By Melinda Young
One of the most important tactics case management leaders can learn and teach their staff is how to resolve interpersonal conflicts.
During the COVID-19 pandemic, case managers and other healthcare professionals have seen a rise in stress and tension at work. This can lead to more conflicts between employees and managers.
“I think this past year and a half has been very stressful,” says Mary McLaughlin Davis, DNP, ACNS-BC, NEA-BC, CCM, senior director of care management nursing at Cleveland Clinic. “We have seen a lot of distress over things that are seemingly not that important, but they become important because of other underlying reasons.”
Davis offers these suggestions for how case managers and case management leaders can successfully resolve and manage conflicts:
• Stay calm and step back. “Always staying calm is absolutely essential,” Davis says. “Really try to listen to what others are saying.”
If a conflict arises between two case managers, they should step back a little and try to listen to what the other person is saying. “They can use those techniques that case managers know, which is repeating back what they thought they heard and always looking for grounds for negotiation,” Davis adds.
It is important to literally remove oneself from the situation. “If you mentally need to remove yourself, then you can do that within your own mind following some very simple techniques,” Davis says.
One technique is to ask oneself the question, “How important is this really?” she says.
Breathing techniques also can help.
“Sometimes, people are really so agitated — it might be a patient or family member — and you just need to excuse yourself from the situation, saying, ‘Let’s take a break here, and when everyone has a little breathing room, we’ll reconnect,’” Davis says.
• Use negotiating skills. One of a case manager’s skill sets is the ability to always look for grounds for negotiation.
Sometimes, even simple negotiations can be stressful, Davis notes. For instance, two employees might argue over desk location. In these kinds of situations, the case manager should look at the situation from the other person’s perspective. The co-worker who is taking a simple issue seriously might have reported to work after a stressful period in their home life, possibly related to the pandemic.
“What’s going on at home or in their life is all part of it,” she says. “Not that any of us are equipped to fix other people’s circumstances, but we can just be mindful that everyone has gone through an unprecedented, stressful situation.”
• Staff scheduling can be rife with conflict. Often, there are times when a couple of employees will want the same days off from work. It might not be possible to accommodate them both. A lot of people are leaving their healthcare jobs, creating even more tension.
“It seems there is an incredible shortage of not only case managers, but also nurses,” Davis says. “The vacancy rate, at least in our area, is quite high.”
Staffing shortages create even more difficulties when the hospital’s patient population increases, as has happened in many facilities since the COVID-19 case rates have dropped due to the national vaccination program, she adds.
“People are coming back to the hospital for elective surgeries and other non-COVID-19 circumstances,” Davis says. “Staffing is very low, so the workload is extremely high.”
This makes it difficult for employees to take time off. When a case management leader is faced with a scheduling conflict, such as an employee who wants a specific weekend off even though the manager has explained that this would be very difficult, they should resort to their negotiating skills, Davis says.
“If it’s obviously really important to them, then I’ll say that we will switch the time around or wait until that date and see what happens, because maybe the conflicting date they’re so concerned about won’t be as much of an issue later on,” she explains. “I ask them if they can live with a little flexibility and revisit it in six weeks.”
Case management leaders also should be aware of how anxiety can be contagious among their staff.
“If one person sees a lot of colleagues leaving or quitting work, there can be a kind of panic effect,” Davis says. “We need to try to help people calm down and keep the lines of communication open.”
For example, the case management leader could say the organization has hired more people to replace those who have left, and they will onboard sometime soon. “Keep communication free-flowing and open so people know what is going on, what we’re doing to try and remedy the situation,” Davis says.
• Encourage staff work it out among themselves. Every day, cases of minor or moderate interpersonal conflicts arise among employees in a department. The leader’s role is to teach people ways to keep these to a minimum. (See story on handling complicated conflicts in this issue.)
One tactic is to tell employees to work it out between themselves, Davis says. For example, employees could handle some scheduling conflicts by finding their own replacement for a particular day off.
This could be more challenging in situations where staff has recently been reshuffled.
“Finding case managers whose skill set is very specific and unique is challenging,” Davis says.
In those situations, leaders might have to think outside the box and engage staffing agencies to help fill in gaps. “They need to make sure they communicate everything they’re doing to their employees, showing staff they’re doing everything can to find solutions,” Davis says.