# Situation: A nurse is the charge nurse of a 20-bed pediatric ward staffed by registered nurses, nursing attendants, and nursing students on clinical duty. The next day, the charge nurse meets the two staff nurses to resolve their disagreement about the feeding schedule. In what order should she carry out these steps? 1. Agree with both nurses on who will do what and by when 2. Listen privately to each nurse's side 3. Generate options that meet both nurses' interests 4. Define the problem together with both nurses

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> subject: Nursing Practice II — Maternal and Child Health Nursing

## 문제

Situation: A nurse is the charge nurse of a 20-bed pediatric ward staffed by registered nurses, nursing attendants, and nursing students on clinical duty.

The next day, the charge nurse meets the two staff nurses to resolve their disagreement about the feeding schedule. In what order should she carry out these steps?
1. Agree with both nurses on who will do what and by when
2. Listen privately to each nurse's side
3. Generate options that meet both nurses' interests
4. Define the problem together with both nurses

## 보기

1. 4, 2, 3, 1
2. 2, 3, 4, 1
3. 2, 4, 3, 1 **✔ 정답**
4. 4, 3, 2, 1

**정답: 3**

## 해설

A manager resolving a staff conflict first listens to each side privately and neutrally to understand facts and feelings. The parties then define the problem together, separating people from the issue, and generate options based on interests. They finish by agreeing on who does what by when, followed by a follow-up review.

## 심화 해설

Conflict Resolution Sequence

When two staff nurses disagree about a feeding schedule, the charge nurse is not simply refereeing an argument—she is managing a process that must protect both the working relationship and patient care. The correct order is 2, 4, 3, 1: listen privately to each nurse, define the problem together, generate options that meet both nurses’ interests, and then agree on who will do what and by when.

The first step is always private, neutral listening with each nurse separately. This is not a formality. In a pediatric unit, feeding schedules directly affect medication timing, blood glucose monitoring, and parent involvement, so each nurse may be defending a legitimate clinical concern rather than being “difficult.” Listening privately allows each person to state facts and feelings without the pressure of the other party interrupting or escalating. A systematic review of nurse managers’ conflict management competency identifies active listening and emotional self-regulation as foundational characteristics of effective conflict resolution [2]. The manager who skips this step risks defining the problem based on assumptions rather than the actual interests of each nurse.

Only after both sides have been heard does the charge nurse bring the two nurses together to define the problem jointly. This is the “separating people from the issue” principle. The problem is not “Nurse A is rigid” or “Nurse B is careless”; the problem is that the current feeding schedule does not reliably meet the needs of the patients on the unit. Evidence from conflict management implementation projects in pediatric inpatient settings emphasizes that constructive resolution requires a shared, objective understanding of the issue before any solution is proposed [1]. Defining the problem together also reinforces that both nurses are collaborators, not opponents.

Once the problem is clearly defined, the next step is generating options based on interests, not positions. A position is “my schedule must stay exactly as it is”; an interest is “I need to ensure the infant with hypoglycemia risk is fed on time” or “I need to avoid clustering all feeds during the busiest medication hour.” Exploring interests opens up multiple possible schedules, role adjustments, or communication tools that neither nurse may have considered alone. The nursing case study literature on conflict management highlights that early, structured intervention focused on underlying interests prevents escalation into power struggles and staff stress .

The final step is agreeing on who will do what and by when. This transforms a discussion into an actionable plan. In a 20-bed pediatric ward, the agreement might specify that Nurse A will update the feeding board by 0700 each shift, Nurse B will flag high-risk patients during handoff, and both will review the revised schedule after three days. Without this concrete commitment, even a well-facilitated conversation can dissolve into good intentions with no change in practice. The follow-up review is implied in this step—the “by when” creates a natural checkpoint for the charge nurse to reassess whether the conflict has truly resolved or needs further intervention.

| Step | Action | Why This Order |
| --- | --- | --- |
| 2 | Listen privately to each nurse | Gather facts and feelings without confrontation; builds trust and identifies true interests |
| 4 | Define the problem together | Separates people from the issue; creates shared understanding before solutions are attempted |
| 3 | Generate options meeting both nurses’ interests | Moves from positions to interests; expands possible solutions before narrowing down |
| 1 | Agree on who does what and by when | Converts discussion into a concrete, accountable plan with a built-in follow-up point |

Watch out! A common error is to jump directly to generating options or demanding agreement before the problem has been jointly defined. If the charge nurse skips private listening, one nurse may feel unheard and resist any proposed solution. If she skips joint problem definition, the two nurses may be solving different problems entirely.

Key point! The sequence is not arbitrary—it mirrors the nursing process itself. Assessment (listen privately) precedes diagnosis (define the problem), which precedes planning (generate options), which precedes implementation (agree on actions). The same logic that guides patient care guides conflict resolution among staff.References (research sources)

- [1]Conflict resolution in a pediatric inpatient unit: a best practice implementation project.Research articleSinclair J, Palokas M (2023) · DOI: 10.1097/XEB.0000000000000364

- [2]Characteristics of Nurse Managers' Conflict Management Competency. A Systematic Review.Meta-analysis/systematic reviewGonzález-García A, Pinto-Carral A, Marqués-Sánchez P, Quiroga-Sánchez E, Bermejo-Martínez D, Pérez-González S (2025) · DOI: 10.1111/jan.16600

## 임상 시나리오

Staff Conflict Resolution SequenceCharge nurse steps for resolving feeding schedule disagreement
Begin with private, neutral listening with each nurse separately. This allows each person to share facts and feelings without interruption, revealing legitimate clinical concerns such as medication timing or blood glucose monitoring that may be driving the disagreement.

Then bring both nurses together to define the problem jointly, applying the principle of separating people from the issue. Frame the problem around the feeding schedule itself, not personal traits like rigidity or carelessness.

Next, generate options that address both nurses' underlying interests. In a pediatric ward, options must also protect patient safety and parent involvement, not just staff preferences.

Finish by agreeing on who will do what and by when, followed by a scheduled follow-up review to evaluate whether the agreement is working in practice.

CautionSkipping private listening risks defining the problem from assumptions rather than actual interests. Jumping to options before joint problem definition may produce solutions that fail to address the real clinical concern.

## 핵심 개념

- **Conflict Resolution** — A process of addressing disagreements through structured communication, active listening, and collaborative problem-solving to reach a mutually acceptable agreement.
- **Active Listening** — A communication technique where the listener fully concentrates, understands, responds to, and remembers what is being said, without judgment or interruption.
- **Interest-Based Negotiation** — An approach that focuses on underlying needs and concerns of parties rather than their stated positions, seeking options that satisfy mutual interests.
- **Separating People from the Problem** — A conflict resolution principle that addresses the substantive issue without personal attacks or blame, maintaining the working relationship.
- **Follow-up Review** — A scheduled check-in after an agreement is implemented to evaluate effectiveness and make adjustments as needed.

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