Leaders who proactively handle tensions among staff members communicate to the entire team that conflict is not acceptable.

Margaret Pearce Photo

As a chief nursing officer, I use conflict resolution techniques to manage difficult conversations with employees. When staff members become emotional or angry, I offer an empathetic ear and remind myself of what not to do in these situations.

Handling Emotional Employees

Healthcare leaders should respond with poise and diplomacy when responding to intense reactions from employees during one-on-one conversations. For example, let’s say a staff member’s chronic absence and tardiness has brought her to your office for a hard talk. As she describes personal problems that are causing her to miss work, she starts to cry.

What not to do:

  • Do not discuss the personal issues, suggest solutions, or provide counseling because you are not qualified to provide counseling services; however, if appropriate, refer the employee to the employee assistance program or other professional support.
  • Do not “forgive” the poor work habits.
  • Do not fail to set clear expectations and identify consequences for continuing to miss work.

 What to do:  

  • Sit patiently and listen until she calms down.
  • Be empathetic but firm in stating the problem.

What you might say:
“I understand that you are having some personal problems that are affecting your ability to work, and we have an employee assistance program that may help you. I also want you to discuss this issue with Human Resources to see if there is additional support available. (This is especially important if the problem would qualify the employee for Family and Medical Leave Act benefits or other resources).

“The bottom line is we must have someone who can come to work and be consistently on time. Our responsibility is caring for our patients, so please use the resources we have in place for you to help you resolve this situation.”

See related article: Create a Safe Space for Confrontation

Managing Staff Conflict

Unchecked tension between staff members can be a significant drain on staff productivity. For example, let’s say everyone on the floor knows that the nurse manager and a certain staff nurse are not getting along.

 What not to do:  

  • Do not ignore the situation because when a manager is involved in ongoing conflict, it sends a message to the entire team that conflict is acceptable.
  • Do not assume the staff person or manager who tells you about the problem provides an accurate assessment of the situation because most things that a senior leader hears are filtered through others’ perceptions.

 What to do:  

  • Meet individually with the manager, the staff member, and others who are involved to learn what’s going on.
  • When you are confident about the facts, be clear and concrete about your expectations and the consequences if the behavior does not change.
  • Both parties must take responsibility for improving their behavior, but they have different roles, so hold the manager accountable for setting the example of how to work well with all team members.

 What you might say:  

  • “Here’s the behavior I am concerned about …
  • “Here’s the impact that it is having on the organization …
  • “Here’s the expectation that I have …
  • “And here are the consequences if the behavior does not change …
  • “I have confidence that you can do this. I expect that this behavior will not occur again.”

Approaching Conflict Head On

Ignoring staff conflict and thorny workplace scenarios will make matters worse. Healthcare leaders who approach difficult situations with evenhandedness and legal issues in mind can maintain and even increase staff productivity and satisfaction, while reducing costly staff turnover at the same time.


Margaret Pearce, RN, PhD, is chief nursing officer for the University of Utah Hospitals and Clinics and assistant dean of clinical affairs at the University of Utah’s College of Nursing in Salt Lake City.

Publication Date: Friday, April 18, 2014