A charge nurse is educating a newly licensed nurse regarding the utilization of critical pathways. What should the charge nurse incorporate?

Choice A Reason:

The Patient Self-Determination Act (PSDA) will explain your rights to change life-saving measures. The PSDA is a federal law that ensures patients are informed of their rights to make decisions about their medical care, including the right to accept or refuse treatment and the right to create an advance directive. However, it does not specifically address the modification of life-saving measures once a patient is unconscious. The living will, which is a type of advance directive, is the document that outlines the patient’s wishes regarding life-saving measures.

Choice B Reason:

The living will states the client’s wishes regarding life-saving measures. This is the correct response. A living will is a legal document that specifies a person’s preferences for medical treatment if they become unable to communicate their decisions. It includes instructions on life-saving measures such as resuscitation, mechanical ventilation, and other interventions. The living will reflects the client’s wishes and should be followed by healthcare providers and family members.

Choice C Reason:

The case manager can make changes to the client’s living will. This statement is incorrect. A case manager does not have the authority to alter a client’s living will. Changes to a living will can only be made by the client themselves while they are still competent to do so. Once the client is unconscious, the living will remains in effect as it was originally written.

Choice D Reason:

The durable power of attorney for health care can cancel the client’s living will. This statement is also incorrect. A durable power of attorney for health care (also known as a healthcare proxy) is a person designated to make medical decisions on behalf of the client if they are unable to do so. However, the healthcare proxy must follow the instructions outlined in the living will. They cannot cancel or override the living will unless the document explicitly grants them that authority.

Choice A Reason:

Follower implies that the nurse manager is taking direction from others rather than leading the situation. In this context, the nurse manager is actively addressing an issue, proposing solutions, and seeking input from the staff, which are leadership behaviors. Therefore, the role of a follower does not accurately describe the nurse manager’s actions in this scenario.

Choice B Reason:

Leader is the most appropriate role for the nurse manager in this situation. By calling a staff meeting, proposing a solution, and asking for input, the nurse manager is demonstrating leadership qualities. Effective leaders engage their team in problem-solving, encourage collaboration, and guide the team towards a resolution. This approach helps in addressing the issue effectively while fostering a supportive and inclusive work environment.

Choice C Reason:

Manager refers to the administrative and organizational responsibilities of the nurse manager. While the nurse manager is indeed managing the situation, the emphasis in this scenario is on leadership. The actions described—proposing a solution and seeking staff input—highlight the nurse manager’s role as a leader rather than just a manager. Leadership involves inspiring and motivating the team, which is crucial in handling complex situations like this.

Choice D Reason:

Regulator implies a role focused on enforcing rules and policies. While maintaining standards and policies is part of a nurse manager’s responsibilities, the scenario described involves more than just regulation. The nurse manager is actively engaging with the staff to find a solution, which is a leadership activity. Therefore, the role of a regulator does not fully capture the nurse manager’s actions in this context.