a gender perspective on conflict management strategies of nurses
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A gender perspective on conflict management strategies of nurses
Author Valentine, Patricia E B
ProQuest document link
Abstract To apply a gender perspective to synthesis of research findings on conflict management.
The Thomas-Kilmann Mode Instrument (TKI), for measuring five conflict-handling strategies: avoiding,
compromising, collaborating, accommodating, and competing.
Nursing research studies with the TKI and other studies are synthesized from perspectives in three gender
theories.
Findings were that two conflict management strategies, avoiding and compromising, were used predominantly
by all categories of nurses. Possible reasons for over- and underuse of the remaining three strategies
(collaborating, accommodating, competing) are described. Implications of these findings for nurses and nursing
organizations are discussed.
Full text Headnote
Purpose: To apply a gender perspective to synthesis of research findings on conflict management.
Organizing Construct. The Thomas-Kilmann Mode Instrument (TKI), for measuring five conflicthandling
strategies: avoiding, compromising, collaborating, accommodating, and competing.
Method: Nursing research studies with the TKI and other studies are synthesized from perspectives in three
gender theories.
Conclusions: Findings were that two conflict management strategies, avoiding and compromising, were used
predominantly by all categories of nurses. Possible reasons for over- and underuse of the remaining three
strategies (collaborating, accommodating, competing) are described. Implications of these findings for nurses
and nursing organizations are discussed.
JOURNAL OF NURSING SCHOLARSHIP, 2001; 33:1, 69-74. 2001 SIGMA THETA TAU INTERNATIONAL
[Key words: administration, gender, conflict management, health care delivery]
In estimated 20% of managerial time is spent dealing with conflict. Conflict management is equal to if not slightly
higher in importance than planning, communication, motivation, and decision-making (McElhaney, 1996).
Research has indicated that nurses tend to take a passive approach to conflict management, and that this
approach is not in the best interests of contemporary work settings, nurses, or nursing. During the current
period of dynamic changes in health care systems when nurses are forced to assume new roles, knowledge of
conflict management strategies is particularly crucial.
Although nursing is a female-dominated profession, research in nursing management lacks a gender
perspective. Gender as a social context variable has been studied mostly in male-dominated organizations.
Therefore, viewing nursing administrative processes using gender as a variable warrants attention. The purpose
of this study was to apply a gender perspective in synthesis of research findings on conflict management, with
particular reference to eight studies that included use of the Thomas-Kilmann Mode Instrument (TKI; Thomas
&Kilmann, 1974) to measure conflict-handling strategies of various categories of nurses.
Three gender perspectives were applied in this analysis. First, the "gender-centered approach" (Riger
&Galligan, 1980; Terbourg, 1977) indicates that gender influences the behaviors, attitudes, and traits of women
and men. Gender differences are attributed to biological makeup and to socialization patterns of both sexes
(Powell, 1988).In another theory, beliefs, perceptions, and behaviors of men and women managers are viewed as a function of
different organizational structures they experience (Kanter, 1977). For example, women are seldom vested with
power or found in top organizational ranks or are found there in small numbers. In this perspective, differences
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in behavior, attitudes, and traits are attributed to situational and structural factors.
A third approach, the gender-organization-system (GOS) perspective (Fagenson, 1993) includes the above two
perspectives but has two added assumptions: (a) individuals or organizations cannot be understood apart from
the culture (society) in which they are embedded; and (b) a change in individuals, organizations, and systems
precipitates change in other aspects of context, such as sex-role stereotypes, expectations, ideologies, culture,
and values. The GOS model is focused on status and experience of women and men in organizations along
with organizational and social systems in which they function.
Background
In management research literature, gender differences were identified in the 1950s, but not until the 1980s and
1990s was gender recognized as an important variable in organizational and administrative studies. During
these two decades, effects of gender were considered in several studies (Hearn &Parkin, 1987; Mills
&Simmons, 1994) that focused on women in male-dominated organizations. Research is sparse about women
in women-dominated organizations such as nursing.
In the past, nurses adopted findings from research on business organizations. This literature was focused
mainly on political and industrial organizations, not on health care organizations. Until recently much of the
research was carried out by male researchers, on male-dominated organizations, using men predominantly as
participants. According to studies on organizations (Fagenson, 1993; Nichols, 1996), women bring different
approaches to the workplace than do men.
Valentine's (1995b) case study of the culture of a Canadian hospital school of nursing indicated that women
nurse educators brought a distinctive orientation to the workplace. The link between work and home was part of
the culture that included an emphasis on workplace relationships. Striving for interpersonal connection was
evident among faculty, students, and staff. Two constructs, food and social events, were part of facilitating and
integrating relationships. The relationships instructors tried to foster were "more than just working relationships,
they strove to be friends" (Valentine &McIntosh, 1990, p. 366). Although meetings were used to accomplish
work goals, they also were used to build cohesion among instructors. Other research has indicated that
women's world is viewed through relationships instead of rules (Parasuraman &Greenhaus, 1993).
Research on gender differences in approaches to conflict management has shown that differences in
orientations and normative expectations resulted in women and men perceiving and handling conflict differently.
Women were more likely to help in expressive ways while men were more likely to use instrumental methods
(Burke, Weir, &Duncan, 1976). Men tended to use social influence and persuasion while women preferred
negotiation and mediation (Lind, Hou, &Tyler, 1994). Generally women were better able to empathize with the
other's perspective.
Other studies have revealed that differences in childhood socialization related to conflict may lead to differences
in adult behavior. For example, female participants had a more difficult time expressing negativecommunications than did their male counterparts (Chiauzzi, Heimberg, &Dody, 1982). Flax (1981) suggested
that women, who frequently function from an inferior position, often dislike themselves and distrust other
women. Workplace studies have associated specific behavioural patterns of women to a dislike of self and other
women (O'Leary, 1988).
Halpern and McLean Park's (1996) research on 50 advanced undergraduate university students who negotiated
funding in a low-conflict public policy negotiation case found differences in processes and outcomes between
women and men dyads. Women more than men focused on personal concerns and requested information
about other people's feelings. Women mentioned personal information sooner than did men. Men more so than
women used confrontational behavior. The researchers concluded that "females and males use some of the
same but also some different techniques. Their different orientation reflects different perspectives on conflict" (p.
63).
Although a generally accepted definition of conflict does not exist, Thomas (1992), who has been studying
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conflict for over 20 years, defined it as "the process that begins when one party perceives that the other [party]
has negatively affected, or is about to negatively affect, something that he or she cares about" (p. 563). The
process model is focused on internal dynamics of specific conflict events and is useful for managing an ongoing
system and coping with crisis (Thomas, 1976).
Various conflict-handling strategies have been described. In a case study of a Canadian hospital school of
nursing, Valentine (1995a) found that avoiding was the major mode used for handling conflict. Instead of
discussing issues, social events were held in anticipation that homemade food and socializing with colleagues
(friends) would ameliorate conflict. According to key participants, avoiding was used to prevent open conflict,
preserve relationships, and be exemplary role models for students. Collaborating was used to resolve one
issue.
Valentine, Richardson, Wood, and Godkin (1998) carried out a retrospective study of nurse educators' and
administrators' perceived group process that included conflict-handling strategies. "Although there were
similarities between conflict management strategies used by [group] members and strategies described in the
management research literature, there also were significant differences" (p. 291). Participants in another study
(Valentine, Richardson, Wood, &Godkin, 1997) maintained that conflict had the potential to jeopardize personal
and work relationships and to thwart goal attainment. Conflict was viewed as negative. "In this context conflict
can be seen as distancing behaviour that could result in rejection, abandonment, or violence" (p. 33).
Shakeshaft (1987) found women educational administrators had similar attitudes towards conflict. Despite the
limitations of sample size, Bendelow's (1983) study of 15 women managers concluded that women used the
term conflict only for major altercations. Bernard (1981) found that conflict was a taboo topic for women. She
contended that "women have rarely defined the nature of conflict nor defined the issues" (p. 297).
Several instruments for measuring conflict-handling strategies have been used (Hall, 1969; Rahim, 1983), but
the TKI (Thomas &Kilmann, 1974) has been the most widely used to measure how nurses handle conflicts. The
TKI indicates five ways of handling conflict: avoiding, compromising, collaborating, accommodating, and
competing. Thomas and Kilmann (1977) reported reasonable support for substantive validity, particularly with
regard to overall population tendencies in social desirability. Their reported average alpha coefficient was .60.
The internal consistency coefficients were in the moderate range, and the average test-retest coefficient was
.64.
A summary of the findings on nurses' conflict-handling strategies is presented in Table 1. Demographic data
indicated Eason and Brown's (1999) and Washington's (1990) participants predominantly had associate
degrees. Seventyfive percent of Barton's (1991) participants were diploma graduates, and over 67% of
Hightower's (1986) participants held 4-year degrees or higher. Cavanagh (1991) classified his participants into
graduates and postgraduates. When gender was indicated, the majority of participants in all studies were
women. Washington's (1990) study had 12% men; Hightower's (1986) study had 2% men. The age of participants in five studies ranged from 21 to 60 years, with the majority 36-50 years (Barton, 1991; Cavanagh,
1991; Eason &Brown, 1999; Hightower, 1986; Washington, 1990). No data on age, education, or gender were
available for Barker's (1984) and Woodtli's (1987) studies, but the deans in Woodtli's study can be assumed to
have had graduate degrees.
Findings
Table 2 shows definitions of five conflict-management strategies, potential uses of the strategies, outcomes of
specific strategies, and frequency of use of particular strategies by staff nurses, nurse managers, nursing
deans, and nurse educators. Table 2 is a template for synthesizing how gender may influence the initial choice
and frequency of use of specific conflict-management strategies.
Avoiding
Avoiding was reported as frequently used, indicating that decisions on crucial issues were not confronted but
were arrived at by default. One possible explanation for frequent use of this mode may relate to the sense of
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powerlessness associated with staff nurses' and nurse managers' roles. In their relationships with physicians
and upper-level administrators, a power differential is perceived. In a case study of nurse educators, Valentine
(1995a) suggested that frequent use of avoiding was related to nurses' orientation to others (caring ideology).
Marriner (1982), Tomey Marriner (1995), and Tomey Marriner and Poletti (1991) suggested that avoiding
produced unsuccessful results. Valentine and associates (1998) found that under certain circumstances, such
as when time was not a factor, avoiding was a successful strategy.
Compromising
Frequent use of compromising indicates a focus mainly on practical aspects of care. Larger issues, such as
principles, values, long-term goals, or well-being of organizations, are not considered. The game-like quality of
trading and bargaining may override the merits of dealing with overarching issues.
Nurses' perceptions of the hierarchicy may influence use of compromising as a way to handle conflict. Nurse
managers are often positioned between traditional decision makers (administrators, boards, physicians) who
are mainly men and subordinate workers (staff nurses, other health workers) who are mainly women. Staff
nurses are positioned between nurse managers and other subordinate health care workers and interact
frequently with health professionals who are perceived to be superordinate to them.
Rossi and Todd-Mansillas' (1990) study indicated that men's tendency was to use power (competing) to resolve
conflict with women. Thus nurse managers' and staff nurses' use of compromising may result in decisions being
made to benefit male professionals instead of nurses. Maxwell (1992) pointed out that men tended to be
"positional bargainers" who focused on their own positions while women tended to focus on others' interests.
Although two studies (Marriner, 1992; Tomey Marriner Poletti, 1991) of nurses indicated that compromising was
a successful strategy, one study showed it was an unsuccessful strategy (Tomey Marriner, 1995). Valentine and
colleagues' (1998) research revealed that compromising was used often because consensus was a group goal
that took precedence over individual and institutional goals. Lachter &Mosek's (1995) study that showed
comparisons of responses of students in social work and medicine showed that the more socialized they
became to their respective roles the more social work students (predominantly women) agreed to less than they
ideally wanted (compromising) instead of engaging in giving and taking (collaborating).
Collaborating
Infrequent use of this strategy indicates that differences in opinion may not be considered as opportunities to
learn and to solve problems, and significant concerns may not be incorporated into decisions. It may result inlack of commitment by subordinates and lack of recognition of collaborative situations.
One explanation for the under-use of this strategy is the perceived power differential that separates nurses and
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other health care workers such as physicians with whom the potential for considerable conflict is strong.
Infrequent use of collaboration by all categories of nurses may also relate to the low self-esteem of many
women (nurses). People who lack selfassurance tend not to confront issues openly (Braiker, 1986). Low self-
esteem also contributes to difficulties expressing negative emotions, another female trait identified by Chiauzi,
Heimberg, and Dody (1982).
Underuse of collaborating indicates that important nursing issues may not be dealt with adequately. This
problem may occur particularly in situations with physicians and other health professionals when working
collaboratively is crucial to ensure quality patient care. Although collaborating is considered the most efficacious
conflict-management strategy (Marriner, 1982; Tomey Marriner, 1995; Tomey Marriner &Poletti, 1991), two
studies of nurse educators and administrators indicated it was used on only two occasions in those studies,
once to deal with a major issue (Valentine, 1995a; Valentine et al., 1998). Although collaborating was used as
the second strategy in Woodlti's (1987) study of 158 American nursing deans, they collaborated far less than
did managers, mostly male, who were used to standardize the TKI.
AccommodatingInfrequent use of accommodating indicates difficulties relinquishing issues, recognizing legitimate exceptions to
rules, forming good intentions, or admitting one is wrong. Low selfesteem and perceived powerlessness among
nurses may make it difficult to waive issues, make exceptions, be charitable, or admit being at fault. Frequent
use of accommodating shows that issues and needs of others (caring ideology) are considered, harmony is
desired, competition is rejected, and social credits are accumulated for later use. Accommodating might also
result in nurses' needs being given insufficient consideration. Valentine and colleagues' (1998) study of nurse
educators and administrators showed that accommodating was not readily identifiable as a group strategy.
Marriner (1982), Tomey Marriner, (1995), and Tomey Marriner and Poletti's (1991) research indicated that
accommodating was ineffective for resolving conflict.
Competing
Infrequent use of competing indicates difficulty in taking a firm stand on issues. It may mean lack of awareness
of power and skills or discomfort in using them. Others' concerns may be given first priority.
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Researchers have suggested that competing is viewed differently by women compared to men. One
explanation for the under-use of competing may relate to nurses' feeling powerless because of the patriarchal
nature of organizations in which they work. It may also relate to nurses' focus on affiliative needs of others.
Several studies of nursing organizations (Harr, 1990; Valentine, 1995b; Valentine et al., 1998) and other gender
studies (Helgeson, 1990; Miller, 1986) have indicated that women's focus on socioemotive aspects of
relationships obviates against the use of power (competing). By putting the concerns of other health care
professionals first, nurses may hinder their effectiveness in advocating for themselves and for patients.
Participants denied using competing in Harr's (1990) study of nurse educators; participants in Valentine and
colleagues' (1998) study of nurse educators and administrators purposely employed the strategy of not
competing. Lachter &Mosek's (1995) study of social work students indicated they refrained from competing. The
explanation was that people who rely more on feelings (mostly women) tended to be less competitive. Although
many researchers stated that competing results in unsuccessful conflict management (Marriner, 1982; Tomey
Marriner &Politi, 1991; Tomey Marriner, 1995), the underuse by nurses (women) and relatively more frequent
use by men (physicians, administrators) indicates that nurses' concerns may be overridden.
Discussion
This synthesis of research studies shows that gender may influence nurses' choice of conflict-management
strategies. Viewed from a gender perspective, women are generally socialized to be more concerned with
interpersonal aspects of relationships than are men. Female nurses tend to view handling conflict as a way to
seek confirmation and support while also attempting to maintain harmony. By frequently avoiding conflict and
trying to preserve relationships, nurses' decisions may be arrived at by default rather than by directly
confronting issues. By treating conflict as individually rather than structurally derived, nurses may fail to work
collectively to resolve conflict.
Because nurses often work in patriarchal organizations in which they are unlikely to occupy the most powerful
positions, the choice of conflict-management strategy may, in part, be based on the powerlessness associated
with their positions. Overuse of compromising by nurses may result in the climate and long-term goals of
nursing organizations not being given serious consideration.
Although significant changes in North American women's roles have contributed to changes in nurses' roles,
changes in stereotypic attitudes and behaviors have been slow. Often the public and other health professionals
continue to hold traditional views about nurses' roles and positions in health care organizations. The lack of
recognizing, the trivializing, or the undervaluing of nurses' contributions by other health care professionals may
result in nurses lacking confidence in themselves and their roles. Low self-esteem often precludes expressing
negative feelings. This behavior coupled with nurses' orientation to others may indicate why nurses frequently
avoid conflictual situations or concede to others (compromising).
The perceived power differential and the lack of selfconfidence may also help to explain the underuse of collaborating by nurses. Nurses may find it difficult to accept that differences in opinion can be used as
opportunities to learn to resolve issues. Also the same feelings preclude the use of power (competing) by
nurses. The underuse of competing may result in the concerns of other health professionals, especially men,
taking precedence over the concerns of nurses and patients. The same results could occur when
accommodating is used often by nurses.
Conclusions
Gender theories make visible theory and practice of organizations that otherwise would be invisible. Gender as
a social construction is relevant for nursing, a women-- dominated profession. By studying organizations and
relationships concerning gender perspectives, nurses and others can better understand nursing administrative
processes such as conflict management. JNS
References
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AuthorAffiliation
Patricia E.B. Valentine, RN, PhD, Mu Sigma, Associate Professor, University of Alberta Faculty of Nursing,
Edmonton, Alberta, Canada. Correspondence to Dr. Valentine, University of Alberta Faculty of Nursing, 3rd
Floor Clinical Sciences Bldg., Edmonton, Alberta, Canada T6G 2G3. E-mail: [email protected]
Accepted for publication August 29, 2000.
MeSH Adult, Female, Group Processes, Humans, Male, Middle Aged, Nursing Administration Research, Sex
Factors, Conflict (Psychology) (major), Interpersonal Relations (major), Negotiating (major), Nursing Staff --
psychology (major), Personnel Management (major)
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Publication title Journal of Nursing Scholarship
Volume 33
Issue 1
Pages 69-74
Number of pages 6
Publication year 2001
Publication date First Quarter 2001
Year 2001
Publisher Blackwell Publishing Ltd.
Place of publication Indianapolis
Country of publication United Kingdom
Publication subject Education--Higher Education, Medical Sciences--Nurses And Nursing
ISSN 15276546
CODEN IMNSEP
Source type Scholarly Journals
Language of publication English
Document type Journal Article
Accession number 11253585
ProQuest document ID 236342261
Document URL http://search.proquest.com/docview/236342261?accountid=1611
Copyright Copyright Sigma Theta Tau International, Inc., Honor Society of Nursing First Quarter 2001
Last updated 2014-06-28
Database ProQuest Research Library
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