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Difficult Conversations with Difficult People Conflict Management:

Conflicts of various magnitudes occur frequently. You share a workspace with a colleague who consistently leaves the space disorganized and messy, which seems unprofessional to you since patients are seen in that office. Or a senior colleague insists being the first author on a research paper when you did all the work. In the preoperative area, the anesthesiologist disagrees with your surgical plan in the presence of the patient. A more extreme example would be a disruptive physician who yells or throws charts or instruments.

The frequency of conflict has been measured in several settings. In an observational study of operating rooms, conflicts were described as “high tension events”; in all surgical cases observed there was at least one and up to four high tension events.1 Another study found on average four conflicts per operation emerged among operating room team members.2 In a survey of 5,000 full time employees in nine different countries, 85% of employees dealt with conflict at work to some degree and 29% dealt with conflict frequently or always.3 Another viewpoint focuses upon “toxic personalities” defined as “anyone who demonstrates a pattern of counterproductive work behaviors that debilitate individuals, teams, and even organizations over the long term.”4 Conflict occurs frequently when working with such people. In a survey, 64% of respondents experienced a toxic personality in their current work environment and 94% had worked with someone like that during their career.4 In another study, 91% of nurses reported experiencing verbal abuse.5 The impact of these interactions on mood is significant. In a real-time study, employees recorded interactions with a coworker or superior at four random intervals daily; the employees rated the interactions as positive or negative and recorded their mood. The negative interactions affected the employee’s mood five times more strongly than positive encounters.