A nurse is caring for a client who has an unrepaired hip fracture. Which of the following actions should the nurse take to prevent the client from developing a deep-vein thrombosis?

Rationale:

A. Call the unit supervisor: While the unit supervisor plays a role in the chain of command, the nurse should first address the situation at the unit level with immediate leadership before escalating to higher administration.

B. Notify the medical director: The medical director is a high-level administrator typically involved in policy and oversight rather than immediate clinical decisions. This step would occur further along the chain if lower-level leadership fails to respond.

C. Consult with the charge nurse: The charge nurse is the first point of escalation in the nursing chain of command. They are immediately available, familiar with the unit workflow, and can take prompt action or assist in contacting the provider or other necessary personnel.

D. Notify the department head: The department head oversees broader unit operations and would be consulted if the charge nurse and unit supervisor cannot resolve the situation. However, this is not the most immediate first step in an emergency.

Rationale:

A. Ask for an orientation to the unit at the first available break after beginning the assignment: Orientation should be provided before beginning the assignment, not delayed until a break. Starting without proper orientation may increase liability risks and compromise patient safety.

B. Refuse to accept the float assignment: Refusing to float could be seen as insubordination unless the nurse is being asked to perform beyond their scope of practice. The appropriate action is to seek support, not immediate refusal.

C. Report the assignment to the Risk Management Department: Involving Risk Management is appropriate if unsafe conditions persist or harm occurs, but this is not the nurse’s first or most immediate step when floated.

D. Request a resource nurse when arriving at the other unit: Asking for a resource nurse helps ensure patient safety and provides support for tasks outside the nurse’s usual expertise. This demonstrates accountability and helps reduce liability by ensuring guidance is available.