護理主管趕到了一間病房，一名非常受挫的新進註冊護理師正與一名患有邊緣性人格障礙且要求極多的 30 歲病患大聲爭執。病患尖叫著：『這個護士太可怕了，她討厭我！我現在就要跟醫院的執行長說話！』護理主管的哪項介入能有效地運用衝突解決策略？
The nursing supervisor responds to a client room where a highly frustrated new registered nurse is arguing loudly with a 30-year-old demanding client diagnosed with borderline personality disorder. The client is screaming, 'This nurse is terrible and hates me! I want to speak to the hospital CEO right now!' Which intervention by the nursing supervisor effectively utilizes conflict resolution strategies?
- AStep between the client and the nurse, request the nurse gently step out into the hallway, and calmly sit down to listen to the client.✓ 正解站在病人和護理師之間，請護理師輕輕走出走廊，並冷靜坐下聆聽病人。
- BQuickly excuse both herself and the young nurse from the hospital room to solidly completely abandon the client to calm down naturally.迅速為自己和新進護理師找藉口離開病房，完全拋下病人使其自然冷靜下來。
- CSupport the young nurse openly by violently telling the client to stop manipulating the floor staff immediately.公開支持新進護理師，激烈地告訴病人立即停止操縱樓層護理人員。
- DCall building security immediately to threaten the screaming client with rigid, heavy four-point physical restraints to establish order.立即呼叫建築保全，以嚴格的四點式身體約束威脅尖叫的病人以建立秩序。
本題測驗行政主管的衝突談判與降溫技巧 (Conflict Resolution / De-escalation)。面對邊緣性人格障礙 (Borderline Personality Disorder, BPD) 這類極易產生「全黑或全白 (Splitting)」心理防衛機制，且情緒高度波動的病患，如果護理人員已經捲入爭執，衝突只會無限升級。護理主管 (Supervisor) 抵達現場時，首要目的是保護雙方安全並『降低現場張力 (De-escalation)』。最有效的降溫策略是打破敵對迴圈：將正處於崩潰與憤怒焦點的新護士調離現場（拉開導火線），然後由一個情緒穩定、帶有權威但語氣平靜的主管坐下來，啟動傾聽與重塑界線（選 A 正確）。選項 C 當面教訓病患會讓病患感覺受到更嚴重的被拋棄與攻擊，引發更加暴力的行為。選項 D 用約束帶威脅並非降溫手段，而是違法的暴力恫嚇。選項 B 完全拋下正在尖叫且無理智的 BPD 精神病患，他們極可能因為「被拋棄感 (fear of abandonment)」發作而在病房內自殘或砸毀物品。
To de-escalate the situation with a client exhibiting borderline personality disorder, the supervisor should remove the agitated nurse to break the conflict cycle and then calmly engage the client. This approach ensures safety and addresses the client's emotional distress without reinforcing maladaptive behaviors or causing abandonment.
這考驗了護理主管的 EQ 處置，台美皆是普世價值觀念：面對崩潰衝突，第一步一定是換人（分離雙方）+ 傾聽降溫。