A home health nurse is caring for a group of older adult clients. The nurse should initiate a referral to the Program of All-Inclusive Care for the Elderly (PACE) for which of the following clients?

The correct answer is Choice A.

Choice A rationale:

Forming a committee of staff members to investigate current staffing issues is the first step the nurse manager should take. This is because it is important to understand the root cause of the problem before implementing any changes. The committee can gather data, identify patterns, and provide insights into why staffing for weekend shifts is a challenge. This could involve surveying staff members, reviewing shift patterns, and analyzing workload and patient acuity data. By involving staff members in the process, the nurse manager can ensure that the perspectives and experiences of those directly affected by the staffing issues are taken into account. This approach aligns with the principles of shared governance and participatory management, which have been shown to improve staff satisfaction and retention.

Choice B rationale:

While providing support to staff members who are resistant to staffing changes is an important part of change management, it is not the first step that should be taken. Resistance to change is often a symptom of deeper issues, such as lack of trust, poor communication, or perceived lack of fairness or respect. By first forming a committee to investigate the staffing issues (Choice A), the nurse manager can gain a better understanding of these underlying issues and address them directly. This can help to reduce resistance when changes are implemented.

Choice C rationale:

Scheduling a staff meeting to present different options to staff members is a key part of the change process, but it should not be the first step. Before presenting options, it is important to fully understand the problem and consider various possible solutions. This involves investigating the current staffing issues (Choice A) and potentially developing and evaluating different scheduling options. Once this has been done, the options can be presented to staff members for feedback and discussion.

Choice D rationale:

Giving staff members advance written notice of staffing changes is a crucial part of transparent and respectful communication. However, it is not the first step in addressing staffing issues. Before any changes can be announced, the nurse manager needs to understand the problem (Choice A), consider possible solutions, and involve staff members in the decision-making process (Choice C). Once a decision has been made, it should be communicated clearly and promptly to all staff members.

How does this make you feel?

• A. Saying "I'm sure your family does not want you to die" is not a therapeutic response, as it invalidates the client's feelings and imposes the nurse's assumption on the client. This option is incorrect.
• B. Asking "Why would you believe such things?" is not a therapeutic response, as it sounds judgmental and confrontational, and may make the client feel defensive or ashamed. This option is incorrect.
• C. Asking "How does this make you feel?" is a therapeutic response, as it encourages the client to express their emotions and shows empathy and interest from the nurse. This option is correct.
• D. Saying "You should talk to your family about your feelings" is not a therapeutic response, as it implies that the client is responsible for resolving their family issues and may increase their guilt or anxiety. This option is incorrect.