A nurse manager observes a newly licensed nurse interacting with clients.
Which of the following actions by the newly licensed nurse requires intervention by the nurse manager?

Choice A rationale

Adopting attitudes and habits of coworkers, especially during reality shock, can lead to assimilation into potentially negative or unhealthy work cultures. This might hinder the development of independent critical thinking and professional identity, potentially perpetuating the negative aspects of reality shock rather than resolving them constructively by integrating diverse perspectives.

Choice B rationale

Volunteering for extra shifts when experiencing reality shock can exacerbate burnout and stress. This action often leads to increased workload and less time for self-care or reflection, making it more difficult for the newly licensed nurse to adapt to the demands of the profession and integrate their learning effectively, intensifying the shock.

Choice C rationale

Integrating nursing school and work environment values involves critically evaluating and synthesizing the theoretical knowledge and ideals learned in academia with the practical realities and expectations of the clinical setting. This process helps reconcile discrepancies, build a more comprehensive professional identity, and reduce the cognitive dissonance associated with reality shock.

Choice D rationale

Seeking mentorship from an experienced nurse provides valuable guidance, support, and practical insights. While beneficial, this choice focuses on a single supportive relationship rather than the broader process of internalizing and reconciling different value systems, which is central to overcoming reality shock through a holistic integration of values and practices.

Choice A rationale

Delaying documentation until approved by a charge nurse suggests a lack of confidence in one's own clinical judgment and assessment skills. Confident nurses document findings accurately and promptly based on their independent assessments, taking accountability for their observations and interventions within their scope of practice.

Choice B rationale

Gathering supplies before entering a client's room to insert an indwelling urinary catheter demonstrates preparedness, efficiency, and confidence. This action reflects proactive planning and a clear understanding of the procedure, minimizing interruptions and ensuring a smooth, competent execution of the task, thereby exhibiting self-assurance in one's abilities.

Choice C rationale

Redirecting the conversation when a client asks about the dying process indicates discomfort or a lack of confidence in addressing sensitive topics. A confident nurse would engage in open, empathetic communication, providing accurate information and emotional support, even when discussing difficult subjects, demonstrating professional composure and compassion.

Choice D rationale

Asking a colleague to perform a skill the nurse is unfamiliar with is a responsible and ethical action, reflecting an awareness of one's limitations, but it does not demonstrate confidence in performing the skill itself. Confidence is shown in the willingness to learn and seek guidance, but directly performing the unfamiliar skill is not implied.