# 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. The head nurse meets the dietary supervisor, who says, "We can deliver breakfast trays to your ward only at 07:30, not earlier." The ward wants trays at 07:00. Which response by the head nurse BEST applies principled negotiation?

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=630455  
> 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.

The head nurse meets the dietary supervisor, who says, "We can deliver breakfast trays to your ward only at 07:30, not earlier." The ward wants trays at 07:00. Which response by the head nurse BEST applies principled negotiation?

## 보기

1. If trays cannot come at 07:00, I will report the delay to the chief of hospital.
2. Our ward has always received its trays at 07:00, so we need that time back.
3. What makes 07:30 necessary for you? We need meals to match morning medicines. **✔ 정답**
4. Let us meet halfway and set every tray for 07:15 starting tomorrow morning.

**정답: 3**

## 해설

Principled negotiation separates the people from the problem and focuses on interests rather than positions. Asking what lies behind the other side's time and stating the ward's own underlying need opens options for mutual gain, such as sending early trays only for the clients who need them.

## 심화 해설

Principled negotiation
Principled negotiation, developed in the Harvard Negotiation Project, rests on four principles: separate the people from the problem, focus on interests, not positions, invent options for mutual gain, and use objective criteria. A position is what a party says it wants (trays at 07:30, trays at 07:00). An interest is the reason behind it. Asking what makes 07:30 necessary and stating the ward's own need, meals matched to morning medicines, moves the discussion from positions to interests.

Why interests open options
Once interests are on the table, solutions appear that neither position offered. The dietary service may need 07:30 because of staffing, kitchen preparation time, or the delivery route. The ward needs meals timed for medicines that must be taken with or after food, such as some antidiabetic drugs. Knowing both, the parties might agree to send early trays only for the clients who need them, or to adjust medication times where clinically safe. Both sides gain, and the working relationship is preserved.

| Response | Approach | Principled? |
| --- | --- | --- |
| Report the delay to the chief of hospital | Threat; contest of power | No |
| We always received trays at 07:00 | Restates a position based on past practice | No |
| What makes 07:30 necessary? We need meals to match medicines | Explores interests on both sides | Yes |
| Meet halfway at 07:15 | Splits the difference between positions | No; a quick compromise |

Why the other responses fall short
A threat attacks the other party and turns the talk into a contest, the opposite of separating people from the problem. Insisting on past practice restates a position without explaining the underlying need, so the other side has nothing to work with. Meeting halfway at 07:15 is a compromise on positions; it skips finding interests and may satisfy neither side, for example if the ward's diabetic clients still need earlier meals.

Watch out! Compromise often looks fair and collaborative, but in principled negotiation the goal is a solution that meets the underlying interests, not simply the midpoint between two positions.

Exam takeaway
Key point! Principled negotiation separates people from the problem and focuses on interests rather than positions; an open question about the other side's needs is the first step.

## 임상 시나리오

Principled NegotiationBreakfast tray timing
Positions: dietary says 07:30; the ward wants 07:00. Interests: the kitchen's constraints and the ward's need to match meals to morning medicines.

The best response asks about the other side's interest and states the ward's own, opening options such as early trays only for clients who need them.

Threats, past-practice arguments, and splitting the difference stay at the level of positions.

## 핵심 개념

- **Principled negotiation** — A negotiation method that focuses on interests, separates people from the problem, and seeks mutual gain.
- **Position** — What a party states it wants in a negotiation.
- **Interest** — The underlying need or concern that explains why a party holds a position.
- **Compromise** — A conflict strategy in which each side gives up part of what it wants.

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