Feature
When Departments Clash
5 Steps to Smoothing Workplace Conflict
Like siblings in a crowded house, sometimes hospital departments just don’t get along. Each department, shift, and area has its own culture, rhythms, expectations, and unwritten rules. When they don’t mesh, the result is friction and irritation on all sides.
If you’ve been a nurse long enough, you’ve probably seen lots of conflicts like that.ICU snaps at the ED for “dumping patients”; med-surg grumbles that ICU always wants everything just so before a transfer; day shift thinks the night shift must be on a totally different planet, and vice versa.
On it goes, round and round. Eyes are rolled, tempers flare, and blood pressures rise. Occasionally, you end up with a full-scale feud.
Calling a Ceasefire
The truth is, no matter what floor, department, or shift we’re on, we all come to work for the same reason: to care for patients and improve their lives. When we butt heads or go to war with each other, it’s the patients who end up suffering. Nobody wants that, which makes it that much more crucial for us to work out our differences.
If we want things to work better, we need to focus on mutual understanding and better communication. Here are some ways to do that.
1. Understand Each Other’s Worlds
Sometimes, departments or shifts really ARE like different planets. Patient mix, patient flow, and the pace and tone of care might be about as similar as Mars and Venus.
The best way to understand where another unit is coming from is to spend a day shadowing them. You may come away with a whole new perspective on what you thought were annoying eccentricities.
Seeing the world through somebody else’s lens builds empathy, and empathy makes teamwork and conflict resolution a whole lot easier.
2. Communication Is Everything
Let’s face it: most departmental drama is caused by poor communication. When nurses call report and feel rushed, dismissed, or ignored, frustration builds. When a unit doesn’t get the full story, trust erodes.
Communication isn’t just about rattling off information — it’s about tone, clarity, and respect. Got a patient with a presenting problem you haven’t figured out? Saying, “Here’s what I’m seeing and what we’ve already done” will land a whole lot better than, “I don’t know, you figure it out.”
One easy fix for communication snarls: Assume competence and good intent, even if you’re annoyed. Chances are, that nurse from another floor isn’t actually lazy, picky, or determined to make your life harder. They might have facts about the situation that you don’t.
Clear, respectful communication helps you bridge that gap, so that, “Ugh, why do they always do that?” becomes, “How can we help each other get what we need?”
3. Leaders Set the Tone
Departmental culture starts at the top, and leaders set the tone, good or bad. Often, a nurse leader feels like a “mother hen” protecting their staff. That’s important, but if protectiveness turns into territoriality, that can quickly become contagious.
When managers and charge nurses model respect and collaboration, their teams notice. If leaders vent about another shift or bash another department, their teams notice that too.
If leaders build bridges instead of walls, everyone else will follow.
4. Build Relationships
Talking about teamwork is nice, but real change takes action. Here are a few “relationship-building exercises” that actually work
- Joint education and skills fairs: Bring staff from different departments together for learning. Shared knowledge builds mutual respect.
- Simulation labs: Nothing builds trust faster than running a code together in a sim lab. The stakes are low, but the teamwork value is high. Once you’ve practiced side-by-side simulation, it’s easier to work together under pressure.
- Departmental intramurals: Yes, softball counts as team-building. A little friendly competition outside the hospital puts us all on the same team. Plus, who doesn’t want to see the OR staff try to outrun L&D after a 12-hour shift?
These kinds of team interactions remind us that we’re not just coworkers, we’re partners.
5. Focus on the Common Goal
At the end of the day, every department wants the same thing: safe, effective, compassionate patient care. Sometimes, that gets lost in the shuffle of short staffing, long shifts, and caffeine-fueled chaos, but it’s true all the same.
When conflicts arise, take a breath and ask, “What’s best for the patients right now?” That is the surest way to cut through the hostility and get everybody back on the same side of the table.
The Final Takeaway
Hospitals really can be a lot like families: big, loud, occasionally dysfunctional, but ultimately full of people who care deeply. Departments and shifts will aways have their differences, but that’s okay. We each bring unique strengths and perspectives to patient care, from critical care to long-term healing.
So, let’s end the turf wars, try hard to see each other’s point of view, and make a point of communicating better. Leaders, let’s lead with respect, and never underestimate the power of shared simulations, shared laughter, and shared food — plus maybe a softball game or two.
SIDEBAR
Empathy and Ice Cream
Our ED went through a stretch where getting our patients admitted upstairs to med-surg-tele felt like a hostage negotiation. I had four nurses in a row come to me saying, “I still can’t get anyone up there to take report.” Every time we called, there seemed to be some new obstacle. I could feel my department getting frustrated.
I decided to call the unit supervisor directly and ask her point-blank, “What is happening over there tonight?”
“Murphy’s Law,” she said. “Literally everything that could go wrong has gone wrong.” She gave me a quick rundown; she wasn’t exaggerating. While we were drowning, their ship was sinking.
After I got off the phone, I gathered the ED team and said, “Listen, we still need to move patients because our waiting room looks like Costco on Black Friday, but med-surg-tele is getting crushed tonight, so let’s give them a little grace.”
There was some scoffing, but one nurse had an inspired idea: “The grocery store doesn’t close till midnight. We should buy them ice cream floats.”
So, in the midst of an objectively terrible shift, a few of us ran out for ice cream and root beer, and we went upstairs with the universal nursing peace offering: sugar.
It sounds ridiculous, but it changed something. We stopped seeing each other as obstacles and started seeing each other as colleagues, surviving a bad night together. ■
TYLER MCCULLOCH, RN, MSN, MICN, is an emergency nurse and trauma analyst. He serves as president of the Inland Empire chapter of the Emergency Nurses Association, and is a past president of California ENA.
In this Article: Leadership and Management
