I U P U I S c h o o l o f N u r s i n g

IUPUI

School of

Nursing

ModuleMaterials

Truth and Consequences:Getting to Solutions

August 15, 2011

© 2011 Kathleen Paris, Station 1, Inc. ~ & ~ Ann Zanzig, AZ Consultants, LLC

T r u t h & C o n s e q u e n c e s : G e t t i n g t o S o l u t i o n s ~ 1 ~ A u g u s t 2 0 1 1

I U P U I S c h o o l o f N u r s i n g

Table of Contents

Overall Objective and Learner Outcomes.............................................................................................................................................3

Expectations.............................................................................................................................................4

Agenda.............................................................................................................................................5

Ground Rules.............................................................................................................................................6

What is Conflict?.............................................................................................................................................7

School of Nursing Core Values.............................................................................................................................................7

Costs of Not Being Able to Resolve Conflict Effectively.............................................................................................................................................8

Biological Effects of Conflict.............................................................................................................................................9-10

What Does This Mean for Conflict Resolution?.............................................................................................................................................11

T r u t h & C o n s e q u e n c e s : G e t t i n g t o S o l u t i o n s ~ 2 ~ A u g u s t 2 0 1 1

I U P U I S c h o o l o f N u r s i n g

"Speak for Yourself" ala The Clover Practice™.............................................................................................................................................12

Breathing Deeply.............................................................................................................................................13

Steps to Mediation.............................................................................................................................................14-17

What's the Difference Between Position and Interest?.............................................................................................................................................18

Bullying vs. Conflict.............................................................................................................................................18

Dialogue vs. Discussion.............................................................................................................................................18-19

Preventing Conflict.............................................................................................................................................20-21

Additional Resources.............................................................................................................................................22

T r u t h & C o n s e q u e n c e s : G e t t i n g t o S o l u t i o n s ~ 3 ~ A u g u s t 2 0 1 1

I U P U I S c h o o l o f N u r s i n g

Overall

Objective

Tools presented in the workshop which are grounded in the core values are the response of first choice for all in the School of Nursing.

Learner Outcomes:

1. Awareness of personal conflict resolution style

2. Use tools for conflict resolution and problem solving including feedback, dialogue, and questioning

3. Model speaking up with peers and in situations where there is a power differentiation

4. Recognize that our individual view of any situation is always limited

5. Demonstrate increased awareness of the core values and how they can be part of daily work

T r u t h & C o n s e q u e n c e s : G e t t i n g t o S o l u t i o n s ~ 4 ~ A u g u s t 2 0 1 1

I U P U I S c h o o l o f N u r s i n g

Expectations

What do you personally hope to get out of this workshop?

Discuss at your table.

Be ready to share common themes.

T r u t h & C o n s e q u e n c e s : G e t t i n g t o S o l u t i o n s ~ 5 ~ A u g u s t 2 0 1 1

I U P U I S c h o o l o f N u r s i n g

Agenda

Truth and Consequences: Getting To SolutionsSchool of Nursing, University of Indiana

Participant AgendaAugust 15, 2011

8:30 a.m. Coffee, rolls, mingle and settle in

Introductions/Ground rules/Overview

The Effects of Conflict and/or Avoiding Conflict

Break

Your Style: Managing Interpersonal Conflict and Tension

“Speak for Yourself” ala The Clover Practice™

Noon Lunch (30 minutes)

Steps To Mediation

Break

Preventing Conflict

Making My Commitment

Wrap-Up/Close

2:00 p.m. Adjourn

T r u t h & C o n s e q u e n c e s : G e t t i n g t o S o l u t i o n s ~ 6 ~ A u g u s t 2 0 1 1

I U P U I S c h o o l o f N u r s i n g

Ground

Rules

1. Turn off cell phones

2.

3.

4.

5.

6.

T r u t h & C o n s e q u e n c e s : G e t t i n g t o S o l u t i o n s ~ 7 ~ A u g u s t 2 0 1 1

I U P U I S c h o o l o f N u r s i n g

What is Conflict?

Conflict may be defined asa difference of wants, needs, or

expectations.What are some other definitions of conflict?

School of Nursing Core Values

RespectWe create a positive environment by treating all people with mutual respect and sensitivity, recognizing the importance of their contributions and diversity.

ResponsibilityWe accept responsibility for our actions.

TrustWe foster trust by acting with honesty, integrity, and openness.

DialogueWe build community through dialogue by sharing and respecting our diversity of opinions, views, and expertise.

What goes into successful conflict resolution?

Biology Self-Awareness Self-Control Personal Responsibility

Skills of "Speaking for

Yourself"

Reinforcement from Others

T r u t h & C o n s e q u e n c e s : G e t t i n g t o S o l u t i o n s ~ 8 ~ A u g u s t 2 0 1 1

I U P U I S c h o o l o f N u r s i n g

Costs of Not Being Able to Resolve Conflict Effectively

1. Costs to the School of NursingYou can calculate the actual dollars wasted due to workplace conflict at: http://www.mediationworks.com/dmi/toolbox.htm. (You will need some "average" salaries for faculty and staff.)

Some of the variables are:

Number of hours per week each individual spends involved in unproductive participation in conflict, including time distracted from work thinking about or worrying about conflict.

Reduction in motivation, enthusiasm, and loyalty resulting from unresolved conflict ("presenteeism")

Number of unscheduled days taken off work during the period of conflictNumber who were terminated involuntarily at least in part due to conflict(s)Number who left the organization voluntarily during or shortly following a period of conflictImpact on business decisions of conflict(s)Costs of replacing and faculty and staff (recruitment, interviews, hiring, h.r., training, start-up

packages, orientation, etc)--generally amounts to 150% of faculty salary.Process changes, job redesign, reporting relationships, location changes, or otherwise unnecessary

structural changes made to accommodate individuals in conflictCost of conflict-incited theft, sabotage, and equipment damage by employeesIncreased costs of health insurance (stress-related illness and accidents)

2. Costs to individuals

Inverse relationship between stress and the immune systemLost hours/days/weeks of productivityDepression, anxiety, worry, loss of enjoymentIncreased healthcare costsSpillover of work stress into close relationships and family life

3. Costs to patients

40% of clinicians have "kept quiet or remained passive during patient care events rather than question a known intimidator." The Joint Commission, 2008

Think of a scenario in a health care setting where active and unresolved conflicts could have a detrimental effect on patients.

T r u t h & C o n s e q u e n c e s : G e t t i n g t o S o l u t i o n s ~ 9 ~ A u g u s t 2 0 1 1

I U P U I S c h o o l o f N u r s i n g

Biological Effect of Conflict

CONFLICT = STRESS

"All human beings have what is called the 'fight or flight' response. It is ruled by the ...brain stem and the limbic system including the amygdala--those areas of the brain that control emotional response as well as such functions as eating, sleeping, sexual arousal, fighting, and running away from danger."

Ferguson, p.3

Fight or flight is a basic survival system and is activated with no conscious effort on our part.

What are some fight or flight behaviors you might see or experience yourself at work?

FIGHT FLIGHT

1. What is passive aggressive behavior?

2. Would you consider passive-aggressive behavior a fight or flight response?

What typically happens under stress?

T r u t h & C o n s e q u e n c e s : G e t t i n g t o S o l u t i o n s ~ 10 ~ A u g u s t 2 0 1 1

I U P U I S c h o o l o f N u r s i n g

Adrenaline

Cortisol

Breathing

Heart rate

Blood flow

Muscles

Awareness of pain

Field of vision

Sense of humor

2. When YOU are upset or angry, what do you typically experience in your body? (Check all that apply.)

clenched jaws heart thudding, racing

tightness in neck tears

tightness in back tics

throat constricted difficulty speaking

tingling sensations stomach pain

chest pains Other:

"We lose creativity, organizational skills, empathy, concentration, and ability to learn new information in direct proportion to the intensity of the stress."

Ferguson, p. 16

T r u t h & C o n s e q u e n c e s : G e t t i n g t o S o l u t i o n s ~ 11 ~ A u g u s t 2 0 1 1

I U P U I S c h o o l o f N u r s i n g

What Does This Mean for Conflict Resolution?

1. Slow things down so your higher level reasoning functions can kick in.

"Let's slow down and figure out what just happened." "I need a drink of water. I'll be right back to talk about this."

2. Timing

It takes at least 20 minutes to physically recover from a fight or flight jolt of adrenaline and cortisol. (Some authorities say longer.) If you have a choice, don't try to resolve a conflict when you are most upset. Take a walk or get a brief change of scenery.

3. Take deep breaths from your diaphragm to prepare for a difficult conversation or even right in the middle of one.

4. Do a brief scan of your five sense. What am I seeing? What am I hearing? What am I touching? What do I taste? What do I smell? This basic awareness of physical sensations will also act to slow down the escalation.

5. Stretch your neck and back.

6. Jot down a few notes--what you noticed, what you want to happen."The stressed out brain does not organize. Writing engages more brain functions and forces you to organize your thoughts. It will cut down on the wheel-spinning thinking..."

Ferguson , p. 68.

7. Don't get furious, get curious. Ask questions to attempt to understand. "What was it that made you decide to do XYZ?" This is another strategy to access the higher level brain functions.

8. Be aware of your own body. If you know where you feel the stress, you can be aware that your fight or flight system has kicked in, but consciously chose actions like 1-7 above.

"That awareness—of how our emotions affect what we are doing—is the fundamental emotional competence. Lacking that ability, we are vulnerable...to being sidetracked by emotions run amok."

Goleman, p. 55

T r u t h & C o n s e q u e n c e s : G e t t i n g t o S o l u t i o n s ~ 12 ~ A u g u s t 2 0 1 1

I U P U I S c h o o l o f N u r s i n g

1. Describe the behavior using specific, concrete language—what you saw, heard, noticed, or felt. (non-judgmental—not assuming you know other people’s motives or thoughts—and without labeling the person or name-calling).

2. Tell " your story" -- what it means from your perspective, including impact.

3. Ask for the other person’s story (if applicable).

4. Say what you want to happen.5. Offer what you will do to make it work

(if applicable).6. Ask for cooperation.

1. You are a co-author on a paper with two other people. You and your colleague P.J. have done virtually all of the work, but the third person still wants and expects to be listed as an author. You don’t think the third person has done his/her share. What would you say to that person if you are Speaking for Yourself?

2. You are a department chair. You overhear a colleague in the hallway “bad mouthing” the new curriculum being developed in the department. The odd thing is that you just got out of a meeting to discuss the new curriculum. When you had asked if there were any questions, this individual said nothing. Would you say something to that individual? Why or why not? If you decided to speak up, what would you say if you are Speaking for Yourself?

3. You are on the Provost's staff and were told that you would be moving into the nice office with windows when the person who had had it for many years retired. Suddenly someone else in your group, Pat Smith, has moved into the office that was supposed to be yours. What could you say to the Provost if you are Speaking for Yourself?

4. You are responsible for creating quarterly reports for your research project. Everyone on the project team provides you the information you need one week prior to the deadline except Chris Jones. This is stressful because the prompt submission of reports is a condition of funding. You just received an Email from Chris indicating that his/her section would be late. What could you say to Chris if you are Speaking for Yourself?

5. You are a member of a university committee that meets monthly. One individual continually interrupts others while they are speaking. The chair seems to ignore the behavior. At one meeting, this person interrupts you three times. After the third time, you are exceedingly upset, given that you feel the issue under discussion is particularly important. What would you say if you were Speaking for Yourself?

6. You chair a committee that has developed an action plan in the spring semester that you thought everyone was "on board with." Now it's time to implement in the fall semester, but half of the group is backing down or undermining the decisions made by the group. What do you say if you are Speaking for Yourself?

"Speak for Yourself"Ala The Clover Practice™

What could you say in the following scenariosto achieve the change you are looking for?

T r u t h & C o n s e q u e n c e s : G e t t i n g t o S o l u t i o n s ~ 13 ~ A u g u s t 2 0 1 1

I U P U I S c h o o l o f N u r s i n g

Breathing Exercise

1. Sit in a straight back chair with both feet on the floor or lie on the floor with a straight spine.

2. Begin inhaling by expanding the abdomen (let it inflate like a balloon), then move the breath into your rib cage and, finally, all the way into your upper chest.

3. Exhale by reversing this action; begin at your collarbones and exhale down through your rib cage and into your abdomen. Contract your abdominal muscles as you finish exhaling.

4. You might find it helpful to lightly place your right hand on your abdomen and your left hand on your rib cage to help direct the breath on its journey.

5. Begin by practicing for one minute and then gradually lengthen the practice to five minutes.

This technique helps to eliminate shallow chest breathing and encourages full exhalation and inhalation.

Preparing for the Conversation to Address a Conflict

"Speak for Yourself" ala The Clover Practice™ What I will say

1. Describe what happened in concrete terms (no value judgment, just the facts)

1.

2. Tell your story--what you make of it, how it affects you, how it makes you feel

2.

3. Ask for the other person's story 3.

4. Say what you want to happen 4.

5. Offer what you will do to make it work 5.

6. Ask for cooperation 6.

T r u t h & C o n s e q u e n c e s : G e t t i n g t o S o l u t i o n s ~ 14 ~ A u g u s t 2 0 1 1

I U P U I S c h o o l o f N u r s i n g

Steps to Mediation

Overview of Mediation Process

Role of the Mediator

The mediator is an impartial third person whose role is to help people involved in a dispute, communicate with one another, understand each other’s point of view, and reach an agreement that resolves their conflict.

The mediator is not a judge, counselor, or advisor; the mediator helps the disputants evaluate the situation, understand how they feel about what has occurred, and focus on the future.

The most difficult and most important lesson for mediator to learn is to remain impartial and non-judgmental.

Mediator should have profound respect for participants’ courage to address conflict. You help them understand their realities.

Phases of the process

1. Pre-negotiation (separate meeting/s)

2. Mediation Session a. Opening statement b. Understanding the conflict c. Working it out (problem-solving) d. Building an agreement e. Closing

3. Implementation/follow-up (after meeting)

T r u t h & C o n s e q u e n c e s : G e t t i n g t o S o l u t i o n s ~ 15 ~ A u g u s t 2 0 1 1

I U P U I S c h o o l o f N u r s i n g

1. Pre-negotiation

Identify needs and concerns facing each person involved in dispute Clarify goals/desired outcomes of the mediation process Be sure all understand your role as a mediator in this situation

Opportunity to build relationship with parties and trust in processHelps you form an agenda

2. Mediation Session

Opening statement

Set the tone for the conversation Establish “ground rules” for the process Clarify what is going to happen in the meeting

Ground rules: Listen, understand Try not to interrupt

Agree on expectations regarding confidentiality

Understanding the conflict

Each disputant shares perspective on the conflict, beginning with initiator Begin by addressing the mediator; other listens Mediator asks clarifying questions, takes notes After each describes issues to mediator, they each repeat to each other

understanding of issues (demonstrating to each other “I get where you’re coming from)

Listen to ideas and feelings.Take notes.I would like to hear your view/perspective of the situation.Help me understand….I’m confused…Describe to each other what you’re hearing…

Working it out (problem solving)

Identify issues agenda Take one issue at a time

Start with a common concern that is a bite-able bite Brainstorm several options Evaluate options Seek agreement on options; search for common ground Manage impasses with patience and respect

Set aside the issue and “name the impasse” Review definition of problem

Reiterate “ground rules” Consider structured break

Capture issues on flipchartThese are the issues as I hear themAre there other issues?

T r u t h & C o n s e q u e n c e s : G e t t i n g t o S o l u t i o n s ~ 16 ~ A u g u s t 2 0 1 1

I U P U I S c h o o l o f N u r s i n g

Building an agreement

Patiently address all key issues Building an agreement results from smaller agreements reached along the way Review agreement for clarity Look for “hallmarks” of good agreement:

Fair Balanced Realistic Responds to needs of the conflict Specific enoughAs self-enforcing as possibleFuture-oriented

Consider doing written agreement Help me understand how this is going to work

Closing the session

Review the agreement; clarify action steps and timeframes Review understandings of confidentiality and who needs to know Congratulate participants for courage and persistence

Consider telling them:I’m going to check in with each of you in the next few days, next few weeks, etc.

3. Implement and evaluate

Arrange a time to meet together and review the agreement: Did we follow through with the agreement? Is it working? How can it be improved? Are there additional areas of concern?

T r u t h & C o n s e q u e n c e s : G e t t i n g t o S o l u t i o n s ~ 17 ~ A u g u s t 2 0 1 1

I U P U I S c h o o l o f N u r s i n g

Sample Opening Statement Thank you for meeting today. I commend you for taking the time and having the courage to get together to discuss these

issues. My role is to help you to clarify your issues and concerns, to help you understand each

other’s perspectives, and to explore solutions that will work best for you. My role is not to judge or advise.

I ask that you observe a few basic ground rules for our discussion. Please listen carefully and respectfully to each other. Try to stay focused on the issues and avoid personal criticism. We need to honor confidentiality and agree that our discussion will go no further that this

room. Are these acceptable? Others? We’ll begin with ______, as the person who initiated our discussion to give us her

perspective, speaking directly to me.

Miscellaneous notes/tips

“Appreciative Mediator” – can validate issues and strengths at once. Use appreciate inquiry to shift to positive focus. What’s working well?

If we can work to understand the true threat (issues) and develop strategies (solutions) that manage it (agreement), we are acting constructively to manage the conflict.

Fear is most common emotion in these discussions – important to find gentle place to uncover issues and feelings

When discussion gets emotional, acknowledge that; validate passion for an issue. o I can see that you feel strongly about this issue. o Help me understand why you care about this issue. o Help me understand why you feel frustrated. o I remind you that you made a commitment to act in a civil wayo It’s important that you be honest with each other.o Tell us about an experience you’ve had that has led you to this place.

T r u t h & C o n s e q u e n c e s : G e t t i n g t o S o l u t i o n s ~ 18 ~ A u g u s t 2 0 1 1

I U P U I S c h o o l o f N u r s i n g

Position vs. Interest

Sticking to "a position" narrows the options for resolution. Ask questions to get at underlying interests. ("Why do we need to end by that date?

What are you hoping to achieve?")

Bullying vs. ConflictBullying Is:

Imbalance of Power: People who bully use their power to control or harm and the people being bullied may have a hard time defending themselves.Intent to Cause Harm:Actions done by accident are not bullying; the person bullying has a goal to cause harm.Repetition: Incidents of bullying happen to the same the person over and over by the same person or group.

stopbullying.gov

Bullying = harassment = a performance issue = legal and financial ramifications

Dialogue vs. Discussion

"Dialogue is not discussion, a word that shares its root meaning with "percussion" and "concussion," both of which involve breaking things up. Nor is it debate.

"...Suspension of thoughts, impulses, judgments, etc., lies at the very heart of Dialogue. It is one of its most important new aspects. It is not easily grasped because the activity is both unfamiliar and subtle. Suspension involves attention, listening and looking and is essential to exploration. ...the actual process of exploration takes place during listening -- not only to others but to oneself. Suspension involves exposing your reactions, impulses, feelings and opinions in such a way that they can be seen and felt within your own psyche and also be reflected back by others in the group. It does not mean repressing or suppressing or, even, postponing them. It means, simply, giving them your serious attention so that their structures can be noticed while they are actually taking place."

From Dialogue - A proposal By David Bohm, Donald Factor and Peter Garrett

T r u t h & C o n s e q u e n c e s : G e t t i n g t o S o l u t i o n s ~ 19 ~ A u g u s t 2 0 1 1

I U P U I S c h o o l o f N u r s i n g

In what situations in the School of Nursing can you imagine that a true dialogue would be helpful?

Phrases that Open Doors

1. Would you be willing to consider...?2. Would you consider...?3. May I make a suggestion...?4. I think you and I have different views of _____________, but may I tell you why I feel the way I do?5. I am worried about "X" and would like to tell you about it.6. I am concerned that if we do "X" we are going to have problems with "Y". Could we talk about it?7. Something has been keeping me awake nights and I would like to talk with you about it.8. It looks to me like ____________________________________________________________________9. It seems like this is what is happening:____________________________________________________10. This is how I am interpreting the situation: _______________________________________________11. I am sorry.12. I hope you will accept my apology.13. May I have a "do-over" on that?14. May I rewind and erase what I just said?15. What would make this more acceptable to you?

T r u t h & C o n s e q u e n c e s : G e t t i n g t o S o l u t i o n s ~ 20 ~ A u g u s t 2 0 1 1

I U P U I S c h o o l o f N u r s i n g

Preventing Conflict

Preventing unnecessary conflict is well worth doing.Looking back at the scenarios on p. 12,

what might have been done to prevent them?

1. Authoring Rights

2. Meeting in the Hall

3. Office Space Promise

4. Missed Deadline

5. Interrupter

6. Belated Objections

You will reduce the amount of conflict in your life if you refrain from addressing conflict by Email.Pick up the phone, Skype, or talk face-to-face when there's a problem.

T r u t h & C o n s e q u e n c e s : G e t t i n g t o S o l u t i o n s ~ 21 ~ A u g u s t 2 0 1 1

I U P U I S c h o o l o f N u r s i n g

As IUSON takes on new challenges and vision, and I find myself in interpersonal conflicts,

I commit to......

1. Using these strategies / tactics first

2. Developing these individual skills:

3. Doing this one thing just for me to relieve personal stress and anxiety:

Thank you for your participation today!

T r u t h & C o n s e q u e n c e s : G e t t i n g t o S o l u t i o n s ~ 22 ~ A u g u s t 2 0 1 1

I U P U I S c h o o l o f N u r s i n g

Additional

ResourcesFerguson, D. (1998). Reptiles in Love: Ending destructive fights and evolving toward more loving

relationships. San Francisco: Jossey-Bass.

Goleman, D. (1998). Working with emotional intelligence. New York: Bantam Books.

Kabat-Zinn, J. (1994). Full catastrophic living: Using the wisdom of your body and mind to face stress, pain, and illness. New York: Dell.

Pagano, B. and Pagano, E. (2004). The transparency edge: How credibility can make or break you in business. Chicago: McGraw-Hill.

Patterson, K., Grenny, J., McMillan, R. and Switsler, A. (2005). Crucial confrontations: Tools for resolving broken promises, violated expectations, and bad behavior. New York: McGraw-Hill.

Patterson, K., Grenny, J., McMillan, R. and Switsler, A. (2002). Crucial conversations: Tools for talking when the stakes are high. Chicago: McGraw-Hill.

Perlow, L. and Williams, S. (May 2003). Is silence killing your company? Harvard Business Review, pp. 52-58.

Ryan, Kathleen and Oestreich, Daniel. (1996).The courageous messenger: How to successfully speak up at work. San Francisco: Jossey-Bass.

Thomas-Kilmann Conflict Orientation Inventory http://www.kilmann.com/conflict.html accessed August 8, 2011.

Ury, W. and Patton, B. (1981). Getting to yes: Negotiating agreement without giving in. New York:

Penguin Books.

Webne-Behrman, H. Conflict resolution http://www.ohrd.wisc.edu/onlinetraining/resolution/index.asp, accessed August 5, 2011.

Kathleen A. Paris, Ph.D.kathleen@kathleenparis.comkathleenparis.comPhone: 608-445-1085

Ann E. ZanzigAZ Consultants, LLCaezanzig@wisc.edu Phone: 608-278-1288

T r u t h & C o n s e q u e n c e s : G e t t i n g t o S o l u t i o n s ~ 23 ~ A u g u s t 2 0 1 1