# Situation: The nurse is a staff nurse on an inpatient psychiatric unit. The unit team of psychiatrist, nurses, psychologist, social worker and occupational therapist meets weekly to review care plans and to settle disagreements about unit routines. A staff nurse and the unit's occupational therapist have argued for weeks about scheduling group activities. The head nurse asks a neutral nurse supervisor to meet with them. The supervisor helps the two talk through their interests and reach their own agreement but does not impose a decision. Which conflict-resolution approach is this?

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> 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: The nurse is a staff nurse on an inpatient psychiatric unit. The unit team of psychiatrist, nurses, psychologist, social worker and occupational therapist meets weekly to review care plans and to settle disagreements about unit routines.

A staff nurse and the unit's occupational therapist have argued for weeks about scheduling group activities. The head nurse asks a neutral nurse supervisor to meet with them. The supervisor helps the two talk through their interests and reach their own agreement but does not impose a decision. Which conflict-resolution approach is this?

## 보기

1. Arbitration
2. Smoothing
3. Compromising
4. Mediation **✔ 정답**

**정답: 4**

## 해설

In mediation a neutral third party helps the parties communicate and reach their own agreement; the mediator does not decide. In arbitration the neutral party hears both sides and makes the decision for them.

## 심화 해설

Core Concept: Mediation vs. Arbitration

The scenario describes a neutral nurse supervisor who facilitates communication between the staff nurse and the occupational therapist, helping them articulate their underlying interests and guiding them toward their own mutually acceptable solution. The supervisor does not impose a decision. This is the defining feature of mediation.

In arbitration, the neutral third party listens to both sides and then renders a binding or authoritative decision for them. In mediation, the neutral third party manages the process but the parties retain decision-making authority. The question hinges on this distinction: the supervisor “helps the two talk through their interests and reach their own agreement but does not impose a decision.”

Mediation is a process in which a neutral third party assists disputing parties to communicate, clarify their interests, and voluntarily reach their own agreement; the mediator has no authority to decide the outcome. Arbitration, by contrast, transfers the decision-making power to the third party.

| Feature | Mediation | Arbitration |
| --- | --- | --- |
| Role of neutral third party | Facilitates dialogue, clarifies interests, manages process | Hears evidence and arguments, then makes the decision |
| Who decides the outcome | The parties themselves | The arbitrator |
| Authority of third party | No decision-making power | Binding or authoritative decision |
| Focus | Interests, communication, relationship preservation | Rights, facts, a final ruling |

Key point! The phrase “reach their own agreement” is the decisive clue. If the supervisor had made the scheduling decision, the approach would be arbitration. If the supervisor had minimized the disagreement or encouraged one party to yield for harmony, it would be smoothing. If each side gave up something to meet in the middle, it would be compromising.

Why This Matters in Interprofessional Teams

Conflict within healthcare teams is a consistent and unavoidable reality, arising from interpersonal relationship strain, role ambiguity, and differences in professional perspectives [2]. On a psychiatric unit, the nurse and occupational therapist each bring distinct disciplinary priorities to the question of group activity scheduling. Unresolved interprofessional conflict negatively affects staff relationships, stress, retention, and ultimately patient care quality [2].

Mediation is particularly well suited to interprofessional disputes because it preserves the ongoing working relationship. Unlike arbitration, which can leave one party feeling defeated and resentful, mediation encourages mutual role respect and collaborative problem-solving. The literature on interprofessional team conflict emphasizes that resolution approaches should address the relational and communicative dimensions of conflict, not merely the substantive issue [1].

Distinguishing Mediation from Related Approaches

Nursing students and new nurses often confuse mediation with compromising or smoothing. The table below clarifies the differences.

| Approach | Neutral third party? | Who decides? | Key characteristic |
| --- | --- | --- | --- |
| Mediation | Yes | The parties themselves | Facilitates communication; no imposed decision |
| Arbitration | Yes | The third party | Hears both sides and decides for them |
| Compromising | Not required | The parties | Each side gives up something to reach a middle ground |
| Smoothing | Not required | One party yields | Emphasizes harmony; downplays the disagreement |

Watch out! The presence of a neutral third party is not unique to mediation; arbitration also involves a neutral third party. The critical difference is whether that third party decides the outcome. In this scenario, the supervisor explicitly does not impose a decision, which rules out arbitration.

Clinical Application for Nursing Practice

Mediation skills are increasingly recognized as valuable for nurses, particularly in settings where family disputes or interprofessional tensions arise . The ability to facilitate dialogue without taking sides or imposing solutions supports a healthier work environment and models collaborative practice for the entire team. For a nursing licensure examinee, recognizing the defining features of mediation—neutral facilitation, party-driven outcome, and absence of imposed decision—is essential for questions on conflict resolution, leadership, and management of care.References (research sources)

- [1]Interprofessional Team Conflict Resolution: A Critical Literature Review.Research articleOrchard C, King G, Tryphonopoulos P, Gorman E, Ugirase S, Lising D (2024) · DOI: 10.1097/CEH.0000000000000524

- [2]Conflict management: importance and implications.Research articleMcKibben L (2017) · DOI: 10.12968/bjon.2017.26.2.100

## 임상 시나리오

Mediation on the Inpatient UnitNeutral facilitation without imposing a decision
In mediation, a neutral third party helps staff members communicate their interests and reach their own agreement. The mediator manages the process but has no decision-making authority.

This differs from arbitration, where the neutral party hears both sides and then makes the decision for them. The key question to ask is: Who decides the outcome?

CautionDo not confuse mediation with arbitration. If the neutral party imposes a solution, it is arbitration, not mediation. In mediation, the parties retain ownership of the resolution.

## 핵심 개념

- **Mediation** — A conflict-resolution process in which a neutral third party facilitates communication and helps parties reach their own voluntary agreement without imposing a decision.
- **Arbitration** — A conflict-resolution process in which a neutral third party hears both sides and then makes a binding or authoritative decision for the parties.
- **Smoothing** — A conflict-resolution style that emphasizes common interests and minimizes differences to reduce emotional tension.
- **Compromising** — A conflict-resolution style in which each party gives up something to reach a mutually acceptable middle ground.

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