Situation: The nurse is a case manager in a community mental… | 마이메르시 MyMerci
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Nursing Practice V — Care of Clients with Maladaptive Patterns of Behavior; Care of Clients with Life-Threatening Conditions, Acute Multi-Organ Problems, High Acuity and Emergency Situations
문제

Situation: The nurse is a case manager in a community mental health program that a provincial hospital runs with the Rural Health Units (RHUs). The program follows adults with severe mental illness after discharge and works with the municipal health officer, social workers and trained barangay health workers (BHWs). A program nurse and a social worker have argued three times this month over who gets the program's only vehicle on home-visit days. Each has complained separately to the case manager, who coordinates the team. All four actions below are part of resolving the conflict. What should the case manager do FIRST?

해설
Conflict resolution follows an order: first meet the parties privately in a neutral setting and listen to each side to understand the facts and feelings; then define the problem together; then identify interests and generate options; then agree on a solution and follow up. Defining the problem or generating options before hearing each side risks solving the wrong problem.
같은 주제 다음 문제Situation: The nurse works on a 30-bed acute psychiatric unit of a general hospital. The i…이 문제가 수록된 문제집PLNE Question Bank 150014,000원 · 무료 체험 가능

심화 해설

Conflict resolution sequence in interdisciplinary community care

The case manager is facing a classic interprofessional conflict over a scarce resource, the program’s only vehicle. When two team members repeatedly clash and each has already complained separately, the immediate task is not to jump to scheduling or brainstorming. The first step is to gather information privately from each party before bringing them together.

Key point! Conflict resolution is a staged process. Moving to joint problem definition or option generation before hearing each side risks addressing only the surface dispute (the vehicle) while missing the underlying relational or power issue.

In community mental health case management, the nurse coordinates a team that includes a social worker and trained BHWs. The vehicle dispute may look logistical, but repeated arguments suggest deeper concerns: perceived inequity in workload, lack of role clarity, or frustration over who controls scheduling. Power conflict is a recognized source of tension in nursing and interdisciplinary settings [1]. A private, neutral conversation lets each person describe the facts and their feelings without the pressure of the other party present, which reduces defensiveness and allows the case manager to identify interests rather than positions.

Watch out! Calling a joint meeting first can escalate the conflict if one party feels ambushed or if the case manager has not yet clarified what each side actually wants. The private step is not about taking sides; it is about active listening and fact-finding.

The sequence that follows from the correct first action is: after private meetings, the case manager defines the problem together with both parties, then asks them to generate options for sharing the vehicle, and finally agrees on a written schedule with a review date. This mirrors structured conflict coaching and management approaches in which the coach or manager first helps each client understand the conflict before working on interaction strategies [2]. Nurse managers’ communication skills and approaches are central to effective problem solving in organizational conflict [3].

In the emergency department setting, unresolved conflict between providers can impair concentration, reduce trust, and compromise care quality . The same principle applies in community mental health: if the case manager skips the private listening step and immediately imposes a schedule or opens a joint brainstorming session, the team may comply superficially while resentment continues, ultimately affecting patient follow-up and continuity of care.

The first action is therefore to meet each of them privately to hear their side of the issue. Only after both perspectives are understood can the case manager accurately define the shared problem and guide the team toward a workable, reviewed vehicle schedule.
References (research sources)
  • [1]
    Putting conflict management into practice: a nursing case study.Research articleVivar CG (2006) · DOI: 10.1111/j.1365-2934.2006.00554.x
  • [2]
    Conflict coaching training for nurse managers: a case study of a two-hospital health system.Case reportBrinkert R (2011) · DOI: 10.1111/j.1365-2834.2010.01133.x
  • [3]
    Conflict management styles of nurse managers working in inpatient institutions: the case of Turkey.Research articleÖzkan Tuncay F, Yaşar Ö, Sevimligül G (2018) · DOI: 10.1111/jonm.12609

임상 시나리오

Conflict Resolution in Interdisciplinary TeamsPrivate listening precedes joint problem-solving

When team members repeatedly clash over a scarce resource, the case manager should first meet each person privately in a neutral setting to hear their side. This reduces defensiveness and reveals underlying interests rather than surface positions.

The correct sequence is: 1 private listening, 2 joint problem definition, 3 option generation, 4 written agreement, 5 follow-up review.

Caution

Calling a joint meeting or proposing schedules before private fact-finding may escalate conflict and solve only the surface dispute, missing deeper workload or role-clarity issues.

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