Night Shift Leaves Everything: A Conflict Between Two Shifts on an Orthopedic Unit, Answered in the Order a Manager Would Say It
Student Name
American College of Education
NUR4063: Leadership and Management in Healthcare
Module 3 Assignment
Instructor Name
September 21, 2026
The Conflict and Its Sources
On a 26-bed orthopedic surgery unit, the tension between day and night shifts had been building for months. Day nurses said that night shift left baths, dressing changes and discharge paperwork for the morning. Night nurses said that day shift sent up late admissions at 1845, left new post-operative patients without pain medication due at shift change and then complained in the morning about work that had been impossible overnight. In the second week of the month, a day nurse posted a photograph of an unchanged surgical dressing in the unit's informal group chat with the words night shift leaves everything again. A night nurse replied with a comment about day nurses that several colleagues found personally insulting. Within a day, two nurses had asked to change shifts and the charge nurses were avoiding each other at handoff. The unit and staff are composites written for this assignment.
Conflict in health care teams rarely has one cause. Almost et al. (2016) reviewed research on conflict in healthcare teams and grouped its sources into individual factors, such as communication styles, interpersonal factors, such as trust and respect, and organizational factors, such as workload, role ambiguity and structural arrangements like shift handoffs. This conflict has all three. On the surface the dispute is about dressings and paperwork; underneath it is about workload that neither shift controls, roles that were never agreed, and a public message that turned a work problem into a personal one.
Choosing a Conflict Mode
Thomas and Kilmann (1974) describe five modes of handling conflict, arranged by how much a person attends to their own concerns and to the other party's: competing, accommodating, avoiding, compromising and collaborating. No mode is right in every case. Johansen (2012), writing for nurse managers, argues that the choice should depend on what is at stake, the importance of the relationships involved and the time available, and that managers often default to avoidance, which lets conflicts grow.
For the main dispute, the division of work between shifts, collaboration is the right mode. Both shifts have legitimate concerns, the relationships will continue every twelve hours for years, and a solution that only one side accepts would last until the next late admission. Collaboration is slower than a directive, but the problem is one that neither shift can solve alone. Two smaller parts of the conflict call for other modes. The personal insult in the group chat is not a matter for negotiation; the manager must address it directly, which is closer to competing, because a norm of respectful communication is not up for compromise. And the question of the group chat itself, which is not an official hospital channel, can be settled with a quick compromise: the chat stays, but it is not used for work complaints or photographs of patient care. A manager who uses one mode for every part of a conflict usually handles at least one part badly.
The Conversations, in Order
First, the manager met privately with the nurse who posted the insult, on the day she learned of it. She began with the fact rather than a judgment: she had seen the message and several nurses had told her it was hurtful. She asked what had led up to it, listened, and acknowledged that the photograph posted before it had also been unfair. Then she stated the expectation plainly: comments about colleagues as people, rather than about work, are not acceptable on this unit, in any channel. She asked him to take the message down and to speak with the nurse he had insulted, and she documented the conversation. She had the same conversation, adjusted to the facts, with the nurse who posted the photograph. Clark et al. (2011) found that nurse leaders see modeling and directly addressing incivility as central to a civil workplace, and this step comes first because the collaborative conversations that follow cannot work while a personal insult is unanswered.
Second, she met separately with the informal leaders of each shift, one senior nurse from days and one from nights. With each, she asked the same two questions: what does the other shift do that makes your shift harder, and what does your shift do that might make theirs harder? The second question was the important one. Each leader could name a specific practice on their own side, late transfers from the recovery unit for days, and dressings left for the wound nurse's morning round for nights.
Third, she brought both shifts together in two short meetings timed at shift change so that each shift could attend. She opened by stating a shared goal both leaders had agreed to in advance: patients should not wait for care because of the clock. She presented the two lists without names and asked the group to sort the items into three categories: work that belongs to a specific shift, work that belongs to whoever is present when it arises and work that is driven by factors outside the unit, such as recovery room transfer times. That sorting turned an argument about effort into a problem of design.
The Agreement and Its Follow-Up
The joint meetings produced four agreements. Dressing changes due on a surgical day were assigned to the shift on which they came due, with the wound nurse's round reserved for complex wounds. Discharge paperwork began the evening before for any patient with a planned morning discharge. Pain medication due within thirty minutes of shift change would be given by the outgoing nurse before report. And the manager agreed to raise the late recovery room transfers with the perioperative director, because that problem sat outside the unit's control. The last agreement mattered more than it looked, because it showed the staff that the manager would carry the organizational part of the conflict rather than asking the nurses to absorb it.
Resolution was defined in advance so that quiet would not be mistaken for peace. The manager would review three measures over the following eight weeks: the number of surgical dressings documented as overdue at the morning safety huddle, the number of pain medication doses given more than thirty minutes late at shift change and the number of transfer requests between shifts. She would also ask both shift leaders at four and eight weeks whether the agreements were holding. If overdue dressings fell and no further transfer requests were made, the conflict could be considered resolved; if not, the agreements would be revisited rather than enforced harder.
Conclusion
The dispute between day and night shifts on this orthopedic unit began as an argument about unfinished tasks and escalated into personal insult. Handling it well required separating its parts: a breach of respect that the manager addressed directly, a question about a group chat that could be settled quickly and a design problem about shared work that only collaboration could solve. Saying things in the right order, starting with the personal breach and then preparing informal leaders before bringing both shifts together, gave the collaborative work a chance to succeed. The measure of success is not a calmer group chat but fewer patients waiting for care at the change of shift.
References
Almost, J., Wolff, A. C., Stewart-Pyne, A., McCormick, L. G., Strachan, D., & D'Souza, C. (2016). Managing and mitigating conflict in healthcare teams: An integrative review. Journal of Advanced Nursing, 72(7), 1490-1505. https://doi.org/10.1111/jan.12903
Clark, C. M., Olender, L., Cardoni, C., & Kenski, D. (2011). Fostering civility in nursing education and practice: Nurse leader perspectives. Journal of Nursing Administration, 41(7/8), 324-330. https://doi.org/10.1097/NNA.0b013e31822509c4
Johansen, M. L. (2012). Keeping the peace: Conflict management strategies for nurse managers. Nursing Management, 43(2), 50-54. https://doi.org/10.1097/01.NUMA.0000410920.90831.96
Thomas, K. W., & Kilmann, R. H. (1974). Thomas-Kilmann conflict mode instrument. Xicom.
How this NUR 4063 Module 3 example is structured
NUR 4063 Module 3 usually takes up conflict, with a scenario answered in the order you would say it; your classroom's instructions set the scenario and whether a script or a narrative is expected. This example describes the conflict and its sources before proposing anything, names the conflict modes available and why collaboration fits the main dispute while two other modes fit smaller parts of it, and then writes the manager's actual conversations in sequence: with each shift's informal leader, with both shifts together, and with the one nurse whose message crossed a line. It closes with how the manager will know the conflict is resolved rather than merely quiet.
NUR4063 Module 3 questions, answered
What does NUR4063 Module 3 usually ask for?
NUR4063 Module 3 usually focuses on conflict management, often through a workplace scenario the student analyzes and resolves. Many sections expect the conflict's sources to be identified, a conflict management approach to be chosen and justified, and the actual steps or conversations to be described in order. Your classroom's instructions decide the scenario and the format.
Which conflict mode should a nurse manager use?
It depends on the part of the conflict. Collaboration suits shared problems where relationships will continue, a direct competing approach suits breaches of basic standards such as disrespect, and compromise suits minor issues that need a quick answer. Using the Thomas-Kilmann modes to explain why each choice fits is usually what earns the analysis marks.
Why does the order of conversations matter?
Because some problems block others. A personal insult left unaddressed will poison a group meeting about workload, and a joint meeting held without preparing informal leaders often turns into a repeat of the argument. Writing out the sequence and explaining why each step comes where it does shows the practical judgment this module is assessing.
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