What prompted you to pursue a career in peer mediation?

My plan was always to become a more specialized nurse. Because I was already involved in family counseling, acquiring specialized education and becoming a mediator was the natural course for me to take. Because I regarded the peer mediation approach to be a less adversarial and more collaborative approach than family counseling, I chose to specialize in peer mediation.

In addition, in the 1990s the insurance companies began to restrict payment for nurse therapists and it was clear that this change in reimbursement would present professional and financial barriers [if I remained] a nurse therapist.

One day, during a brainstorming session, a committee was looking for ways to develop a more respectful workplace. I suggested peer mediation and this idea was so well-received that I became the director of peer mediation. Our workplace, which consists of 22,000 employees, was receptive to the implementation of peer mediation and became the only health care system in the United States to utilize this process.

Within one year, our peer mediation program was in place companywide.

Describe peer mediation.

Peer mediation is an alternative dispute resolution process facilitated by peers of the involved parties. It is an opportunity for employees to deal with conflict or problems or workflow issues while a mediator controls the process, assuring everyone involved will be respectful.

The peer mediation process is voluntary and confidential-two key factors that make this approach so successful. No one is mandated to attend. No reports are made to anyone.

People respond well to the peer mediation approach: employees don't know how to deal with conflict, managers don't want to deal with conflict and doctors don't want to deal with conflict, so peer mediation offers a successful and much-needed alternative for problem resolution.

Peer mediation is successful because it works, and it works because it assists the parties to move to resolution. Employees can't do this on their own; they don't know how, and they're afraid to try it alone. The triumph is in that each person leaves the peer mediation session with a better understanding of each another, which is a success in itself.

Share your most interesting and challenging peer mediation case(s).

My most interesting peer mediation case was over a toilet! Two departments, one toilet. The issues were who should be using the toilet, how long certain individuals were using the toilet and to which department the toilet belonged.

It may sound amusing, but these issues were causing conflict between two departments. We held a peer mediation session involving eight or nine people and two mediators and after one two-hour session the conflict was resolved. Six years later, the agreement is still holding.

My most challenging case involved an open-heart team whose members were no longer talking to one another. Communication consisted of writing a message on a board. The issue involved turf disputes between nurses and technicians and physicians, in addition to workflow issues and personality conflicts. The team had fallen apart.

Nine people met for a four-hour session on a Saturday. The session included four RNs, four ORTs and a nurse manager. At the end of the session, the parties had agreed to a number of ways to communicate better and more respectfully.

What is the greatest challenge you face as a peer mediator?

Persuading people before they participate that the process will be worth their while and that they will be safe. They're afraid. They think of peer mediation as a last-chance effort when it really is often the first step toward problem resolution. Getting the parties to trust before they come to the table-that it is worth their while-is the greatest challenge I face. Employees are assured that they have the power to stop the mediation at any time without having to disclose any reason why they are doing so.

How have your nursing skills and clinical background contributed to your career as a peer mediator?

The issues that come to the table are health care-related issues or problems that involve health care personnel. All 22,000 of us at [Allina's] Mercy Hospital and the Allina Health System are delivering or supporting health care. That's our commitment.

Being a nurse mediator gives me the opportunity to utilize the nursing process in a different setting. I also offer training courses for others within the organization to assure that a group of housekeepers or dietitians or respiratory therapists has a mediator who is not only familiar with the problem coming to the table, but the entire medical system as well. This departmental and companywide knowledge is a primary advantage for mediating.

As a nurse mediator, I am also responsible for ensuring the quality of our mediation program and implementing continuing education opportunities for employees.

What advice do you have for nurses interested in peer mediation?

Think outside the box! The glory of nursing is the ability to create unique practice opportunities. Don't be afraid to try something new. Don't be afraid to suggest something. Peer mediation is an inspiring and energizing process for participants. In fact, once employees have participated in a peer mediation session, many really want to become mediators themselves!

There are six qualifications I recommend for nurses who are interested in pursuing a career as a nurse peer mediator: integrity, respect from others, effective listening skills, excellent speaking skills, a desire to help, and the time and availability to actively participate in the mediation process.