LAB EXERCISE:  CASE ANALYSIS (CONFLICT IN THE CLINIC)

OBJECTIVES

 In this lab exercise you will:

1. Identify the different types of conflict.
2. Analyze the consequences, both positive and negative, of conflict.
3. Identify the barriers to resolving a conflict.
4. Apply the responses to conflict.
5. Demonstrate strategies used to manage an incivility and bullying incident.

INSTRUCTIONS

1. REVIEW your knowledge concerning Conflict and Bullying
2. READ the case.
3. As a team ,ANALYZE the case.
4. CO-WRITE your responses to the questions.

Part I.

The Case…

Shelby Washington is a 28-year-old gender not identified (they/their/them pronouns) with the date of birth, 4-28-92.  Shelby is visiting the sports medicine clinic for evaluation and treatment of right knee injury and left shoulder injury. Shelby sustained the knee injury one month ago while performing the clean and jerk weightlifting maneuver and continues to have weakness in the knee with weight bearing.  Shelby is training for an upcoming triathlon. Yesterday on a Sunday, Shelby tripped and fell on to their left shoulder while running.  Shelby went to the Emergency Department (ED) after the shoulder injury on the same day and had x-rays of the shoulder and knee which were both negative. The ED discharge instructions were a sling and crutches, RICE, and OTC Ibuprofen.

Shelby has a medical history exercise-induced asthma and a psychiatric history of panic attacks and performance anxiety and thought to be a complication of sexual abuse by a coach.  they have a prescription for an albuterol inhaler and Paxil (paroxetine) 12.5 mg PO daily, but they use these inconsistently.  Shelby reports recreational use of marijuana and alcohol, mostly in social settings.  They have cut back on vaping and a daily Monster; although these helped with focus at work, they seemed to be causing more frequent panic attacks.

Currently, Shelby lives alone in a two-story walk-up apartment.  Shelby has a highly demanding job at the regional office for a US Senator and often works 12 or more hours a day 6-7 days a week.  Shelby commutes to work by using the bus (doesn’t have a car); the commute includes a four-block walk to the bus stop and a four-block walk from the bus stop to the office.  Shelby took one day off from work after trying to make the commute on crutches; but turned around and went home before Shelby got to the bus stop.  None of Shelby’s close friends have cars.  Shelby’s job cannot be done as telework.

Phase 1 Questions.  Before moving on in the case you will stop and review your knowledge concerning conflict.  Answer the following questions concerning conflict for healthcare professionals:

1.What are some of the potential conflicts/issues for her healthcare providers?  List at least 5.

2.Define Task conflict and Relationship conflict.  Then, categorize the conflicts listed in Question #1 by task conflict and/or relationship conflict.

3.In general, what are the positive consequences of conflict?

4.In general, what are the negative consequences of conflict?

5.What are barriers to resolving a conflict?

Part II.

The Case continues…

You are providing/managing/coordinating care to patients at the sports medicine clinic.  You overhear and see this conversation in the supply area of the clinic between three other staff members, the family practice medical resident (Gerry), the nurse (Shawn), and the athletic trainer (Taylor).

Gerry:   “Have you finished the intake for patient SW?  I need to see 3 more patients before I go on-call at the hospital at 5PM.”

Shawn:  “No.  SW is still at the desk.  It seems to be taking a long time to check SW in.  SW is a new patient.  There must be something wrong with SW’s insurance.”

Gerry:   “That can’t be it. Is SW here for pain meds? SW will probably be non-compliant or a psych patient? Or like HH, the hypochondriac, frequent flyer who is here every week for some lame reason.”

Taylor:   “That’s not it.  SW has had an injury while training for a competition.”

Gerry:   “I must be nice to have time to do that kind of thing – I used to have time to swim, but not anymore.”

You, the clinic manager can see by their faces that Shawn and Taylor are disturbed by this comment, but do not respond.

Gerry says “Hi!” with a smile to you as Gerry leaves the room with the lab supplies are needed for patients.  It is two hours later.   Shawn and Taylor come to report the incident and their discomfort with the conversation.

Phase 2 Question.  Before moving on you will review your knowledge of negotiation, and conflict management.  Answer the following question:

6.Describe your interventions for this conflict.

Part III. 

Alternative conflict management…

As the clinic manager, you decide to address this conflict with Shaun and Taylor and discuss their comments about Gerry.  Complete the following:

7.Describe how you would manage this conflict that involves implicit bias.

RUBRIC – Case Analysis (Conflict in the Clinic)