A nursing unit is undergoing changes to accommodate new bariatric services that will be available on the unit. Some staff members have verbalized displeasure with the changes. Which of the following actions should the charge nurse take?
Role model a positive approach to the changes.
Redirect the conversation when staff members make negative comments about the changes.
Encourage staff members who support the changes to discuss the issue with resistant staff.
Suggest that resistant staff members transfer to a different unit.
Reprimand staff members who are resistant to the changes.
Correct Answer : A,C
The correct answers are Choices A and C.
Choice A rationale: Modeling positivity leverages social learning and transformational leadership, sets constructive norms, reduces uncertainty, and promotes psychological safety, facilitating Lewin’s change movement and sustained adoption of bariatric workflows and equipment safely.
Choice B rationale: Redirecting negativity suppresses concerns, undermines just culture, and blocks feedback necessary for Lewin’s unfreezing, reducing trust, psychological safety, and data to address barriers, thereby entrenching covert resistance to change process.
Choice C rationale: Engaging supportive peers utilizes diffusion of innovations and social proof; peer dialogue surfaces practical barriers, shares tacit knowledge, normalizes change behaviors, and increases motivation and adherence to bariatric care practices.
Choice D rationale: Suggesting transfers is coercive and punitive, contradicting transformational leadership and just culture, damages morale and retention, bypasses root-cause analysis, and fails to address legitimate change barriers or build sustainable engagement.
Choice E rationale: Reprimanding resistance pathologizes normal adaptation, undermines psychological safety and voice, increases turnover intentions, entrenches oppositional behavior, and conflicts with evidence-based change management; reserve discipline for misconduct, not expressed skepticism alone.
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Related Questions
Correct Answer is D
Explanation
Choice A rationale:
The National League for Nursing (NLN) focuses on nursing education standards and resources for nursing faculty. While it could provide useful insights, it's not the primary resource for policy creation related to procedures like catheter insertion.
Choice B rationale:
The American Academy of Nursing (AAN) is a professional organization that promotes leadership and education within nursing. While it might offer recommendations, it's not the primary resource for policy related to procedural changes in clinical settings.
Choice C rationale:
The Agency for Healthcare Research and Quality (AHRQ) is involved in research and quality improvement initiatives in healthcare. While it could provide evidence-based practices, it's not the primary source for policies specific to nursing procedures.
Choice D rationale:
The State Nurse Practice Act (NPA) outlines the scope of nursing practice within a particular state. It governs what nurses are allowed to do, including procedures like catheter insertion. The NPA ensures that nursing actions are within legal and regulatory bounds, making it the most relevant resource for creating a policy about catheter insertion.
Correct Answer is B
Explanation
Choice A rationale:
Showing the AP how to remove an indwelling urinary catheter may not provide sufficient evidence of their competency to perform the task safely and effectively. This approach assumes that observation alone is enough to determine competence, which is not necessarily the case. It's important to have a more structured assessment of the AP's skills.
Choice B rationale:
Reviewing the AP's skill competency checklist is the most appropriate action to ensure the AP is qualified to remove the indwelling urinary catheter. Competency checklists outline specific skills and steps required for a task, and they serve as a standardized way to assess the AP's capabilities. This process ensures that the AP has received proper training and has demonstrated competence before performing the procedure independently.
Choice C rationale:
Simply asking the AP if they know how to remove an indwelling urinary catheter is not a comprehensive method for verifying their qualifications. Self-assessment can be unreliable and may not accurately reflect the AP's actual skill level. Relying solely on self-reporting could compromise patient safety and quality of care.
Choice D rationale:
Pairing the newly hired AP with an experienced AP might provide some guidance, but it doesn't systematically assess the individual's competence. The level of experience of the experienced AP may vary, and their ability to teach or evaluate the new AP's skills may not be standardized.
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