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Managing Conflicts in a Multicultural

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This paper reveals the difficulty that nurse managers have in creating a productive work environment with such a wide variety of individuals. The cultural diversity, generation differences and variety of background experience that each nurse brings to the organization presents a challenge to managers trying to create a functional team. Communication styles may clash and values and goals may be different. Bringing all of these different people together to meet the goals of the organization takes skill and innovation. This paper explores the use of personality indicators and mentoring programs in creating a productive team.

Two years ago a young nurse, named Maria, came to work on our medical floor. She had been working at a nursing home the year before, so she had worked with elderly, was competent with wound care, and was proficient in medication administration. Her skill mix seemed to fit the work that we did on our floor, however, Maria was not able to keep up with the workload. Maria also had a difficult time getting along with our unit secretary Amanda. Amanda complained that Maria was bossing her around and being overly demanding. A unit is supposed to work as a team and Amanda thought Maria was acting out of place and treating her disrespectfully. Maria was African American and also part of generation Y. “Aggressive is one word that white people consistently used to describe black people. Assertiveness is normally valued…but blacks who display such a style are often perceived as threatening, demanding and speaking out of place” (Mcglowan, 2004, p. 10). Maria’s cultural background and communication style may have contributed to the poor work relationship with Amanda.

This may have in-turn sabotaged her time management efforts, because a unit secretary is very important to the success of the entire unit. Workers who are part of generation Y are sometimes characterized as “demanding and impatient” (Stanley, 2010, p. 84). Maria’s generational differences may have also contributed to her working relationship issues. Because of the fact that nurses come from such a wide variety backgrounds, with regard to culture, age and experience, managers today must be aware of these differences, become skilled at resolving conflicts, and find innovative ways to form a productive team.

In all occupations employees comes from a wide variety of backgrounds and nationalities. This is especially true in professional nursing. There were an estimated 3,063,162 licensed registered nurses living in the United States, as of March 2008. (The US Department of Health and Human Services, 2010). Among RNs who have graduated since 2005, Black/African-Americans comprise 7.4 percent, a small increase from the 6.8 percent of Black/African-Americans among RNs who graduated from 1996 to 2000. Among nurses who completed their education in 1980 or earlier, only 4.0 percent are Black/African-American. (USDHHS, 2010). Asians are slightly overrepresented among RNs, with 5.8 percent of RNs reporting a racial background of Asian, Native Hawaiian, or Pacific Islander, as compared with 4.5 percent of the U.S. population.

Hispanics are the most rapidly growing group, rising from 4.8 percent of RNs who graduated between 1996 and 2000, to 7.1 percent of RNs who have graduated since 2005. Among nurses who graduated in 1980 or earlier, only 1.4 percent were Hispanic (USDHHS, 2010). In 2008, 6.6 percent of all RNs were male, a small increase from 5.8 percent in 2004. However, the share of male nurses was much higher for the more recent nursing graduates. Only 4.1 percent of nurses who graduated in 1990 or earlier were male, while 9.6 percent of those who completed their initial RN education after 1990 were male (USDHHS, 2010). Healthcare is such a diverse field that managers must become aware of cultural differences to be successful.

Cultural differences in the workplace can create conflicts and misunderstandings that could lead to productivity and communication issues. Communication is most successful when the communicators understand the values of their own culture as well as the values of the other culture. When a manager takes the time to understand the different culture of an employee, they have an advantage in building trust and establishing a rapport. This helps with conflict resolution and may help to increase productivity. For instance, managers should understand that many Asian cultures believe that too much eye contact is rude and aggressive.

Body language and physical space between people is variable in different cultures as well. Being unaware of differences can damage relationships. Managers should also become familiar with Holidays and religious observances of other cultures. If a manager is aware that a Holiday is very important to an individual, granting time off can be weighted more appropriately and less tension will develop in the workplace.

Another issue that nurse managers must be aware of is the generational differences with regard to communication styles, expectations, and work experience. In 2008 the median age of the nurse population was 50-54 (USDHHS, 2010). This survey included nurses under the age of 25 as well as those over the age of 75. The ideas and experiences of a 25 year old will differ substantially with a 75 year old nurse. It’s very important to recognize differences in generational expectations. “Millennials crave knowledge but enjoy their independence, and as such they like to be mentored but not managed. Boomers and traditionalists have deep experience and relationships, so they like to collaborate and share their wisdom. Gen Xers expect accountability of themselves and their peers, and focus on getting the job done” (Gale, 2012, p.28). There are also differences with regard to the preference for the use of technology. Younger workers tend to be more comfortable with learning new technologies; while more experienced workers may have difficulty adjusting.

With so many generational differences in the workforce today, managers must also be aware of these issues to facilitate good working relationships and efficient productivity. Last year, while working on a medical floor, the management decided to include several telemetry beds. The entire floor of nurses had to learn to use the monitors and to read cardiac rhythms. Some of the older nurses who had been there for twenty years or more complained the most. I remember one nurse, in particular, who was very distraught. Claire, who had worked as a nurse for 30 years, was not happy. She was a very good nurse (the kind that you like to follow, because she was very efficient and didn’t leave work unfinished). Claire was very unhappy about having to use the cardiac monitors and learn the rhythms. Although she was proficient at using the computers on the floor and the pixus in the med room, she seemed very overwhelmed at having to learn these new skills.

I believe this is a generational difference. The younger nurses seemed to adjust much more quickly without the same hesitation and reluctance. Nurses from older generations who have been on the job longer, should be given more time and support when introducing new technologies. Managers who recognize this will have a smoother transition when making these changes.

When management takes the time to understand how to resolve conflicts in such a diverse staff, it has a large impact on nursing leadership practice and the healthcare system. Imagine a well-run hospital floor. The rooms are clean, and the reception area is well staffed. Patients and families have their questions answered quickly. Meals and medications are given on time. Admissions and discharges are uncomplicated. In order for this scene to play out, the staff has to work together as a team. Conflicts need to be understood and addressed for the team to function effectively. Ignoring conflicts and allowing problems to persist will lead to dysfunction and a less productive team. This will also lead to a decrease in employee satisfaction and an increase in employee turnover. This will then cause a shortage in staffing and facilitate a higher turnover.

Many managers place little importance on team work, but this is a mistake. In healthcare we are not individuals functioning as separate units. We rely on each other and are interdependent, so being able to work together is vital to the success of the entire organization. When teams are dysfunctional, it will lead to dissatisfaction and a high turnover rate. This is expensive. The cost of training nurses is by far higher than making the effort to retain them. Placing a high value on employee relationships, cooperation and the ability to function well as a team will keep costs lower and make the delivery of healthcare more efficient.

One recommendation for creating a more cohesive staff is to start with hiring people that have personalities, goals, and values that match those of the organization. To succeed, employers need to hire applicants who perform well on the job and who are unlikely to quit the organization (Sujarto, 2011, p. 1). If an employee believes in the same values as the organization, they are a much better fit than someone who has different beliefs. It is easier for a person to do their job and be more satisfied if they are working for a purpose that they believe in. It would be frustrating to go to work every day and perform a job that has no personal value to you. Also some personalities will match those of the others in the organization than other personalities. It may be a good idea to introduce the prospective hire to some of the people on the unit and get a sense if they fit in.

Hiring someone who does not fit in would be counterproductive and that much harder to assimilate in the team. Vanmatic, a manufacturing company, uses a Predictive Index test that is a behavioral index test. This test offers insights into the behavior of employees and job candidates. (Production Machining, 2011, p. 16) By identifying people’s strengths compared with job requirements, the PI enables business owners and managers to make better-informed human resource decisions p16. Since implementing the PI in 2005, Vanamatic has seen its retention rate for new hires increase from 56 to 80 percent. This improvement resulted in more than $22,000 in annual cost savings for the company (Production Machining, 2011, p.17).

Personality tests have been used for many years to single out people with positive and negative personality traits. Some of the traits that can be identified include honesty, integrity, anger management skills and stress management skills. Being able to identify people with traits that may indicate the individual’s ability to function as part of a team, is useful to a nurse manager.

Another recommendation for managing a diverse staff is to implement a mentoring program. Each new employee should be paired with a mentor. Mentoring can help close the training gap, and improve recruitment, retention and career development—and the bottom line (HR Specialist 2012, p. 1). When cultural and generational differences come into play, the mentor could be very important in showing the new hire the “ropes” in terms of what is expected. Just being thrown into a new environment without enough training about the organization is not enough to help a new employee succeed and become part of a team. Having the inside knowledge from another employee who has been with the company for a while would be very valuable to the new employee in their training. “Mentorships allow less-experienced employees to learn and grow faster under the tutelage of a more seasoned professional. Mentors themselves grow professionally, too” (HR Specialist, 2012, p. 2).

Mentoring relationship also may help bridge the generation gaps that exist in the work place. “Implementing mentoring relationships can help older and younger workers share their knowledge and experience while strengthening team bonds, suggests Conrado Morían, DHL, Dallas, Texas, USA.”The younger generations respect the older generation, and they like to get feedback on their efforts,” he explains. (Gale, 2012, p.1).

A survey showed that 71% of Fortune 500 companies have a mentoring program (Bridgeford, 2007, August 1). Intel began a mentoring program, in the New Mexico plant, that has been very successful. Intel took the idea of mentoring and reinvented it to fit a competitive environment where what matters most is an employee’s ability to do the right things right away. The New Mexico team didn’t want its version of mentoring to be about pushing a few people up the corporate ladder. Instead, the program’s success would hinge on how well knowledge was passed along to a new generation. That meant rethinking how mentors and “partners,” or those looking to be mentored, were paired up, and then outlining in detail what they should do once they were in a mentoring relationship (Warner, 2002, March 1). This kind of program would be very useful in a healthcare setting.

Often times, in the real world, everyone seems to be so busy doing their own work, there is little time for a mentoring relationship to develop between individuals. Putting a formal mentoring program in place in a nursing environment would have a beneficial effect on the ability of a new employee to assimilate into an organization. Overall this would increase productivity and decrease dysfunctional behaviors.

At Yale University, they have a mentor-like program for incoming freshman. At most Colleges and Universities freshman are usually housed together in the same dorms. They are separated from the upperclassmen and have to learn about college life from their own experiences for the most part. However, at Yale, each freshman is housed with upperclassmen. In this way, the freshmen are able to learn much faster and assimilate into their new environment. Yale is one of the top Universities in the United States. This organization educates many of our presidents and scientists and serves as a respected leader in education.

In conclusion, nurse managers today have the responsibility to create an environment where people of all ages and cultures can work together productively. This is a challenge, because so many people bring different experiences and expectations to their job. Careful attention to the hiring process will go a long way toward weeding out applicants that have a small chance of fitting in with the company to begin with. Using a personality test and gearing the interview process toward understanding the applicant’s values and goals is the key to a good “fit.” Also, putting in place a mentoring program to help the new employees learn to adjust to the environment will help further the creation of a good team. Mentoring will fill in training gaps as well as teach the new employee the unwritten rules that exist and may take years to discover without this help.

Learning how the organization works from the viewpoint of a seasoned employee will give the new employee a greater advantage over someone who does not have this knowledge. If a manager starts the entire process with a “team” building mentality and directing the team toward mutual goals is the formula for success. If these processes work in the business world, then they should be useful in the healthcare field as well.


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Mcglowan-Fellows, B., & Thomas, C. S. (2004). Changing roles: Corporate mentoring of black
women. International Journal of Mental Health, 33(4), 3-18. Stanley, D. (2010). Multigenerational workforce issues and their implications for leadership in
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