From Tension to Confidence: Mastering Conflict and Difficult Conversations in Healthcare

Having difficult conversations is one of more uncomfortable challenges of working in healthcare.

No matter how many complex situations we manage in a day without breaking a sweat, somehow having a tough conversation can feel so much heavier.

These conversations may be with patients, family members, staff or management.  And despite all our training and best intentions, when emotions start running high it can through us off balance

Worse yet, the negative anticipation of having a difficult conversation can have us avoiding the situation all together.

Unfortunately, that doesn’t actually make us feel any better. Our nervous systems just stay amped up.

For me, the hardest part isn’t only the conversation itself, it’s the anticipation. Just knowing I have to address something uncomfortable can make my stomach tighten and my thoughts spin. Honestly, avoidance can feel really tempting.

But as I’ve learned (the hard way), avoiding the situation doesn’t make me feel any better. The tension just lingers. My nervous system stays on high alert and the anxiety continues to build.

On a positive note, there are ways to make these conversations a lot more manageable and less emotionally draining. Here are a few strategies that can help:

1. Tend to yourself first.

   You can’t regulate a situation if you can’t regulate yourself. Pause to check in with yourself. Take a few deep breaths, ground your feet, do a quick stretch. When your nervous system is calm, you’re more capable of listening, thinking clearly, and responding with compassion.

   
   

2. Lead with empathy.

   Acknowledge emotions, both yours and theirs. Yes, even if you don’t appreciate someone’s behavior, they have emotions and feelings too. Tapping into that, seeing their humanity will allow compassion. Phrases like “I can see this is really difficult” or “I understand why you’re upset” can defuse tension and create space for mutual understanding. Take a minute to consider why you are upset AND why they may be upset too.

   
   

3. Listen more than you speak.

   If we share the goal of patient wellness (with the patient themselves, the staff, or the family), then listening is mandatory. If we speak to get our points across without focusing on reaching a solution and supporting wellness, the conversation can be easily slide into an argument. Truly listening and hearing BEFORE considering what you want to communicate can validate the other party and lead to openness.

   
   

4. Strive to be curious, not combative.

   Curiosity turns confrontation into collaboration. How did you get here? What do you both want? Is there something that you haven’t considered, perhaps a new and creative solution?

   
   

5. Set boundaries respectfully.

   If a conversation becomes aggressive or unproductive, it’s okay to pause. Stopping with,  “I want to continue this when we can both speak calmly” protects your emotional energy.

   
   

6. Reflect and debrief.

   After a tough conversation, take time to process what went well and what could be improved. Sit down with piece of paper and take some quick notes or talk it through with a trusted colleague. This can help release emotional residue and give insight into your own emotions and strengths. It allows closure instead of rumination.

7.   Remember your “why.”

At the end of the day, most difficult conversations happen because we care—about our patients, our teams, and the quality of care we provide. Keeping that purpose in mind helps can help us show up with compassion, even when it’s uncomfortable.

Each time I navigate one of these conversations with intention and empathy, I grow a little stronger, a little calmer, and a little more aligned with my purpose. It’s not about having the perfect words, it’s about showing up with presence, compassion and courage. When we do that, we create space for healing—not just for our patients and colleagues, but for ourselves, too.

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Ready to feel more in control when tough conversations arise? Building just this one skill can have a marked impact on resilience protect against burnout. Through personalized 1:1 coaching, I’ll help you develop strategies to communicate effectively, manage emotional triggers, and show up as your best self. Reach out today Megan@NursingBeyondtheJob.com