A charge nurse is reviewing the documentation completed by a newly licensed nurse. Which of the following entries should the charge nurse recommend for revision?

A) Use hot water so rinse hand sanitizer off:
Using hot water is not recommended when performing hand hygiene with alcohol-based hand sanitizer. Alcohol-based sanitizers do not require rinsing off, as they are designed to evaporate quickly, killing germs as they dry. Rinsing with water, especially hot water, can dilute the sanitizer, reducing its effectiveness. Hands should be left to dry naturally after applying the sanitizer.

B) Dry hands with a reusable towel:
While towels can be used for drying hands after washing with soap and water, they should not be used after alcohol-based hand sanitizers. Alcohol hand sanitizers should be allowed to air dry on the hands. Using a towel could reintroduce contaminants and diminish the effectiveness of the sanitizer. Ideally, hands should be rubbed together until they are dry without the need for any towel.

C) Rub hands together for 20 seconds:
Alcohol-based hand sanitizers are effective in killing germs in a short amount of time—usually within 20 seconds or less. However, the correct technique for using alcohol-based hand sanitizers involves rubbing hands together until they are completely dry, not for a full 20 seconds as one might with handwashing. The important factor is ensuring the sanitizer has covered all surfaces of the hands, including between fingers and around nails, before allowing it to air dry.

D) Rub hand sanitizer around rings on fingers:
Rubbing the hand sanitizer around rings is a necessary step. Jewelry, such as rings, can harbor bacteria or other pathogens, making it essential to ensure the sanitizer comes into contact with areas that are often missed during hand hygiene, like around rings. The nurse should rub the hand sanitizer thoroughly over all surfaces of the hands, including around jewelry, to ensure effective hand hygiene.

A) "It sounds like you are exhausted":
This response demonstrates empathy, as the nurse is acknowledging the client's emotional state by reflecting back what the client might be feeling. The nurse recognizes the client's experience of being overwhelmed, using empathetic language to show understanding without judgment or offering solutions prematurely. The phrase "sounds like you are exhausted" is a way of mirroring the client's feelings and giving validation to their experience.

B) "You have so much to deal with. How can I be of help to you?":
While this response offers support and suggests the nurse is ready to help, it does not focus as much on empathy. It is more solution-focused, and while helpful, it doesn’t directly acknowledge or validate the emotional experience of the client as much as an empathetic response would. Empathy focuses on acknowledging the emotional state rather than jumping immediately to offering help.

C) "Tell me more about how you are feeling":
This is a good open-ended question that encourages the client to elaborate on their feelings, but it doesn’t directly reflect empathy. The question prompts the client to talk but does not explicitly acknowledge or validate their emotional experience, which is the primary goal of an empathetic response.

D) "It is impressive how you have managed to deal with this situation":
This response is more focused on offering praise, which, while positive, can come across as dismissive or minimizing of the client's distress. Instead of acknowledging the client's current feelings, it praises their past coping, which may not fully validate the emotional burden they are feeling at the moment. An empathetic response would focus on the client's current emotional state, not necessarily on past strength.