# Situation: A 30-bed adult medical ward admits many clients with diabetes, liver disease, and thyroid disorders. It uses team nursing: each team has a registered nurse team leader, one or two staff nurses, and a nursing attendant. The head nurse is working to improve how the teams work with the laboratory, pharmacy, and dietary services. Ward nurses and pharmacy staff often argue over who should complete the medication reconciliation of clients transferred from other units. The head nurse gathers these findings: - The arguments began 3 months ago, when a new transfer form was introduced. - The form has a reconciliation box and one signature line, with no label for the department. - The nurse job description and the pharmacist job description both include "ensures medication reconciliation." - A pharmacist was on leave during the first month; pharmacy has been fully staffed since then, and the arguments continue. - Nurses say pharmacy is slow to answer calls during the lunch hour. Which cause of this conflict is MOST evident?

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=630454  
> language: ko  
> subject: Nursing Practice IV — Care of Clients with Problems in Nutrition and Gastrointestinal, Metabolism and Endocrine, Perception and Coordination

## 문제

Situation: A 30-bed adult medical ward admits many clients with diabetes, liver disease, and thyroid disorders. It uses team nursing: each team has a registered nurse team leader, one or two staff nurses, and a nursing attendant. The head nurse is working to improve how the teams work with the laboratory, pharmacy, and dietary services.

Ward nurses and pharmacy staff often argue over who should complete the medication reconciliation of clients transferred from other units. The head nurse gathers these findings:
- The arguments began 3 months ago, when a new transfer form was introduced.
- The form has a reconciliation box and one signature line, with no label for the department.
- The nurse job description and the pharmacist job description both include "ensures medication reconciliation."
- A pharmacist was on leave during the first month; pharmacy has been fully staffed since then, and the arguments continue.
- Nurses say pharmacy is slow to answer calls during the lunch hour.
Which cause of this conflict is MOST evident?

## 보기

1. Scarcity of resources
2. Differences in values
3. Poor communication
4. Role ambiguity **✔ 정답**

**정답: 4**

## 해설

The dispute is about who completes the task, and two findings together explain it: both job descriptions claim the same duty, and the new form gives one unlabeled signature line, so neither department knows whose task it is. The staff shortage ended while the arguments continued, so it is not the cause, and slow calls at lunch would delay contact but would not make the two groups argue over ownership of the task.

## 심화 해설

What the dispute is about
Ward nurses and pharmacy staff argue over who should complete medication reconciliation for transferred clients. The cause of a conflict is found by asking which findings explain the specific disagreement. Two findings together explain it: both job descriptions claim the same duty, and the new transfer form has a single unlabeled signature line, so responsibility for the task is unclear. This is role ambiguity. The arguments began exactly when the form was introduced.

Testing each possible cause against the data
A good conflict analysis checks each cause against the timeline and the facts.

| Possible cause | Evidence | Explains the dispute? |
| --- | --- | --- |
| Scarcity of resources | A pharmacist was on leave in the first month only | No; arguments continued after full staffing |
| Differences in values | Both departments list reconciliation as their duty | No; both value the task |
| Poor communication | Pharmacy is slow to answer calls at lunch | Partly; delays contact but not ownership |
| Role ambiguity | Duplicate job descriptions and an unlabeled signature line | Yes; directly explains who-does-it arguments |

Why the distractors fail
The staff shortage was temporary, and the conflict persisted after pharmacy returned to full staffing, so scarcity cannot be the main cause. Both groups claim the task, which shows they consider it important; nothing suggests they disagree about its value. Slow responses during the lunch hour are a real communication problem, but they would cause delays and frustration, not an argument about which department owns the reconciliation.

Watch out! Exam stems often include several true problems. Choose the cause that explains the specific conflict described, here a dispute over ownership, and use timing to rule out causes that have already ended.

Resolving role ambiguity
The head nurse can work with the pharmacy to clarify responsibilities: define which parts of reconciliation each discipline performs, revise the job descriptions so they do not overlap, and redesign the transfer form with labeled signature lines for each department. Clear roles prevent the conflict from recurring and improve client safety at transfer. Key point! When two groups argue over who does a task and their role documents overlap, the cause is role ambiguity; clarify roles and revise the documents.

## 임상 시나리오

Conflict Over Medication ReconciliationFinding the real cause
Nurses and pharmacy argue over who completes reconciliation. Both job descriptions claim the duty, and the new form has one unlabeled signature line.

This is role ambiguity. The staff shortage ended while arguments continued, both groups value the task, and slow lunch calls do not explain ownership disputes.

Fix: define each discipline's part, revise job descriptions, and label the form's signature lines by department.

## 핵심 개념

- **Role ambiguity** — Uncertainty about who is responsible for a task or what a role includes.
- **Medication reconciliation** — Comparing a client's current medicines with new orders at transitions of care to prevent errors.
- **Scarcity of resources** — A shortage of staff, time, money, or equipment that can cause competition and conflict.
- **Job description** — A document stating the duties, responsibilities, and qualifications of a position.

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