# Situation: A 64-year-old man is in the intensive care unit (ICU) on day 2 after emergency intubation for severe community-acquired pneumonia. He is sedated with a propofol infusion and receives mechanical ventilation. His care team includes ICU nurses, a resident, an attending intensivist, respiratory therapists and the hospital dialysis nurses who treat ICU clients. For 2 weeks, ICU nurses and dialysis nurses have argued about who should record hourly fluid removal and answer machine alarms during dialysis in the ICU. Each group says the other is responsible, and the hospital has no written policy on the matter. Both units are fully staffed, and both agree that the recording must be done hourly. Which analysis BEST describes this conflict?

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=630062  
> language: ko  
> subject: 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: A 64-year-old man is in the intensive care unit (ICU) on day 2 after emergency intubation for severe community-acquired pneumonia. He is sedated with a propofol infusion and receives mechanical ventilation. His care team includes ICU nurses, a resident, an attending intensivist, respiratory therapists and the hospital dialysis nurses who treat ICU clients.

For 2 weeks, ICU nurses and dialysis nurses have argued about who should record hourly fluid removal and answer machine alarms during dialysis in the ICU. Each group says the other is responsible, and the hospital has no written policy on the matter. Both units are fully staffed, and both agree that the recording must be done hourly. Which analysis BEST describes this conflict?

## 보기

1. Interpersonal conflict caused by poor communication skills
2. Intragroup conflict caused by differing professional values
3. Intergroup conflict caused by unclear roles and duties **✔ 정답**
4. Intergroup conflict caused by competition for scarce staff

**정답: 3**

## 해설

The dispute is between two departments, which makes it intergroup conflict. Its cause is role ambiguity: the task is shared between the units, yet no policy says who does which part. It is best resolved collaboratively, for example by a joint task force that writes a clear policy for dialysis in the ICU.

## 심화 해설

Conflict Analysis

A conflict between two distinct departments or professional groups—here, ICU nurses and dialysis nurses—is classified as intergroup conflict. The defining feature is not personality clashes or individual communication failure, but a structural problem at the boundary where two units must share a single task.

The precipitating issue is role ambiguity. Hourly fluid removal recording and machine alarm response are tasks that sit at the intersection of ICU nursing care and dialysis nursing care. Both groups agree the recording must be done, and both units are fully staffed, so the dispute is not about workload capacity or scarce personnel. The absence of a written hospital policy means no formal authority assigns the task to one group, leaving each side to assume the other holds responsibility. This is the classic setup for intergroup friction.

When a shared task has no designated owner, each group interprets professional boundaries according to its own norms, and conflict becomes structural rather than interpersonal. The fact that both groups have argued for two weeks without resolution indicates the problem is not a single miscommunication event but a persistent gap in role definition.

Key point! Intergroup conflict caused by unclear roles is best addressed through collaborative policy development—for example, a joint task force with representatives from both units that writes a clear protocol for dialysis in the ICU. Assigning blame to one group or relying on informal negotiation will not resolve ambiguity that originates at the systems level.

The qualitative evidence on critical care nurses managing kidney replacement therapy reinforces why this boundary is prone to conflict. Continuous kidney replacement therapy (CKRT) places substantial technical, cognitive, emotional, and relational demands on critical care nurses [1]. The technology is embedded in the ICU environment, yet the dialysis expertise often resides with a separate dialysis nursing team. When formal training and written protocols are inconsistent, nurses develop informal, experience-based workarounds—learning "while doing" rather than through standardized policy [2]. This informal learning environment can deepen role confusion because each unit develops its own undocumented expectations about who handles which part of the dialysis process.

The absence of formal policy not only creates ambiguity but also forces each group to rely on informal, unit-specific norms that may not align, making intergroup disputes more likely and harder to resolve.

Watch out! Do not confuse this with intragroup conflict, which occurs within a single team. The dispute here is explicitly between two departments, so option 2 is incorrect. Also, because both units are fully staffed and the issue is not about insufficient personnel, option 4 (competition for scarce staff) does not apply. Option 1 (interpersonal conflict) would require the conflict to center on individual communication styles or relationships, but the scenario describes a structural, policy-level gap affecting entire groups.References (research sources)

- [1]Critical care nurses' experiences of managing patients receiving continuous kidney replacement therapy in intensive care units: a qualitative study in Saudi Arabia.Research articleAlmulhim MY, Abdulqader AKA, Badr MN. (2026) · DOI: 10.1186/s12912-026-04793-8

- [2]"We learn while doing": informal training experiences of critical care nurses managing dialysis technologies in intensive care units.Research articleAlmulhim MY, Fakhry SF. (2026) · DOI: 10.1186/s12912-026-04914-3

## 임상 시나리오

ICU-Dialysis Shared Task ConflictResolving intergroup role ambiguity
Conflict between two departments over a shared task with no written policy is intergroup conflict caused by role ambiguity. The dispute is structural, not personal.

Best resolution is collaborative policy development, such as a joint task force with representatives from both units writing a clear protocol for dialysis in the ICU.

CautionDo not assign blame to one group. A persistent 2-week dispute without policy indicates a gap in role definition, not a communication failure.

## 핵심 개념

- **Intergroup conflict** — Conflict between two or more distinct departments, units, or professional groups.
- **Role ambiguity** — Lack of clear definition of responsibilities for a task shared across unit boundaries.
- **Intragroup conflict** — Conflict occurring within a single group or team.
- **Interpersonal conflict** — Conflict between individuals, often related to communication or personality.
- **Joint task force** — Collaborative group with representatives from multiple units to develop shared policy.

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