護理主管前往一間病房,一名感到挫折的護理師正與一名邊緣性人格障礙病人發生爭執。下列哪一項主管的介入最能展現衝突解決策略?
A nursing supervisor responds to a client room where a frustrated registered nurse is in a verbal conflict with a client diagnosed with borderline personality disorder. Which intervention by the nursing supervisor best demonstrates conflict resolution strategies?
- AExcuse both herself and the nurse from the room and leave the client alone.藉口帶護理師離開房間並將病人獨自留下
- BPublicly support the nurse and tell the client to stop manipulating the staff.公開支持護理師並告訴病人停止操弄員工
- CCall security immediately and threaten the client with restraints.立即呼叫保全並威脅對病人使用約束帶
- DStep between the client and the nurse, ask the nurse to step out, and calmly listen to the client.✓ 正解站在病人與護理師之間，要求護理師退出，並冷靜聆聽病人
本題測驗護理主管面對人際衝突時的降溫 (De-escalation) 與衝突管理技巧。邊緣性人格障礙 (Borderline Personality Disorder, BPD) 病人在壓力下容易出現情緒不穩與人際衝突,若照護人員已與病人陷入爭執,主管的優先任務是中斷衝突循環:將處於高張力的護理師暫時調離現場,再由主管以冷靜、傾聽的態度與病人溝通並重新設立照護界線 (選項 D 正確)。選項 B 公開站在護理師一方並指責病人,會加劇衝突;選項 C 以警衛威脅與約束作為手段,缺乏臨床指徵且違反倫理;選項 A 將護理師與主管一同帶離,等於放棄當下的照護介入,可能使病人更不穩定。
The supervisor should de-escalate the conflict by separating the involved parties and removing the upset nurse from the scene. Calmly listening to the client helps restore safety and allows the supervisor to re-establish therapeutic boundaries without reinforcing the client's disruptive behavior.
面對崩潰衝突，第一步一定是換人（分離雙方）+ 傾聽降溫。