it turns out, he resented the fact that he was in charge of booking the meeting
room and copying the documents.
He felt that this responsibility was beneath him.
We changed that responsibility and the team started to produce.
Step two, team coaching.
Sometimes conflict emerges from the norms and meeting style of the team.
I was working on a multi-cultural team in which tension was high, but
no one was saying anything.
Deeper discovery revealed that some members of the team felt that they were
being publicly embarrassed when asked to verbally report their progress.
We changed the meeting style by having members submit their reports
prior to the meeting and solved the problem.
Step three, conflict skills.
Sometimes team members have different experiences with regard to conflict and
expressing disagreement.
Mary was a student in my class.
Prior to joining her current company,
Mary had worked at a company in which people felt free to challenge and
debate one another openly, but not in an accusatory fashion.
However, when Mary joined her new company, she discovered,
to her dismay, a new culture of passive-aggressive silence.
So, Mary hired a debate coach to teach her team how to have spirited
conversations that were not personal attacks.
Step four, personal coaching.
Suppose you've tried team redesign, team coaching, and
teaching conflict skills, and you've still got a problem with a certain team member.
At that point, you may want to get that person involved with personal coaching
to work on specific skills.
Let's sum up regarding conflict.
Number one, conflict is a sign of a high performance team.
Two, effective conflict management is a teachable skill.
Finally, as a leader you
need to role model the kind
of debate you want to have.
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