Interprofessional Relationships

I manage a team of RNs, LPNs and RPNs who work together with OT, PT, physicians, dietary and many other health care providers. At times, there has been tension between the RNs and other team members resulting in strained relationships. What are the responsibilities of RNs in resolving unhealthy professional relationships?

• RNs are expected to demonstrate effective collaborative practice, including communication, problem-solving strategies, decision-making and conflict resolution (1).
• RNs treat each other, colleagues, students and other health care providers in a respectful manner, recognizing the power differentials among formal leaders, colleagues and students. They work with others to honour dignity and resolve differences in a constructive way (2).
• When differences among members of the health care team affect care, RNs seek constructive and collaborative approaches to resolving them and commit to conflict resolution and a person-centred approach to care (3).
• Professional RN leadership is demonstrated by participating in and contributing to health care team development by:
  • Building partnerships based on respect for the unique and shared competencies of each team member; and
  • Contributing RN perspectives on issues being addressed by the health care team (4).
• RNs intervene, and report when necessary, when others fail to respect the dignity of a person they are caring for or a colleague (including students), recognizing that to be silent and passive is to condone the behavior. They speak up, facilitate conversation and adjudicate disputes, as appropriate/required (5).
• When the integrity of RNs is compromised by patterns of institutional behavior or professional practice that erode the ethical environment and the safety of persons receiving care (generating moral distress), RNs express and report their concern individually or collaboratively to the appropriate authority (6).
• The CRNS always promotes resolution of professional practice issues at the lowest level. RNs have a responsibility to collaborate with the employer and other organizations as needed to resolve professional practice issues (7).

When working with people, personalities, beliefs and values may collide. As a manager, it is important to develop your individual skills in coaching and supporting your staff to resolve conflict.

• Proactively explore supports available through human resources.
• Use self-reflection to identify areas in which you need to further develop your skills and incorporate that information into a learning plan. If you are an RN, you may wish to incorporate learning goals into the mandatory continuing competence program (CCP) learning plan you develop each year.
• Things you might consider doing that directly impact your staff include:
  • Engage staff in discussions in which they provide ideas on what might be helpful in creating a positive practice environment.
  • Embrace the use of a solutions-based approach when working with staff towards resolving conflict. Foster the use of this approach by others.
  • Focus on the development of soft skills for both yourself and your staff, such as communication skills, emotional intelligence, teamwork, leadership skills, emotional empathy, time management, understanding generational differences, power relationships, etc.
  • Invite staff who may be interested in developing a learning module as part of their CCP to approach you to develop a plan for sharing or presenting this information. If you are an RN manager, you may want to add this activity to your own CCP learning plan.

If there is a conflict within the team, is it the responsibility of the RN to attempt to resolve it?

Yes. Although all team members share the responsibility for conflict resolution, as leaders within the health care team, RNs are expected to support collaborative teams and interpersonal relationships within those teams. RNs are leaders in every role and should use their knowledge to positively foster high-performing teams.

If the team has been unsuccessful in resolving the conflict at the lowest level, what steps should I as the manager take?

For conflict resolution to be successful, everyone needs to commit themselves to the process. If this is not happening, possibly you will need to speak to the individuals involved and outline your expectations for conflict resolution and respectful productive teamwork. When situations such as these are not dealt with in an effective and timely manner, there can be a negative impact on patient care and workplace morale.

CRNS Resources

Code of Ethics for Registered Nurses (2017)

Registered Nurse Practice Standards (2019)

Ask a Nursing Advisor: A Solutions-Based Approach for Practice Questions

External Resources

AIDET: Five Steps to Achieving Satisfaction

Interpersonal Skills