Learning Nurse Newsletter - March 2011

Welcome to the March 2011 edition of the Learning Nurse Newsletter. We have enhanced and expanded our newsletters and will post all future editions on this website. We publish three to four times a year to keep our nurses and other interested parties informed about developments and news at LearningNurse.com. (For more timely updates, follow us on Twitter.)

Conflict happens!Nurses and Conflict

Nurses are no strangers to conflict! A nurse faces conflict every day - with patients and their families, with colleagues and other staff, and with their managers and administrators. More recently, nurses are in fierce battles with their state and national governments who are trying to reduce their wages and benefits to control escalating health care costs.

With all this conflict in their work lives, perhaps it is not surprising that the Conflict Resolution Profile is by far the most popular of all our Personality Diagnostic tests on the Learning Nurse website. We thought it would be interesting to analyze the data that we have collected so far to see how well nurses are coping.

But first a short review. A conflict is an unpleasant situation that arises when two or more people have different opinions on a given subject or issue. Conflict creates an imbalance and discomfort in personal relationships. This is the reason why most of the time people will try and resolve the situation, or at least try and avoid or escape from it.

Our Conflict Resolution Profile measures two scores - Resolution Score (measures positive approaches such as negotiation to resolving conflicts) and Conflict Score (measures the negative ways you tend to handle conflict). The Resolution Score should be higher than the Conflict Score. The maximum score on each is 100%. A "perfect" person in terms of conflict management would have a Resolution Score of "100" and a Conflict Score of "0." But alas, no such nurse exists.

Our analysis shows that nurses appear to be coping fairly well in resolving the conflict in their lives. Of the nurses that self identified in our Conflict Resolution Profile (N=182), the average Resolution Score was 79 and the average Conflict Score was 44. Figure 1 shows the distribution of both scores. Nearly half the nurses fell into the 81 to 100 category for Resolution and another 42% fell into the 61 to 80 category. On the Conflict scores only about 15% were in these two higher categories.

We were curious to see whether there were any differences in the Resolution and Conflict scores based on any demographic variables. There do appear to be a few differences. Female nurses have higher Resolution scores than male nurses (average of 79 for females vs. 74 for males). The distribution of scores comparing gender are shown in Figure 2. However, there were no obvious gender differences in the Conflict scores.


We also found differences in Resolution scores based on how long an individual had been working as a nurse. The average Resolution score for those with 10 years or less of experience was 77, while it was 84 for those who have worked for more than 10 years. It may be that experience teaches you how to better resolve conflicts. There distribution of scores is shown in Figure 3. Again there were no significant Conflict score differences based on years of experience.

We could not detect any obvious differences when we compared those working in a hospital setting to other work locations such as clinics, offices and nursing homes.

Looking through the individual Conflict Resolution Profile questions, we found some interesting results.

Some 38% of the nurses said they "never or rarely" look for another solution if the one found seems ineffective. However, nurses who have worked for 11 to 15 years are most likely to look for another solution (92%), compared to nurses who worked for 21 to 30 years (52%). 

Over half the nurse respondents (54%) said they "never or rarely" are able to apply the agreed solution to settle a conflict. More males (25%) said they "never" are able to apply the agreed solution than females (7%). Those with 26 to 30 years of nursing experiences were most able to apply the solution (61%).

Some 58% of the nurses said they are "never or rarely" are able to negotiate the most appropriate solution. The best negotiators appear to have 21 to 25 years experience (71% are "sometimes" able to negotiate the best solution), followed by those with 26 to 30 years experience (57% said "sometimes").

About a third of the nurses said that they "sometimes" elaborate on all kinds of strategies to prove their point. Males were more likely to do so (43%) than females (32%).

Nearly 75% of the nurses said they "never or rarely" can find the most efficient solution to settle a conflict.

Some 35% of the nurses said they "never or rarely" are willing to admit they are wrong. Those with 5 or less years work experience were least likely to admit they are wrong (58% checked "sometimes").

Nearly half the nurses said they "never or rarely" tackle potential conflicts quickly and try and resolve them before things get worse. Nurses with 5 or less years experience were most willing to tackle potential conflicts (54% said "sometimes").

About 30% of the nurses said they "never or rarely" carefully listen to the other points of view in a conflict situation. Females were more likely than males to listen carefully (73% vs. 47% "sometimes"). Nurses with 26 to 30 years work experience were the best listeners (83% said "sometimes).

These findings suggest that nurses still have some work to do to develop their skills and competences to effectively managing conflict in their workplaces.

Here are some tips for daily actions that will reduce the risk of conflict beginning and escalating:

  • Recognize and admit your mistakes
  • Apologize when you are wrong
  • Clarify situations with simple and honest suggestions
  • Listen to the point of view of others
  • Use humour
  • Share your opinions in a factual manner
  • Do not get emotionally involved in every disagreement or conflict.

Once a conflict results, here are some additional tips for resolving the disagreement efficiently:

  • Determine the nature of the conflict with the facts rather than emotions
  • Initiate the communication
  • Make your point of view clearly and calmly
  • Focus on the conflict that needs to be resolved
  • Confront the problem, not the people
  • Listen attentively to others - have an open mind and tolerance
  • Seek a solution acceptable to all parties by negotiating in good faith
  • Assume responsibility for implementing the solution agreed to by all parties.

Looking at the data presented above, it appears that some nurses have difficulty in following the recommended steps to resolve conflicts.

How do you compare? Take the Conflict Resolution Profile in our Personality Tests page and compare your results to the ones published here. Then work on the skills and attitudes needed to effectively resolve conflict. You will be glad you did as your nursing work will become a little less stressful.

[I know many readers of this Learning Nurse Newsletter are nursing educators and professional associations. Are you doing enough to prepare new and current nurses with the critical conflict resolution competencies to enable them to be successful and satisfied in their careers?]

Learning Nurse Users

Analyzing the Learning Nurse website statistics for 2010, shows the following:

  • 26,200 unique visitors (IPs), growing every month
  • 46,000 visits with 896,000 page views and 86 GB of traffic
  • 24 hour traffic (many from night shifts)
  • 15% spent 30 minutes or more per visit.

The year 2011 promises to be even busier. For example, for the first two months of 2011, the traffic analysis shows the site already had:

  • 9,300 unique visitors
  • 15,700 visits with 298,000 page views and 30 GB of traffic.

The geographical location of visitors was as follows:

 52% from the United States - 40 states with the highest traffic from Vermont (7.9% of US total traffic), California (6.8%), Illinois (5.4%), Pennsylvania (5.1%), Texas (5.1%), Virginia (4.5%), Georgia (4.5%), Connecticut (4.2%), Ohio (4.2%), South Carolina (3.9%), New York (3.8%), Florida (3.7%), Louisiana (3.6%), and Wisconsin (3.3%).

20% from Canada - all 10 provinces with the highest traffic from British Columbia (40% of all Canadian traffic), Saskatchewan (20%), Ontario (14%), Manitoba (10%), Quebec (4%), Alberta (4%) and Newfoundland Labrador (3%).  

8% from the United Kingdom (Great Britain).

7% from Australia with the highest traffic from New South Wales (29% of total Australian traffic), Victoria (25%) Southern Australia (21%), Tasmania (8%) and Queensland (7%).

4% from Philippines, 2% from India, 2% from Saudi Arabia, 1% from New Zealand.

5% from 26 other countries - Malaysia, Jordan, Jamaica, Cyprus, Ireland, etc.  

For the first two months of 2011, traffic analysis shows visitors coming from: United States (54%), Great Britain (15%), Canada (13%), Australia (4%), Philippines (3%), India (2%), Saudi Arabia (2%), New Zealand (1%), and Malaysia (1%). 

The Learning Nurse website has a loyal following with a high rate of repeat visits. This is demonstrated by

  • Some 85% of visitors come directly from a bookmark or URL entry
  • 12% come to the website from a search engine - Google, Yahoo and Bing; "nursing quizzes" is the most common search term with Learning Nurse being listed at the top of these search engines
  • Only 3% of traffic comes from links on other websites
  • Over 134% of visitors bookmark the website.

Despite the fact that our visitors are increasing every month, we are still a long way away from reaching the approximately 5 million English speaking nurses on this planet.

New and Improved

Since the October 2010 newsletter, we have made several additions and changes to the Learning Nurse website. These include:

  • Added some new links in our Library and Resources page about the profession of nursing ... ethics, codes, standards, best practices, etc.
  • Added a Professional Boundaries quiz
  • Updated and expanded two of our Managing Patient Rage quizzes
  • Added two new Diabetic Foot Care quizzes
  • Added two new quizzes on Diabetes
  • Updated our Medical Video Resources page
  • Amalgamated several street drugs related quizzes into one - Street Drugs Facts Quiz.

We now have 104 nursing quizzes with 6,822 questions. However, from our polls nurses say they want even more quizzes!

Quiz Results

As of this writing, some 52,864 Learning Nurse quizzes (with nearly 1.3 million questions) have been completed and recorded. Between 100 to 200 quizzes are completed every 24 hours! The quiz results are tracked on the website in real time, both in a searchable query table, and in a series of statistical reports for each quiz.

The 15 most popular quizzes are: (N)

  • Anatomy Terminology I (3,379)
  • Medical Terminology I (2,987)
  • Disease Terminology I (2,174)
  • Safe Medication Principles (1,735)
  • High Blood Pressure (1,636)
  • Cardiology Terms (1,562)
  • Anatomy Terminology II (1,473)
  • Medical Terminology II (1,344)
  • Medication Abbreviations (1,333)
  • Anatomy and Physiology (1,314)
  • Infection Prevention and Control (1,300)
  • Pediatric Nursing I (1,255)
  • Endocrine System (1,184)
  • Tablet Dosage Calculations (1,103)
  • Disease Terminology II (1,101).

The ten least completed quizzes are: (N)

  • Herb-drug Interactions (17)
  • Suicide Prevention (23)
  • Nasal and Sinus Disorders (31)
  • Rectal Disorders (35)
  • Dizziness (36)
  • Dangerous Drug Combinations (38)
  • Diabetic Foot Care II (40)
  • Limb Pain (41)
  • Ear Pain (44)
  • Confused Drug Names II (46).

The complete list of the Learning Nurse quiz results sorted by descending frequency can be seen here.

Average scores are computed for all of the completed Learning Nurse quizzes. The 15 highest scoring quizzes are: (average percent)

  • Medication Abbreviations (93%)
  • Tablet Dosage Calculations (88%)
  • Injection Dosage Calculations (88%)
  • Fluid Dosage Calculations (87%)
  • Managing Patient Rage (86%)
  • Intravenous Flow Rates (85%)
  • Cardiology Terms (81%)
  • Metric Conversion (78%)
  • Anatomy Terminology II (77%)
  • Ecstasy / MDMA Facts (77%)
  • Antidotes (76%)
  • Anatomy Terminology I (74%)
  • Disease Terminology I (73%)
  • Disease Terminology II (73%)
  • Nicotine Facts (73%).

The ten quizzes with the lowest average scores were:

  • Cancer Risks (36%)
  • Dangerous Drug Combinations (40%)
  • Diagnostic Tests I (45%)
  • Diarrhea (46%)
  • Nutritional Disorders (48%)
  • Diagnostic Tests II (49%)
  • Substance Misuse (49%)
  • Skin Disorders (50%)
  • Mental Status (51%)
  • Herb-Drug Interactions (53%).

The complete list of the Learning Nurse quiz results sorted by descending average scores is available here.


I will be doing two workshops - Use of Interactive Quizzes for Professional Development and Use of Avatars in Nursing Education Simulations - at the Canadian Association of Continuing Health Education (CACHE) / National Continuing Competence Conference (NCCC) to be held in Banff Canada, on April 13-15, 2011. I will also have a poster session on the Learning Nurse. For more information on the CACHE 2011 conference and/or to register, go to http://www.cachecanada.org/  

A copy of my presentation on the Learning Nurse, made at the Canadian Society for Training and Development (CSTD) in Toronto, Canada in November, 2010, is now available for viewing and downloading in our Library.

About Learning Nurse

The Learning Nurse Resource Network (LearningNurse.com) was created by Steppingstones Partnership, Inc. and went online in April 2008. The purpose of this nursing professional development resource is to make available free, informal, accessible and convenient learning opportunities for nurses. Because of the shortage of nurses in many facilities, it is very difficult to get away for traditional courses and workshops. This is particularly true in smaller and rural areas where it nearly impossible to obtain leave and funding to attend professional development events.

Although the Learning Nurse was originally designed for all levels of practicing nurses, it has become popular with nursing students, graduate students and nurses returning from leaves. Many of the visiting nurses take time during breaks in their night shift to review and refresh using our quizzes and e-learning modules.

That's it for now. If you have any questions, comments or suggestions, please let me know. Thanks for your continuing support and interest.

Best regards,

Russ Sawchuk
Webmaster and Editor

Note: Permission is granted to reprint all or part of the information in this newsletter provided that the source – LearningNurse.com – is credited.

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