A nurse recognizes a change in a colleague's behavior and suspects the nurse is practicing while chemically impaired.
Which of the following actions should the nurse take?
Ask the colleague if he is impaired.
Notify the nurse manager.
Contact risk management.
Confront the colleague directly about the suspicion.
The Correct Answer is B
Choice A rationale
Directly asking a colleague if they are impaired is not the most appropriate initial action as it can lead to defensiveness or denial and may not effectively address the safety concerns. The priority is patient safety, which requires reporting to a higher authority who can intervene objectively and professionally.
Choice B rationale
Notifying the nurse manager is the most appropriate action. The nurse manager has the responsibility and authority to address concerns about a chemically impaired colleague. They can initiate the proper procedures, including investigation, intervention, and referral to employee assistance programs, ensuring patient safety and colleague support.
Choice C rationale
Contacting risk management is not the immediate first step. While risk management might become involved later, the direct supervisor or nurse manager is the initial point of contact for personnel issues that pose a potential risk to patient safety. The manager can then involve other departments as needed.
Choice D rationale
Confronting the colleague directly about the suspicion is generally not advisable. This approach can be confrontational, potentially escalating the situation without resolving the underlying issue. It may also violate professional boundaries and lacks the formal authority needed for effective intervention.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale
Peer-reviewed articles represent the highest level of evidence in healthcare, as they have undergone rigorous scrutiny by experts in the field. This process ensures the validity, reliability, and scientific rigor of the research, making them the most current and trustworthy source for evidence-based practice to guide clinical decision-making and improve patient outcomes.
Choice B rationale
Experiences of expert clinicians, while valuable for practical insights and nuanced clinical judgment, are considered a lower level of evidence compared to empirical research. Clinical expertise is subjective and may lack generalizability, making it less suitable as the primary source for establishing broad evidence-based practice guidelines that require systematic validation.
Choice C rationale
Current textbooks provide foundational knowledge and summarize established concepts, but their publication cycle often means the information is not as up-to-date as the latest research. While essential for learning, textbooks may not reflect the very newest findings or rapidly evolving best practices, making them secondary to recent peer-reviewed literature.
Choice D rationale
Opinions of colleagues, while offering immediate perspectives and shared experiences, are highly subjective and anecdotal. They are considered the lowest level of evidence in the hierarchy of evidence-based practice, as they lack systematic review, empirical data, and rigorous validation necessary to inform generalizable and reliable clinical practices.
Correct Answer is C
Explanation
Choice A rationale
Clarifying performance expectations would be a subsequent step if the nurse's behavior continues to be problematic after initial intervention. The immediate priority is to address the suspected impairment, which directly impacts client safety and professional conduct, before focusing solely on performance metrics.
Choice B rationale
Reporting to the state board of nursing is a serious action typically taken after internal measures have been exhausted or if the impairment poses an immediate and grave risk that cannot be managed internally. The initial step focuses on a more direct, supportive, yet firm approach.
Choice C rationale
Discussing concerns with the nurse privately is the appropriate first action. This allows the manager to directly address the observed behavioral changes, express concern, and assess the situation without immediately escalating to more punitive measures. It provides an opportunity for the nurse to seek help while maintaining privacy.
Choice D rationale
Immediately terminating the nurse's employment is a premature and potentially unjust action without proper investigation and adherence to organizational policies. Due process and opportunities for intervention or rehabilitation should typically be explored before resorting to termination, unless an immediate, severe threat to safety exists.
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