# Team members disagree about a client's care plan. Which nursing behaviors promote safe conflict resolution and collaboration? Select all that apply.

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=368576&lang=en  
> language: en  
> subject: Assignment/Delegation/Supervision  
> category: MOC

## Question

Team members disagree about a client's care plan. Which nursing behaviors promote safe conflict resolution and collaboration? Select all that apply.

1

Use a huddle, debrief, or interprofessional round to raise concerns, agree on the care plan, and document assigned actions and follow-up

2

Complain about the coworker to uninvolved staff or post about the behavior on social media without naming the client before speaking with the coworker

3

Yield to the most senior team member whenever disagreement occurs because preserving harmony takes priority over raising a client-safety concern

4

Settle the interpersonal conflict at the bedside in front of the client and family so the team demonstrates accountability in real time

5

After the immediate clinical issue is safe, speak privately and assertively with the coworker, describe the observed behavior, and use an 'I' statement to discuss its effect

6

For an unresolved safety concern, use TeamSTEPPS CUS language: 'I am Concerned. I am Uncomfortable. This is a Safety issue.'

## Explanation

Structured huddles, debriefs, and interprofessional rounds help the team raise concerns, build a shared plan, and assign follow-up (Choice 1). Address a coworker privately with specific, respectful, assertive language and an 'I' statement after the immediate clinical issue is safe (Choice 5). TeamSTEPPS CUS language clearly escalates an unresolved safety concern: 'I am Concerned. I am Uncomfortable. This is a Safety issue' (Choice 6). Complaining to uninvolved staff or posting on social media undermines trust and does not resolve the conflict (Choice 2). Yielding to hierarchy can compromise professional accountability and client safety (Choice 3). Personal conflict should not be argued in front of the client and family (Choice 4).

## In-depth explanation

Conflict Resolution Strategies
1. Avoidance: ignore the conflict — short-term peace, long-term resentment; rarely appropriate alone
2. Accommodation: yield to the other party — useful when the issue is minor or relationship matters more
3. Competition: assert one's position — useful in emergencies or when ethical principles are at stake
4. Compromise: each side gives up something — quick, partial satisfaction
5. Collaboration: work together for a win-win — best for important issues with time

TeamSTEPPS Communication Tools
- CUS: Concerned → Uncomfortable → Safety issue (graduated escalation)
- DESC: Describe, Express, Specify, Consequences (assertive feedback)
- SBAR: Situation/Background/Assessment/Recommendation
- Two-challenge rule: if first concern is dismissed, voice it twice; then escalate
- Huddle, brief, debrief: structured team check-ins

Direct Communication Principles
- "I" statements not "You" attacks ("I felt..." vs "You always...")
- Private and timely
- Focus on behavior, not personality
- Listen + ask + clarify before judging
- Document if pattern continues

Triangulation (Avoid)
Discussing the conflict with uninvolved coworkers instead of the involved person. Damages team trust, bypasses the issue, and creates a culture of gossip. Manager involvement is appropriate AFTER direct attempts fail.

Memory Tip
"Direct + Private + I-statement; Use CUS for safety; No bedside or break-room drama"

## Clinical scenario

Scenario
Busy unit; interpersonal conflict + care-plan disagreements; nurse navigating evidence-based resolution.

Action Map
1. Direct + private + assertive with "I" statements
2. CUS for safety concerns: Concerned → Uncomfortable → Safety issue
3. Two-challenge rule if dismissed; escalate chain of command
4. Use huddle/debrief/IP rounding to align team plan
5. Document; follow up

Avoid
- Triangulation (gossip to uninvolved staff)
- Avoidance / yielding to seniority on safety issues
- Confrontation in front of client/family
- Personality attacks; "You always" statements

## Key concepts

- **TeamSTEPPS / CUS Framework** — Evidence-based teamwork system from AHRQ for healthcare. Core communication tools include SBAR, Call-out, Check-back, Handoff, and the CUS framework: I am Concerned → I am Uncomfortable → this is a Safety issue. CUS provides graduated, respectful escalation when clinical safety is at stake. Two-challenge rule: voice a concern at least twice; if still dismissed, invoke the chain of command. Huddle, brief, and debrief structure team check-ins.
- **Conflict Resolution Strategies** — Five common strategies (Thomas-Kilmann): Avoidance (ignore), Accommodation (yield), Competition (assert), Compromise (mutual concession), Collaboration (joint problem-solving). Collaboration is generally preferred for important issues with adequate time; Competition may be appropriate in true emergencies or when ethical principles are non-negotiable; Avoidance and Accommodation are appropriate for trivial issues or short-term de-escalation but become harmful when used chronically for substantive concerns.
- **Triangulation in Team Communication** — Discussing a conflict or grievance with uninvolved coworkers (or on social media) instead of addressing the involved person directly. Damages team trust, bypasses problem-solving, creates culture of gossip, and may violate professional codes. Standard practice: address the involved person directly and privately first whenever safe; involve a manager only after direct attempts have been made or when the behavior threatens client safety. Never venti about colleagues in client-facing or public spaces.

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