Nursing care
Conflict Resolution: the method, the errors, and the exam
Written and reviewed by Dana Whitfield, RN, MSN · 5 min read · Updated September 2026
Short answer
Resolve conflict by addressing the other person directly and privately, first, before involving anyone else. Going over someone's head is nearly always the wrong option, both in practice and on the exam. State the specific behaviour, its effect, and what you need to change, then listen before proposing a plan.
What the skill is for
Conflict on a unit is not a personality problem to be managed away. It is a mismatch between two people's understanding of a task, a priority, or a boundary, and left alone it degrades handoffs, delays care, and pushes errors into the gaps between people who have stopped talking to each other properly. A nurse who raises a disagreement with the physician about a medication order, who pushes back on an unsafe assignment, or who tells a colleague their documentation was late two shifts running, is not being difficult. They are doing the part of the job that keeps the rest of it safe.
The skill matters because avoidance has a cost that shows up later and worse. A tension that is not named tends to surface as passive resistance, incomplete tasks, or a complaint routed sideways to a manager instead of forward to the person involved. Direct, private, early conflict resolution is cheaper in time and safer in outcome than any version of letting it sit.
The method, step by step
Address it directly and privately first. Find the person alone, not in the corridor with three others in earshot, and raise the issue as close to the event as the shift allows. Open with the specific behaviour and its effect, not a character judgement: not "you never listen" but "the wound dressing wasn't documented, and I couldn't tell if it had been changed on days." State what you need going forward in one sentence.
Then stop talking and listen. The other person may have context you don't: a competing priority, a system failure, an instruction from someone else. Reflect back what you heard before you respond to it, and only then move to a plan both of you can live with — who does what, by when, and how you'll check it worked. Close the loop afterward; a conflict that is 'resolved' but never followed up tends to reopen.
Where it goes wrong
The most common error is skipping the private conversation and going straight to a supervisor, a charge nurse, or a group message. This reads as escalation before negotiation, and it usually damages the working relationship more than the original issue did, because the other person learns about the complaint from someone other than you. Reserve escalation for genuine impasse, safety risk, or a repeated pattern that direct conversation hasn't shifted.
The second error is timing: raising the issue mid-crisis, in front of a patient, or three weeks after the event once the details have blurred and the emotion has hardened into resentment. The third is substituting a vague complaint for a specific one — "you're not a team player" invites defensiveness, where "the 1400 meds were still due at 1530" invites a fix.
Practising it deliberately
This is a rehearsable skill, not a trait you either have or don't. Before a known difficult conversation, write the opening sentence down: the behaviour, the effect, the ask. Say it aloud once before you say it to the person, so the first time you hear it isn't also the first time they hear it.
Debrief afterward, even briefly. Did the private, direct approach get taken as intended, or did it land as an attack despite your wording? Adjust the next opening line accordingly. Nurses who do this repeatedly get faster at reading which of two or three phrasings will land calmly with a given colleague, which is the actual skill underneath the technique.
Applying it on the exam
NCLEX conflict items are prioritisation items wearing a communication costume. Among the answer options, eliminate anything that reports the problem to a third party — charge nurse, manager, physician, risk management — before the nurse has spoken to the colleague directly. That option is almost always a distractor, unless the stem describes an immediate safety threat or a documented pattern that direct conversation has already failed to resolve.
The correct option is usually the one where the nurse addresses the colleague privately, states the specific issue, and proposes or asks about a resolution. Watch for options that sound assertive but are actually accusatory — "tell the aide she is lazy" fails on tone even though it is technically direct. Direct and respectful both have to be true.
A worked example
A stem: a nursing assistant has twice left a patient's call bell out of reach after repositioning, and the nurse discovers it on rounds both times. The options include reporting the assistant to the unit manager, documenting an incident report, ignoring it since it was corrected both times, and speaking to the assistant privately about the specific pattern and the safety risk it creates.
The last option is correct. It names the concrete, repeated behaviour, addresses the person who can actually change it, and does so before involving anyone with disciplinary authority. If a third instance occurred after this conversation, escalation to the manager would then be reasonable — the method allows for it, it just isn't the first move.
The next step on this is the same as on everything else here: answer questions and read the rationales. Our prioritization and delegation practice questions are the closest set to what this page covers.
Common questions
Should I ever go straight to my manager instead of talking to my colleague first?
Only when there is an immediate safety risk, a pattern that direct conversation has already failed to fix, or a power dynamic that makes a private conversation unsafe, such as harassment. Outside those situations, going over someone's head first tends to be read as an ambush and makes the underlying issue harder to resolve.
What if the other person gets defensive as soon as I raise it?
Slow down and check your opening line for judgement words. Restate the specific behaviour and its effect, then explicitly invite their side: 'what happened from your end?' Defensiveness often eases once the person feels heard rather than accused.
How does this differ from assertiveness as a general skill?
Assertiveness is the stance — clear, calm, non-apologetic. Conflict resolution is the sequence you apply it in: private first, specific behaviour named, listening before proposing, and a concrete plan at the end. You can be assertive and still resolve nothing if you skip the listening step.
Do NCLEX questions ever make the 'report it' option correct?
Yes, when the stem specifies an immediate danger, a pattern that direct address has already failed on, or a matter genuinely outside the nurse's authority to resolve, such as suspected abuse. Read the stem for those signals before eliminating the reporting option automatically.
More on prioritization and delegation